The most recent publication from the CHASE Lab, published in mHealth (short for mobile health), explores women’s views on mobile applications for tracking the menstrual cycle and associated symptoms. These apps allow women to keep tabs on their period and reduce the burden of memorizing this information.
We were interested in updating the evidence on this topic after the United States Supreme Court overturned Roe v. Wade in June 2022, which ended federal protections on aspects of women’s reproductive healthcare. This decision leaves laws about women’s healthcare up to individual states and has dramatically changed the landscape of women’s reproductive rights. In addition to consequences for women of reproductive age, there may also be consequences for researchers dedicated to improving women’s health.
For example, one consequence was that women have new or increasing concerns about privacy on menstrual cycle tracking apps. They’re concerned about companies sharing personal reproductive health data that they enter in the app with law enforcement, which can be used to prosecute for suspected violations of reproductive healthcare laws. In fact, many women have stopped using these apps since June 2022.
This could be a huge problem for women’s health researchers. Menstrual cycle apps are valuable tools for understanding women’s experiences, especially as they can help to identify when women have various physical or psychological symptoms. They’re also easy to use and useful for linking symptoms with other daily activities such as exercise. We recognized a potential problem right away, as our team has a particular interest in promoting women’s physical activity and overall health. In fact, our team had planned to conduct this kind of research when Roe v. Wade was overturned. Would women be willing to participate in this research now? We had to reconsider our plans to include the possibility of women feeling hesitant about using menstrual cycle tracking apps, and we wanted to learn more about women’s perspectives on these apps after Roe v. Wade.
What Did We Do?
We launched an anonymous, electronic survey in August 2022 and collected responses from menstruating women until November 2022. This allowed us to gather insights from 206 women between the ages of 18 and 60, to understand their preferences for menstrual cycle tracking methods. We asked about their preferences for their personal tracking as well as for participating in research focused on the menstrual cycle.
What Did We Find?
The majority of women who responded to our survey had used menstrual cycle tracking applications before; they were either current users or ex-users. More than one-third of these women (38%) reported that they had concerns about using menstrual cycle tracking apps due to current events in the United States. When asked about their preferred way of tracking menstrual cycle information, 30% said that they would prefer methods that did not involve app-based technology (such as electronic spreadsheets or paper records). Finally, 34% said that they would not be willing to participate in research if it involved daily tracking of the menstrual cycle. Of note, we collected a low number of responses from women from underrepresented backgrounds, and we did not include any information on our survey about gender identity (meaning that our work may not be entirely representative of the population of menstruating people).
What Does This Mean and Why is it Important?
The results of this study show that a large subgroup of women are concerned about using mobile apps to track their menstrual cycle experiences and are not willing to use them in research. This means that some women’s perspectives would not be included in future research, as they would decline to participate, and we would miss critical information about this subgroup of women. So it’s important for researchers to tailor menstrual cycle tracking to the needs of menstruating women in today’s cultural climate, to ensure participant comfort and maximize representation across groups. This may involve offering other methods for menstrual cycle tracking if they are uncomfortable with mobile apps, such as paper records.
For researchers, these findings also highlight a pressing need to establish new criteria for menstruation-related research that reflects the current climate around women’s healthcare. It is urgent for women’s health researchers to investigate how to reach groups of women who are currently underrepresented, including women who identify with racial and ethnic minority groups. This study provides us with initial insight into how menstruating women (presumably cis-gender women) in the United States view and use these mobile apps, and our goal is to use broader inclusion criteria in the future so that we further improve this understanding.
What Was It Like to Work on This Study?
It has been very rewarding to see this study advance from idea conceptualization to data collection and manuscript writing! I am so glad we were able to develop this survey in direct response to a decision that has implications for women’s health research, in general and specifically for menstruating women living in the United States. I led the execution of the data collection, data analysis, and writing the published paper, with valuable contributions from Iris and Dr. Arigo. I’ve learned a lot about being flexible during the research process and with my research questions when the unexpected happens. It’s been a pleasure to work with a group committed to advancing women’s health research, and I look forward to expanding on this line of research in the future!
Dr. Gabrielle Salvatore, CHASE Lab postdoctoral fellow and lead researcher on this project
It was exciting to work on this study given the timeliness and importance of women’s experience trusting menstrual cycle tracking applications post Roe V. Wade. Additionally, this study contributes to a growing understanding of the wide implications that distrust in mobile health applications may have in the collection of women’s health data. As a co-author on the published paper, I was also grateful for the collaborative nature of the writing process and study development. I learned more about how to work productively as a team which was an invaluable experience!
Iris Bercovitz, 2nd-year clinical psychology Ph.D. student
For the past 10 years, an important subset of our work has been dedicated to understanding how women use mobile technology (including smartphone applications) for self-monitoring of health experiences such as physical activity. We were delighted when Dr. Salvatore joined our team in 2022 – her specific interests in the menstrual cycle and its potential effects on physical activity aligned with and expanded our impact. With this study, I was very proud of our team’s ability to pivot to address societal shifts that are critical to informing future work. I look forward to our next steps.
Dr. Dani Arigo, CHASE Lab director
Next Steps
This study was a necessary step to explore women’s willingness to use menstrual cycle applications after the overturning of Roe v. Wade. Now that we better understand women’s perspectives, we have set up a new study to understand how to best include menstrual cycle tracking in research on women’s physical activity. In fact, we’re currently recruiting women to participate in a 2-part pilot that includes a virtual interview and wearing a Fitbit to log physical activity and menstrual cycle symptoms. If you are interested, please complete this short survey to find out if you’re eligible to participate. This work will help us move toward women’s health research that is inclusive and responsive to women’s needs.
Keep reading for more insight into our team’s experiences of these next steps!
When I joined the CHASE lab I was quickly introduced to this topic of menstrual cycle tracking applications in a post-Roe era. Contributing to a study that sheds light on the impact of the shift in women’s reproductive healthcare was both challenging and rewarding. It highlighted the evolving dynamics of women’s health, especially in a time where privacy concerns have become so paramount. Working closely with esteemed professionals like Dr. Arigo and Dr. Salvatore has been a valuable learning experience. I was able to conduct secondary analyses from this survey to explore women’s anxiety levels, and I’m now helping with data collection for Dr. Salvatore’s active 2-part study (described above). This work has greatly enhanced my understanding of research methodologies and the nuanced aspects of women’s health studies. Learning how to effectively contribute within a team dynamic and navigate the intricate aspects of research is an opportunity I will always appreciate.
Haley Thiel, undergraduate research assistant
Clinical Health And Social Experiences Lab 