“Alternative” approaches to health: How we think about health information at Clue

Originally published February 28, 2018.

We sometimes get emails asking how we view “alternative” medicine. It’s a fair question — evidence-based medicine is at the center of all we do at Clue. Here’s a quick look into how we think about delivering health information at Clue.

First-stop resources for Clue content

When deciding how to incorporate a new topic into Clue, we look for the highest available quality of up-to-date research, the current scientific consensus when possible, and existing clinical gold standards (methods or procedures recognized as the best available). These are our first stops when writing informational content on health topics, or when doing background research for new features.

We work directly with some of the world’s top clinical researchers on menstrual health through our med board and research partners. We do internal literary reviews, of varying depths, when appropriate.

At the same time, many elements in the fields of reproductive and menstrual health remain vastly under-researched. This is something that we are working to change at Clue, with our research collaborations. But as it stands, people can be left without answers to important health questions, and without sufficient treatment or management plans. It takes a lot of time for emerging research to reach and be integrated into the mainstream.

In many cases, sufficient treatments just don’t exist yet or focus on symptom management, even for very common conditions like endometriosis, or polycystic ovarian syndrome (PCOS). In the USA, it’s estimated that PCOS affects between 6-12% of women, making it the most common cause of female infertility. But researchers still don’t know exactly what it is, what causes it, or how to treat it (everything about PCOS is being debated, including its name). The typical management plan is long-term hormonal contraceptives. This works for a lot of people, but others are turning to the internet to read theories on what might be causing their health condition, or to explore other options for management. Finding the best of that information, or sorting through the evidence (or lack thereof) behind other treatment options is difficult.

Second-stop resources for Clue content

This brings us to our second-stop resources (not secondary sources, just number two on our list). We look out for newer research (and the researchers conducting them) to see what recent contributions are being made to burgeoning bodies of knowledge. Sometimes this is all of what’s out there.

We aim to make it clear if we ever share any findings which are controversial, unreplicated, or when further research is needed. It’s surprising how much fits into this category.

Many menstrual health-related researchers go into their fields thinking they’ll research a specific topic, to then learn how much fundamental research is still lacking, and then have to back up to start with basics.

This happened to a Columbia University collaborator of ours, Noemie Elhadad, when she started her machine learning research into endometriosis: it’s still not known what causes endometriosis, exactly, and the diagnostic tools aren’t well-defined.

Can alternative medicine be evidence based?

Just because a method is considered “alternative” or not mainstream doesn’t mean there’s no evidence to support it. For example, the use of essential oils may be considered alternative medicine, but there is evidence to support peppermint oil for the use of several conditions, including irritable bowel syndrome, headache, and dyspepsia. In cases like these where this is sufficient evidence to support an alternative method, we will include it in our articles.

Clue is working to bridge the gap

When searching for options and opinions to underreseached menstrual health issues, it’s unapproachably difficult to distinguish the level of rigor behind an opinion or any advice that is outside of clinical norms. We’re working to bridge that gap.