Why are period apps getting so popular? What in the World podcast, BBC World Service

Key Concepts

• Fertility tracking apps (Clue, Flo, Period Tracker)
• Menstrual cycle phases
• Ovulation and fertile window
• Natural Cycles (FDA-approved contraception app)
• Hormonal contraception vs. non-hormonal methods
• Data privacy and security
• Accuracy and reliability of fertility tracking apps
• Individual variation in menstrual cycles

Menstrual Cycle and Fertility Tracking Apps

The discussion centers around fertility tracking apps, their functionality, usage as contraception, and associated concerns. Three popular apps – Clue, Flo, and Period Tracker – have over 250 million downloads. These apps primarily function by tracking a woman's menstrual cycle to predict periods and fertile windows.

Understanding the Menstrual Cycle

The menstrual cycle is broken down into phases:

• Period Phase (Day 1): The first day of menstruation.
• Pre-Ovulation Phase (Day 1-14): Estrogen rises, causing the endometrium (lining of the uterus) to thicken and prepare for a potential pregnancy. Developing follicles grow into an ovum.
• Ovulation (around Day 14): A fully developed egg (ovum) is released from the ovary.
• Post-Ovulation Phase/Traveling Egg Phase (Day 15-28): The egg travels through the fallopian tube. If fertilization doesn't occur, the egg dissolves, and the uterine lining prepares to shed.

How Fertility Tracking Apps Work

These apps function as digital calendars, allowing users to input data such as:

• First and last day of period
• Symptoms experienced throughout the cycle
• Mood changes
• Body changes

Using this data, along with algorithms and average cycle lengths, the apps predict the next period and fertile window. The app Natural Cycles is highlighted as the only app approved as a contraception; it also utilizes basal body temperature tracking for increased accuracy.

Reasons for Using Fertility Tracking Apps

Rayka Kumru, a social sexologist, explains the various reasons individuals use these apps:

• Understanding moods and symptoms: To correlate health issues with menstrual cycles.
• Birth control: As a non-hormonal method of contraception.
• Pregnancy planning: To track ovulation and increase chances of conception.
• Lifestyle trends: A move towards more organic and mindful approaches to health, driven by Gen Z and later generations.
• Limited Access to Contraception: In locations where access to contraception is difficult, period tracking apps become more useful.
• Embracing traditional methods: These apps can represent a return to older contraceptive methods.

Global Usage and Motivations

Dr. Francesco Rampazzo from Oxford University conducted a study analyzing the use of menstrual tracking apps across 112 countries.

• Rapid growth: Hundreds of millions of downloads were estimated in 2021, with even higher usage now.
• Geographic distribution: The US, UK, France, and Australia have the most downloads, with significant usage in South America and the global South.
• Primary motivation: General menstrual tracking (61% of users, according to app reviews).
• Secondary motivations: Achieving pregnancy (22%) and avoiding pregnancy (8%).
• Supplement for reproductive health services: Apps are sometimes used as a substitute, especially where access to contraception or healthcare is limited.

Reliability and Accuracy as Contraception

While apps can be useful, their reliability as contraception is a significant concern.

• App design intent: Fertility tracking apps were not originally designed for contraception, but user behavior has led to this application.
• Cycle irregularity: Menstrual cycles, especially in young people (until mid-20s), can be irregular, making predictions less accurate.
• External factors: Stress and life events can influence the menstrual cycle and ovulation.
• Lack of STI protection: Apps do not offer protection against sexually transmitted infections.
• Human variation and error: Accuracy depends on the quality of data inputted by the user.

Companies claim up to 93% reliability when used correctly, resulting in 7 out of 100 women getting pregnant over a year. Comparatively, the pill, when used perfectly, has a 99% success rate.

Privacy Concerns

Data privacy is a major issue.

• Lawsuits: Flo faced a lawsuit (denied by the company) in Canada for allegedly sharing user data with Facebook.
• Unknown future uses: There is uncertainty about how health data collected by these apps may be used in the future.
• Precaution needed: Users should be mindful and cautious when sharing health information with third-party apps.

Advice for Choosing Contraception

Rayka advises individuals to:

• Research all options.
• Weigh the pros and cons.
• Consult healthcare providers, trusted adults, and reliable websites (medical websites, NGOs, local clinics).
• Choose a method that aligns with their needs and preferences.

Conclusion

Fertility tracking apps offer convenience and insights into menstrual health, but their reliability as contraception should be carefully considered. Individual variations in cycles, potential for user error, and data privacy concerns necessitate a comprehensive understanding of their limitations. Consulting healthcare professionals and weighing all options is essential before relying on these apps for contraception. Data privacy and security should be important concerns.