Redefining Reproductive Health: The Struggle Over Control & Privacy

Written by Sophia Ly, PharmD 2027

March 3rd, 2024

In the age of major technological advances, there is a lesser-known digital companion that is quietly revolutionizing the landscape of reproductive health: menstrual-tracking apps. While nearly 70% of adults in the United States track a health indicator, lesser attention has been drawn to factors relating to women’s health.2 Beyond mere conveniences, these phone applications are becoming indispensable tools for women to monitor their health and assume bodily autonomy. Its value in the modern era is defined by its role in shaping health literacy, promoting reproductive rights/advocacy, and personalizing healthcare for the average consumer. 

Imagine being able to predict your next cycle at your fingertips– literally. Although a majority of women rely on paper notes, awareness of their premenstrual physiological states, and passive memory to track their cycle, these methods were rendered to be ineffective predictive tools. Digital apps, such as Flo, Clue, and Apple’s in-house tracker, provide benefits over traditional methods, including improving adherence, ease of data entry, and computer algorithms to more accurately map out menstrual patterns. Unlike traditional methods, which assume that all women operate on the 28-day period cycle, these apps leverage diverse inputs, such as physiological data and user-reported symptoms.3 By integrating inputs such as basal body temperature, cervical mucus consistency, cycle length, and menstrual symptoms, these algorithms can discern patterns unique to each user, resulting in more precise predictions.4 For instance, Clue utilizes machine learning algorithms to continuously improve its predictions based on user feedback and data inputs. These algorithms enhance the accuracy and reliability of menstrual cycle predictions, empowering users with better knowledge about their reproductive health.

These apps also serve as a form of Telehealth, allowing users to anonymously ask questions pertaining to women’s health. Flo, in particular, offers evidence-based medical articles, tips, and recommendations from a team of doctors and health experts for users of the app. By facilitating evidence-based discussions with healthcare providers, they equip users with the knowledge and confidence to make proactive decisions about their bodies.  Literature in the past decade indicates that increased health literacy correlates with better health outcomes and decision-making.1 In states grappling with restrictive abortion laws, post-Roe v. Wade, these apps emerge as lifelines, enabling early detection of missed periods and potentially bridging the gap to timely access of essential reproductive services. 

Amid the promise of convenience, several privacy concerns have been raised by users and lawmakers. The Flo app in particular has amassed over 43 million active users, and was soon embroiled in a settlement with the Federal Trade Commission amid evidence that it misled users about how the data from the app was distributed.5 The sensitive nature of health data stored in period-tracking apps raises legitimate questions about data security and user confidentiality. As users entrust intimate details of their reproductive health to these platforms, privacy experts are increasingly concerned about the ‘mysterious’ third parties that are receiving each user’s personal health data. Some users have chosen to forgo these apps out of fear of losing privacy and agency, highlighting the ethical dilemma that users face when using digital healthcare technologies.  

References:

1. DeWalt, D. A., Berkman, N. D., Sheridan, S., Lohr, K. N., & Pignone, M. P. (2004). Literacy and health outcomes. Journal of General Internal Medicine, 19(12), 1228–1239.

2. Epstein, D. A., Lee, N. B., Kang, J. H., Agapie, E., Schroeder, J., Pina, L. R., Fogarty, J., Kientz, J. A., & Munson, S. A. (2017). Examining Menstrual Tracking to Inform the Design of Personal Informatics Tools. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems . CHI Conference, 2017, 6876–6888. 

3. Fehring, R. J., Schneider, M., & Raviele, K. (2006). Variability in the Phases of the Menstrual Cycle. Journal of Obstetric, Gynecologic & Neonatal Nursing, 35(3), 376–384.

4. Johnson, S., Lamb, D., Marston, L., Osborn, D., Mason, O., Henderson, C., Ambler, G., Milton, A., Davidson, M., Christoforou, M., Sullivan, S., Hunter, R., Hindle, D., Paterson, B., Leverton, M., Piotrowski, J., Forsyth, R., Mosse, L., Goater, N., & Kelly, K. (2018). Peer-supported self-management for people discharged from a mental health crisis team: a randomised controlled trial. The Lancet, 392(10145), 409–418.

5. Torchinsky, R. (2022, May 10). How period tracking apps and data privacy fit into a post-Roe v. Wade climate. NPR.