Period apps are the second most popular health related apps amongst teenagers
Dealing with preteen and teenage girls for so many years has opened my eyes to what’s going on in the world and reminds me how lucky I am to have grown up in much simpler times. A recent trip to a retreat in West Cork where phones were in airplane mode for most of the day reminded me of the great peace and ease that exists outside the external world. An experience denied to today’s adolescents who are constantly bombarded by externals, drawn out by pressure to do well at school, be the best athlete, be the most popular attractive girl in the classroom etc. And all the while under the watchful eye of social media which often knows a lot more about our teenage daughters than we do.
A particular area of concern for me as a gynaecologist has been the introduction of menstrual apps. Menstrual apps are among the most popular health related apps available in app stores. A search for terms such as menstruation, period tracker, fertility brings up 225 results. Researchers in Columbia University have found that menstrual apps are the 4th most popular among adults and 2nd most popular among adolescents.
Using period apps to tap into our menstrual cycles
At first this looked like a good idea to me. After all, we always have our phones with us and knowing where we are in our menstrual cycle is a good thing. It can help us understand and manage our energy and moods. Knowing that we are premenstrual can help us understand why we might be feeling a bit tearful or angry or why we are experiencing a skin break out. Being aware that coming up to ovulation can be a time full of energy and creativity and that this can foster personal bests in sport or successful handling of a tricky situation in school or work. Knowing when we are ovulating is obviously essential for a woman who wants to achieve or avoid a pregnancy, and apps are certainly very helpful here.
Period apps – Data collection and sharing
However, many period tracking apps do a lot more than just record your menstrual cycle. Menstrual apps collect information about your health, your sexual life, your smear results, your pregnancy test, pregnancy gestation, your alcohol and drug habits, your mood, your appetite, your skin condition, your vulval discharge. The list goes on and on. Frankly, the information obtained by period apps would beat the information received by many gynaecologists at a consultation!! This personal data shared by users on these apps is information you would only share with a trusted friend, partner, or health care professional.
ORCHA – the Organisation for the Review of Care and health apps in the States reviewed the privacy policies of 25 period tracker apps and revealed that 84% share data with third parties and that 68% is used for marketing purposes. Out of 36 apps tested by the ICO, (Information Commissioners Office) in the UK, 61% automatically transfer data to Facebook. This happens whether the user has a Facebook account or not, and whether they are logged into Facebook or not! Much of this is extremely detailed and sensitive personal data. Many other businesses can access this data allowing them to target advertising. For example:
- period products to women who may be due a period
- skin products to those suffering with acne
- STI home testing kits to those who may be having unsafe sex
- pregnancy and baby related products to those expecting a baby
The list is endless, and the aim of the game is to make money. This is a case of the person becoming the product and multinationals profiting from their personal data. Privacy international, an agency in the UK state that many apps incentivise their users to disclose additional personal information. Some don’t allow access to particular services unless you enter data and others promise a better quality of service if you give more data.
Period apps diagnosing gynae conditions
Another issue I have come across in my practice is that teenagers who have accessed these apps can occasionally be diagnosed with gynaecological conditions. Two well-known apps, Flo and Clue, have introduced health tools which evaluate a woman’s risk for Polycystic ovarian disease (PCOS). As many are aware PCOS is a hormonal imbalance which can cause irregular periods as well as other symptoms. Many things can cause irregular periods such as weight change, stress, travel, changing your birth control. The diagnosis of PCOS is tricky and can take more than one consultation with a gynaecologist. It is important to get it right as a diagnosis of PCOS has many implications for a woman, not least the issues of sub fertility and insulin resistance. And diagnosing PCOS in adolescence is even more challenging because features of normal pubertal development overlap with adult diagnostic criteria. There are many scientific papers counselling a very conservative approach to diagnosing PCOS in adolescents.
Irregular periods are normal in adolescence for the first 3-5 years after puberty, as the body and gynae system mature. However, I have met many young girls in my practice who are concerned and anxious that they have PCOS after filling in a questionnaire on an app. And it can be very difficult to reassure a young person that irregular periods don’t necessarily equate with PCOS. This in turn can lead to performing unnecessary investigations which lead to further medicalisation and anxiety in a young girl.
Your daughter wants to use period apps? Do your research!
My advice to my patients and their parents when it comes to tracking periods was always, use a diary or a calendar, something that you alone can access. Informing yourself and your daughter about the different parts of the menstrual cycle and figuring out what is going on in your body is an interesting journey and can develop insights into our own body. We facilitate this information in the courses we run in schools, sports clubs, and libraries, and in our on-line course.
Period apps and privacy policy
Menstruation apps can be a useful tool if used correctly with appropriate data protection. They should be a helpful aid and not exploit data for profit. Giving away our private data to remote multinationals is not a road to empowerment. It is fostering a dependence on algorithms which, contrary to their advertising, serve the interest of the company and not you.
Since starting my research for this article, I have received many offers to join various menstrual apps.
Resources
https://bmcmedicine.biomedcentral.com › articles
by AS Peña · 2020 · Cited by 199 — PCOS cannot be diagnosed during adolescence unless both irregular menstrual cycles or hyperandrogenism are present. It was recommended
https://ico.org.uk › news-and-blogs › 2023/09 › ico-to…
7 Sept 2023 — The Information Commissioner’s Office (ICO) is reviewing period and fertility apps as new figures show more than half of women have concerns …
http://privacyinternational.org › long-read › no-bodys…
9 Sept 2019 — In December 2018, Privacy international exposed the dubious practices of some of the most popular apps in the world.
https://orchahealth.com › Resources
21 Jul 2022 — A research team at ORCHA, the Organisation for the Review of Care and Health Apps, has examined the privacy policies of 25 period tracker …