Fertility app Flo helps identify predictors and common symptoms of PCOS

Women with PCOS had a higher average BMI than women without the condition.
By Laura Lovett
10:57 am

(Photo: Getty Images Darla Willams) 

Femtech tools may be one way to understand the complex condition of PCOS (polycystic ovary syndrome). A new study, published in Reproductive Biology and Endocrinology, used the fertility app Flo to help gather insights into PCOS symptoms, including period bloating and rhythm, weight and hirsutism.

Researchers found that bloating was the most prevalent predictor of PCOS-positive women. The scientists also found a correlation between women with PCOS and higher BMIs.

"Our findings are based on the largest known PCOS dataset and indicate that symptoms are more complex than previously understood. The most frequently reported symptoms (bloating, facial hirsutism, irregular cycles, hyperpigmentation, and baldness) are broader than those included in the Rotterdam criteria," researchers of the study wrote.


Researchers zeroed in on participants from the U.S., U.K., India, Philippines and Australia. The highest ratio of PCOS cases was in the Philippines, followed by India, and the lowest was in Australia, according to the study.

In the top five countries mentioned, 14.4% of users self-reported having PCOS that was previously diagnosed by a physician. Another 8.1% of users self-reported negative PCOS status and 77.5% of users had not been checked by a physician for the status.

Researchers found a significant difference in overall BMI for PCOS-positive women from those five countries. In fact, PCOS-positive women had a mean BMI of 27.7, whereas PCOS-negative users had a mean of 26.4.

"Across all BMI groups, there is an observed trend that as BMI increased, the percentage of women with a self-reported PCOS diagnosis also increased," researchers wrote. "While this percentage of women with PCOS increases, the percentage of women without a PCOS diagnosis stays relatively stable across BMI groups."

Authors found that across countries PCOS symptoms varied. For example, in the U.S., U.K. and Australia the most common symptoms for PCOS-positive women were bloating, facial hirsutism (excessive facial hair) and irregular cycles.

However, in the Philippines, researchers report that women with the condition were most likely to report bloating, hyperpigmentation, irregular cycles and baldness. In India, baldness was the most common symptom reported.


Flo's app lets users track menstruation and reproductive cycles. Users can track 84 symptoms that range from cramps and headache to sex drive and vaginal discharge. The tool uses AI to give personalized insights to a user about their cycles.

The data used in the study was taken from the PCOS chatbot dialog that was offered to Flo users from September to October 2019. The tool asked users 18 questions related to reproductive and general health, as well as about their PCOS status.

Participants were asked about their age, weight, symptoms and if they were trying to conceive or had already conceived.

"A user dataset from the PCOS chatbot dialog was used to analyze the effect of PCOS symptoms as predictors of disease. A second dataset based on the results of the same chatbot dialog, which also included user BMI information, was used to analyze the impact of BMI on the odds ratio of having PCOS. Further analyses were conducted using only the data of women coming from the top five countries with the highest number of survey respondents."

According to researchers, the cohort included users from 142 countries with at least 100 respondents in total. Researchers then focused on the five largest country cohorts, which included the U.S. (243,238), UK (68,325), India (40,092), Philippines (35,131) and Australia (29,926).


Women's health conditions are notoriously under-researched. According to the CDC, PCOS impacts between 6% and 12% of U.S. women of reproductive age. Women with the condition are more at risk for diabetes, gestational diabetes, heart disease, high blood pressure, sleep apnea and stroke.

"Previous research on global PCOS symptomatology is both limited and inconsistent," researchers wrote in the report.


"Within these top five countries, the most prevalent predictors of PCOS were bloating, both high cholesterol and glucose, and high glucose alone. Additionally, among four of the top five countries, bloating was the most frequently reported symptom.

"When examining BMI in relation to PCOS, there is a trend that as BMI increased, the percentage of women with a self-reported PCOS diagnosis also increased. However, women in India did not follow this trend, as there was no significant relationship between BMI and PCOS status."




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