Here, Liudmila tells us how this team utilizes Flo’s vast dataset to ensure that product features are safe and have scientifically proven benefits and explains why collaboration with external experts is like turning raw gems into the scientific equivalent of jewelry.
Liudmila: I started my research career in biology and microbiology. I’ve been fascinated by how our lives begin since the early days of my Bachelor of Science degree. Specifically, I wanted to learn about the biology of reproduction, the genetics that lay the foundations of our reproductive processes, and what that means for babies coming into this world.
For my PhD, I studied how our genes direct oocyte formation. Oocytes are what we call the eggs in the ovaries, and we actually don’t fully understand the processes that regulate how these eggs are formed. By studying this, we can gain a better understanding of how and why things sometimes go awry, which can lead to problems later on in development and in life.
Following my PhD, I went on to study the genetics of early embryo development — again, there are many things that we don’t fully understand yet about these processes — and also had the opportunity to gain hands-on experience as a trainee embryologist, helping couples facing fertility challenges.
In 2019, I joined Flo, where we now analyze data from millions of women and people who have periods across the world to advance female health. My switch from academic research to health tech was driven by the desire to bridge the gap between understanding fundamental biological processes and applying that knowledge to real-world problems. In academic research, I learned to explore the basic mechanisms behind biological processes, and in embryology, I applied that knowledge in a clinical setting. At Flo, I get to do both — combining scientific expertise with practical application — but on a global scale.
Liudmila: We have an amazing team of scientists here at Flo who care very deeply about female health. We have team members with expertise in data science and statistics, others with backgrounds in public health, mental health, and behavioral economics, and even someone who focuses on science communication.
But really, they are more than just their skills.
They are a diverse group, hailing from six different countries. Some are parents, some are dog-lovers, adventurers, gym-goers — they are ordinary people but with unique backgrounds. What connects them is their interest in using scientific research to improve people’s health.
Our team has the largest dataset of menstrual cycle patterns and related symptoms in the world. And crucially, they have the expertise to work with this dataset. In addition, many of our members have been hugely generous with their time, filling in surveys to contribute to our research. Our work involves analyzing this vast dataset to identify meaningful patterns and trends that can contribute to advancing female health.
Imagine a treasure trove of incredibly valuable, individual pieces — like raw gems, pearls, and bits of gold — but they haven’t been put together yet into finished works of jewelry.
When we conduct our research to advance female health, we work very closely with external experts, such as academic scientists, doctors, health economists, and psychologists. They are the absolute experts in their field, with years of experience, and know precisely what research questions to ask and what the results mean in the larger framework of their discipline.
Going back to our jewelry analogy: Flo provides the treasure trove and the craftspeople to put individual pieces together, and our external experts are the ones who guide the design and ultimate finish of the piece of jewelry and what impact it will have on the world.
Liudmila: We do not share any personal data outside of Flo. We have really strict privacy policies at Flo because our members share a lot of sensitive, personal data with us, given the nature of our app. And we are proud to say that Flo is the first and only period tracker to be dual-certified in both ISO Security 27001 and ISO Privacy 27701, which are internationally recognized standards in privacy and security. These audits are rigorous and require close collaboration across the entire business. This, of course, includes the science team, and we work closely with our privacy team colleagues to make sure that these standards are incorporated into how we run every one of our research projects.
What this means is that when we are conducting a study with external research collaborators, only our Flo scientists can access the data that we collect from our members. We then analyze the data and put together the aggregated results so that we can discuss and interpret them in collaboration with our external academic partners.
For example, for one of our research projects, we looked at data from over 19 million Flo members to understand patterns in their menstrual cycles and related symptoms. What was particularly important about this research was that it included members over the age of 46 who are very often ignored in these types of studies. By including these members, we were able to identify patterns in their menstrual cycles and symptoms, which are important to understand in the context of the years around menopause.
We then shared the aggregated results, which did not identify any individuals, in our discussions with our external collaborator, who in this case was Dr. Lubna Pal, a professor of obstetrics and gynecology at Yale School of Medicine and a member of Flo’s scientific advisory board.
Liudmila: Tracking platforms like Flo help people record how they feel from day to day. This level of detail can be incredibly helpful for them, for example when they want to discuss patterns in their symptoms with their doctor.
Who can remember what they did last week, let alone last year? With a tracking app, you have the ability to log your experiences across, whether you're just starting your period, trying to become pregnant, or entering perimenopause.
And for us, the collective data from our millions of members becomes an invaluable treasure chest of data. With this level of detail, we are in a position to look for patterns and symptoms in female health across entire populations. So, for you as an individual, you access your own data that can help you understand your health and any health concerns. With data from millions of members, we can also look at other members who are a bit like you and compare your data. Now we’re in a position where our research may help not just you, but also many other women and people who have periods around the world by looking at how demographics or lifestyle factors influence certain symptoms and potential health problems, like fertility issues, for example.
When I first joined Flo in 2019, we made a commitment to advancing female health through research. One of the projects we started in those early days was research into polycystic ovary syndrome (PCOS), which is a common female reproductive condition. Many of those with PCOS find it difficult to get pregnant when they are trying to conceive. And many of our members at that time, and still to this day actually, have PCOS.
What our data allowed us to do was look at self-reported symptoms among women and people who have periods across the globe who told us that they had PCOS. We found that beyond the clinical symptoms that are most often discussed in the medical literature — like irregular periods, excessive hair growth, weight gain, and skin problems — there are other common, self-reported symptoms, such as bloating and skin pigmentation issues, although there was variation between members living in different countries. Overall, our study included over 300,000 people from 142 countries. It’s a really large piece of research.
We have done studies using a similar approach about premenstrual syndrome, postpartum depression, and female sexual response.
This research is exciting because it benefits everyone’s understanding of female health. For example, we can use our research to help women and people who have periods who log their symptoms in the app understand if their symptoms may be similar to those of other members who have PCOS. Doctors and medical societies also have access to our results, and it may inform their understanding of female health conditions.
And of course, at the heart of it all are women and people who have periods themselves who will get better information about female health and hopefully better care for their health concerns.
Liudmila: With the growth of the company, the science team has grown, and our responsibilities have expanded. In parallel, Flo’s core product also grew, and we realized early on that it’s crucial that our product is based on science and evaluated through scientific research.
So, today, the team really has three functions: one is to run studies to advance our understanding of female health, and the other two are to support the development of new product features and evaluate their effectiveness.
In the beginning, cycle tracking and educational content were the core features of the product, but since then, we’ve added many additional features, such as chatbots and Flo for Partners.
Flo was the first to develop and implement some of these new features, so they are very innovative. Being the first is great, but it also comes with responsibility because first and foremost our features need to be clinically safe, not do any harm, and be based on the latest scientific evidence.
More than half of our time is spent on this type of research so we can make sure that our members get a product that delivers on its promise.
For example, we have a lot of educational content in the Flo app, literally hundreds of articles about all aspects of female health. To assess if using the Flo app, with all of this content, actually makes an impact on female health, the team ran a randomized controlled trial, which is the gold standard of testing. It’s what pharmaceutical companies use to test new drugs, for example.
For this project, we collaborated with Sarah Hill, PhD, a professor in the psychology department at Texas Christian University, US; Dr. Jennifer Payne, a professor of psychiatry and neurobehavioral sciences at the University of Virginia, US; and Liisa Hantsoo, PhD, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins University, US. All three are members of Flo’s scientific advisory board.
In the trial, the team showed that using the app for around three months led to greater improvements in knowledge about menstrual and reproductive health and feelings of being better prepared for conversations with your doctor when compared with not using the app, among other measures.
This is important because we want our app to provide tangible health benefits to our members.
Liudmila: The team is always busy. In 2024, we ran a number of studies about sex where we looked at female sexual functioning and sexual satisfaction. It’s an area that’s still underexplored. In 2025, we’ll be publishing our results.
In addition, we’ve started a number of projects around perimenopause. Half of the population will be impacted by perimenopause at some point in their lives, but there really isn’t enough research into issues like the pattern of symptoms, and women and people who have periods are not getting the care they should to help them during this life stage.
We’ve got world-leading academic collaborators working with us on our perimenopause research, and I’m excited to see our results.
One other project I want to highlight is a study we are running to support Flo’s Pass It On Project, which provides free access to Flo Premium to women and people who have periods living in countries where health education and trustworthy health information are limited.
The science team has been investigating whether access to Flo Premium has tangible benefits for our members in such countries and what these benefits are.
As we’ve seen with our randomized controlled trial study, when women and people who have periods have higher knowledge about their menstrual health, their overall health improves. It’s crucial that we explore this because health knowledge tends to be lower in low- and middle-income countries.
This means that improvements in health knowledge have the potential to make an even greater impact on female health. It also opens up further opportunities to collaborate with organizations that work at the local level to improve health.
We will be publishing our results later this year.
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