Studies and science are finally catching up to period tracking apps.
The trouble with these apps? Inflexibility, assumptions made about preferences and lifestyle, and a lack of privacy. Oh, and these apps are a marketing trove for female health companies.
Why Do Women Use Apps?
There’s been a dearth of research into the use of tracking apps. The best and most recent study is from the computer science department at University of Washington.
Called Examining Menstrual Tracking to Inform the Design of Personal Informatics Tools, this 2017 paper examined the phenomena from three angles. First, the researchers collected 2,000 reviews of popular tracking apps. They then surveyed 687 people on their habits and conducted in-depth interviews with 12 of the survey respondents.
The study found five reasons women track cycles.
“Women track to: (1) be aware of how their body is doing, (2) understand their body’s reactions to different phases of their cycle, (3) be prepared, (4) become pregnant, and (5) inform conversations with healthcare providers. Participants were typically motivated by multiple factors,” the study found.
It also found that 47% of those surveyed used apps, not paper or memory, to track their cycles. Respondents felt it was a natural fit. And then came the criticisms.
Why the Apps Often Fall Short
As it turns out, menstrual tracking apps work, but only within certain guidelines. Apps use algorithms to determine average cycle lengths, which can give them certain predictive powers. But, many of these apps have no way of coping with outside factors such as an exercise or dietary change, stress or even a pregnancy. In fact, get pregnant and then have a long bout of breastfeeding, and the tracking app might end up thinking your cycle is 700 days long. After the pregnancy, a woman might have to start over anew, erasing previous cycle info that might prove useful.
The study found that “Current app predictions do not sufficiently account for life experiences that can impact a woman’s menstrual cycle (e.g., stress, exercise or diet changes, some emergency contraception). At minimum, apps should allow women to record when the app’s prediction falls out of line with when their period actually occurs, and should use this information to improve future prediction accuracy. Designers should consider how to account for the variability caused by irregular cycles and life changes. For example, designs could occasionally ask women to offer their own prediction, using that opportunity to identify changes.”
Other criticisms: too much emphasis on heterosexuality. These apps track sexual behavior, including frequency, but only offer heterosexual options. Some apps seem obsessed with pregnancy, when women track periods for many other reasons. And, some apps seem to pink it up, which many women simply find irritating.
“Most apps make a lot of assumptions about the user, such as that they want a stereotypically feminine design, that they’re tracking for conceiving or contraception, and that they have a single male sexual partner,” Daniel Epstein, associate professor of informatics at UC Irvine and co-author of the University of Washington study, explains to Parentology. “These assumptions make certain people who don’t fit into the assumptions feel excluded or uncomfortable. For example, a few participants were struggling with infertility, and really despised how the app highlighted their inability to become pregnant. The overly pink nature of most apps made some people embarrassed, and made others feel like the practice of tracking was childish.”
Another study, from Obstetrics and Gynecology entitled Evaluation of Smartphone Menstrual Cycle Tracking Applications Using an Adapted APPLICATIONS Scoring System, found accuracy problems with free period tracking apps, stating rather bluntly, “Most free smartphone menstrual cycle tracking apps for patient use are inaccurate. Few cite medical literature or health professional involvement.”
That means that depending on these apps for predictive purposes, whether for getting pregnant, figuring out PMS symptoms and mood swings, or simply wanting to not be caught out and about without period products is a problematic proposition.
“Accuracy in predicting their period and/or fertility window is most important to people, and people will switch or stop using apps if the app isn’t accurate enough,” Epstein says. “Making an accurate prediction is hard for a lot of different reasons, but apps should at least surface how the prediction is being made or let people indicate when it falls out of line with reality.”
And when a tracking company touts itself as a contraceptive device, it turns into roulette, baby style.
The Case of Natural Cycles
Natural Cycles, a Swedish tracking app, was the first (and maybe last) period tracking app to get the go ahead from the FDA to be used as a contraceptive device. Initially, Natural Cycles advertised an astonishing 99% success rate, which made it far superior to the birth control pill.
Quickly, though, reports emerged to the contrary. Some women were using the app (which runs about $60 annually), and claiming they were using it perfectly and according to directions (which includes taking your temperature every day with the app’s included thermometer), and got pregnant anyway. A most unwelcome result.
The success rate was downgraded to 93%, which still seems high for an app that’s really just a high tech version of natural family planning. Successful contraception for this device depends entirely on the woman’s ability to wake up every morning and immediately take her temperature, allowing the app’s algorithm to then give her either a “green” light for safe, or a “red” light for fertile (meaning no sex that day).
In a 2016 Guardian article about Natural Cycles, company researcher “Kristina Gemzell Danielsson points out that it’s not a good option for women who absolutely want to avoid a pregnancy. Nor does she recommend it for anyone who has what she describes as “an irregular lifestyle”, irregular menstrual cycles or lacks the motivation to stay on top of their cycles.”
In fact, the ideal candidate for Natural Cycles, according to company founder Elina Bergland, “…is a woman in a stable relationship who is planning to have children at some point, and who would like a break from hormonal contraception ahead of trying.“
That very specific description is a far cry from the average woman who is looking for effective contraception. Yet, Natural Cycles was marketed to the masses, mostly through Instagram, a platform rife with young women decidedly not fitting this demographic, with no caveats in place.
Don’t Assume This Tracking Info is Private
Dr. Karen Levy, an associate professor of information science at Cornell, was ahead of her time in 2016. She wrote a paper for the Idaho Law Review in which she termed the phrase “intimate surveillance.” Intimate surveillance refers to tracking apps (such as, but not limited to) like Clue, Glow, and Flo, which depend on the user recording intimate details about their bodies and sex lives.
“Surveillance poses new challenges in intimate relational contexts. It encourages an “algorithmic subjectivity” about sexual behavior, normalizes monitoring practices and data-driven approaches to intimate relations, and brings to the fore complex and thorny issues around privacy, consumer expectations, and the integrity of information flows,” Levy wrote.
Much of what is self recorded in period tracking apps is considered marketing gold. A woman who is probably pregnant, or trying to conceive, is in line for a lifetime of new purchasing possibilities, from toys to life insurance. Almost any of the details a woman documents, from her PMS symptoms to her number of sex acts per week (an option on some apps, for those seeking pregnancy) can be mined for products later down the line. And there’s not much stopping the data from being shared.
Levy backs up this point, writing:
“ A second set of privacy risks relates to the fact that intimate data are typically collected by, and stored on, decidedly non-intimate commercial platforms. Thus, even data that appear to be shared only within an intimate partnership may also be shared with (or sold to) other parties—including app developers, internet service providers, advertisers, or data brokers and aggregators.”
Want to avoid having your very personal data mined? Just record the bare minimum needed to track cycles. And use the app Clue, which apparently doesn’t share its data and leaves it stored on the personal device.
These Apps are Works in Progress
As time goes on, the look and feel, the efficiency, and the privacy issues will probably get sorted. For instance, one site, Clue, does not share information and each woman’s data is stored in her device. A scholar like Epstein, who specializes in informatics, looks at the crossroads of the personal and the technological, and works toward tracker apps that do better.
“Given how many people use or have tried to use period tracking apps, we were surprised at how little attention had been paid to the topic in the research literature,” Epstein says. “ But we’ve been excited to see the interest in the topic pick up in recent years, and are continuing to look at how we can improve period tracking apps for consumers.”
Sources:
Daniel Epstein, associate professor of informatics at UC Irvine
University of Washington
Idaho Law Review
Bloomberg
The Guardian