Your New Hormone Tracker Generates 10,000 Data Points. Your Doctor Has 7 Minutes.

Let's start asking "so what."

I have been curiously watching the flood of conversation about continuous hormone monitoring with a mixture of amusement and horror. On one hand it is difficult to watch women trying to understand what is real and what isn’t. (Hint: no one has cracked actual continuous hormone monitoring. They just haven’t.) On the other hand, how much bolder can these claims get before we turn the conversation to where it really needs to go?

If we could monitor hormones continuously, who cares?

Now, everyone calm down. I am not saying that women should not be given the ability and agency to understand their bodies. By definition, our hormones play a huge, and still largely not well understood, role in our health. But therein lies the rub: largely not well understood.

By saying “who cares?” I am actually saying “so what?” That is an important distinction.

Imagine handing your gynecologist a 47-page PDF of your minute-by-minute hormone values. Now imagine her face.

Let’s just pause there. Can you imagine? Hormone levels are episodic, pulsatile and context dependent. A single estrogen reading means almost nothing with a validated reference range that takes into account age, cycle phase, time of day and clinical presentation. More data without a clinical decision algorithm is NOT precision medicine.

It is noise with a subscription fee.

Your doctor is sitting there staring at this beautiful document you’ve just handed her, and she has no protocol. No reimbursement code. No time to interpret the data.

What is even worse is that where the science is today means that all that data is not validated or reliable. For continuous hormone monitoring to make a real difference in our health, the doctor receiving that glorious printout has to be very comfortable accepting those readings as reliable.

An AI assisted interpretation of your hormones based upon changes in heart rate, blood pressure and skin temperature is about as useful today to your doctor as an interpretive dance expressing your feelings about the water chestnut. (Personally, I love the crunch!)

Clinical hormone testing is done by measuring hormones or hormone metabolites in blood or urine. The utility is to answer specific questions in the context of a patient’s condition and the results are interpreted against validated thresholds.

More numbers do not always equal better decisions. Without a decision rule of some kind, the data won’t change your treatments.

Continuous Glucose Monitoring (CGM) was an extraordinary breakthrough that allowed for monitoring of glucose levels in the body without frequent finger sticks for blood. Unfortunately, their ubiquity in our world has fooled many into thinking it is just as easy to wear a patch and continuously monitor hormones. It’s not.

What’s more, glucose monitoring carries a specific “if then” pathway. You can adjust your carb intake or insulin units in response to the numbers on the screen. There is no equivalent decision rule when it comes to estrogen.

Who is the search for continuous hormone monitoring actually serving? Well, women who want to have more insight into their health and how it is affected by hormones. Of course, I applaud the desire to take ownership in understanding your body. But that information in the current state of science and technology is for personal use only.

Which means I am going to say: follow the money. The value capture for these devices and their claims is in engagement and subscription dollars. Not outcomes. There are no randomized control trials showing improved endpoints. There is an enormous gap between “biomarker” and “clinical improvement.”

We need to start asking a question that goes beyond which technology might actually be able to deliver insight into hormones. Will any medical decision-making change because of this data? If these companies can’t answer that, then you are buying anxiety, not insight.

Your continuous hormone monitor is solving a problem that no one is ready to receive. All these devices have conveniently failed to mention that.