“The more technology available for women, the better”: Interview with Natural Cycles’ co-founder and CEO, Elina Berglund

elina berglund

Natural Cycles is the world’s first and only CE and FDA approved hormone-free, digital contraception solution. Natural Cycles aims to educate and empower women to take control of their fertility and future.

We caught up with Dr. Elina Berglund, co-founder and CEO of Natural Cycles. Elina co-founded the company with her husband, Dr. Raoul Scherwitzl. Prior to Natural Cycles, Elina was working in research as a particle physicist at CERN. She was part of the Higgs boson discovery, which led to the Nobel Prize in Physics in 2013.

To date, Natural Cycles has raised over $38 million (€31.2 million). It currently has over 1.5 million registered users across 162 countries. In the largest clinical study of its kind, the app was shown to be 93% effective with typical use – 98% effective with perfect use.

We chatted with Elina about her experience launching novel contraception technology where there is a high level of regulation and consumers are relying on the product to be precise. And also about starting and scaling a business as a scientist and her predictions for the evolution of the femtech industry.

Thanks for taking the time to catch up with us, Elina! Let’s start from the beginning of your journey with Natural Cycles. We would love to hear about how you got your first customers. Can you tell us more about that?

I like to think I was my own first customer – Natural Cycles is the product of my own search for a different type of contraception. Testing the product on myself came first, but I realised that what I had created would be useful to women looking for alternative methods to plan and prevent pregnancy when there’s so few non-invasive options out there currently.

When discussing Natural Cycles’ algorithm with my physicist colleagues at CERN, several of them started measuring their temperature too, and I ran my algorithm over their data and informed them about their fertility, even before there was an app. Many of them now work in the data science team at Natural Cycles today.

When I later developed the first version of the app, I thought that customers would simply just arrive on their own, since I was convinced that this was a product that women both needed and wanted. I was right about the latter part, but quickly realised that the users need to also find Natural Cycles and be informed about it first. We needed to invest in marketing as well.

As a physicist by trade, launching a business. What advice would you give to other scientists looking to launch their startup?

My advice would be that your research skills will work to your advantage, so keep that analytical mentality for your business. Everything we did was, and still is, extensively backed by research. For us, we were carving out a new market within the medical sphere, and any medical device must be backed up thoroughly and regularly with clinical data. Coming from a science background means you’re well-acquainted with lots of trialling and testing different ways of working which, again, is a strong advantage. The culture of innovation and exploration that comes from a research background suits the start-up life too.

Can you share more about some of the challenges you encountered when starting Natural Cycles?

Needless to say, building a business from the ground up in itself is challenging. The pressure to deliver the best product to a new customer base, hiring the right team of experts – none of it is easy. Natural Cycles had no existing regulatory category to fit into as a product, so we had to work with regulators to create our own. As the app is a medical device, there are many tests and requirements to meet in order to become CE-marked and FDA-cleared.

Natural Cycles is the first of its kind as the world’s first non-hormonal form of birth control. With anything that’s the first of its kind, you need to build trust with customers. And especially for contraception, this is something that people are relying on to be precise. Could you tell us more about how you went about establishing the Natural Cycles brand and building trust with customers?

We always knew that because our technology is novel, there was going to be some scepticism. People often react this way to new products, so we did expect this. Our priority has firstly been to ensure the app’s effectiveness, and for this we report using the Pearl Index, which is the benchmark for reporting contraception efficacy. As with all contraception, perfect-use effectiveness is a picture of what can happen if it is used completely correctly, which in the case of Natural Cycles means to use protection when the app gives a red day. Considering this, our typical perfect-use effectiveness is on a par with the contraceptive pill, slightly below LARCs (long-acting reversible contraception) such as the copper coil that you can insert and then forget about, but significantly better than other methods e.g. just using condoms.

Building trust takes time, and there is always a lot of scrutiny on products like Natural Cycles. However, we’re a company founded on science, and are regularly required to present our research and data to regulators and authorities, demonstrating the effectiveness of the algorithm and the app itself. We have a really engaged community of users – after the algorithm has had a chance to get to know their unique body and cycle, they themselves also feel very empowered by the insights they get into how their body works. Soon, they begin to trust not only the app but their own bodies, and when it comes to women’s health this is such a rare and beautiful outcome. No contraception method is ever 100% effective so each user must spend time on their own research into which is the most suitable for them based on their lifestyle.

Startups are known for being scrappy, testing things out, and perhaps getting things wrong along the way when starting. As you are in the industry of contraception and people are trusting you to get things right with Natural Cycles. How did you go about refining your product before launching it?  

Here it really helped being scientists ourselves and particularly a particle physicist with a really strong understanding of data and statistics. This is since it very much comes down to getting the algorithm right and I was lucky to find a large published dataset of womens’ cycle and temperatures that I could train and optimise the algorithm on. Now, many years later, we have published 10 clinical studies to date and gone through countless regulatory audits to ensure that the quality of both our product and how we operate is to the highest standard.

Could you share more about your journey raising investment as a female founder at a time when the femtech industry was relatively nascent?

It can definitely be more challenging to raise money for a product mainly aimed at women when pitching to investors that are mainly men. They simply don’t “get it” right away and need to read up more about it to understand the problem we are solving, compared to if we were building a product for men. With that said though, we always did manage to raise money, so if you do have a product with enough potential that is really solving a problem – which we do – then I think it will work out in the end.

You have a team of 60+ people now with offices in Stockholm, Geneva, and New York. Could you tell us more about your approach to growing the team and conserving company culture?

Initially we tried to launch into too many markets at once, but we quickly learned to focus on one area at a time. It’s also tempting when you receive a round of funding to outsource and hire in bulk, quickly, but actually you are at risk of diluting your culture by doing that. Instead, spending more time on recruiting the right experts is advisable. You can’t scale yourself, only your team and talent, and as a founder it’s easy to hoard all tasks which can block growth. Maintaining culture as you scale up is achievable by making your values as a business clear, communicating them to all teams and taking time to choose the right experts for the appropriate areas of business.

Now with COVID-19 we have all been remote for more than a year and we have also hired remotely. This has worked surprisingly well, and I think it has also helped us all feel more equal across countries and time zones.

What’s next for Natural Cycles?

Our aim is to continue building and improving our user experience and expand further into the US market. Our next step is to enable wearables as part of our product offering, which will seriously take Natural Cycles to the next level. As we’re a regulated medical device we must validate each wearable we add, so we’re in the process of collecting and presenting data to the FDA as well as the European authorities for clearance. Our aim is to ensure users have multiple options, so the wearables function really speaks to that.

What do you think the femtech industry will look like in the next 5-10 years?

There’s so much opportunity for growth in the femtech space, I do see some interesting developments in wearables and health taking shape. The more quality data we can gather on our bodies together with smart algorithms, the better the insights and preventative health care. I think femtech will continue to rise and one interesting area where more technology is needed is menopause. It’s hopefully going to be a much more crowded market – the more technology available for women, the better! Hopefully we will be seeing more female entrepreneurs too and a community forming among them.