Abstract

Abstract Study question What are women’s experiences, behaviours and attitudes to ovulation and period prediction when using a period tracker app? Summary answer Some women altered their behaviour in response to ovulation prediction and some felt stressed in response to their period arriving earlier or later than predicted. What is known already Period tracker apps are designed to help women track and predict menstrual cycle dates and symptoms. The majority of period tracker apps predict the date a woman is ovulating and the date of her period. Several studies have shown that ovulation cannot be accurately predicted using menstrual cycle dates, and many apps assume that women ovulate on day 14 of their cycle whereas recent large studies have shown this to be closer to days 16/17. With regards to the prediction of the first day of the period, reports have shown that period tracker apps do not always correctly predict this. Study design, size, duration We conducted an anonymous, online survey using multiple choice and open-ended questions on Qualtrics software. The survey was live for 19 days, from 30th June – 20th July 2021 and was promoted using the social media of authors 1 and 3 (Twitter, Instagram, Facebook and Linkedin). The qualitative data was analysed thematically. Participants/materials, setting, methods The inclusion criteria was that participants had to be using or had previously used a period tracker app, be able to read English and have access to the online survey. Main results and the role of chance From 375 total responses, 330 complete responses were analysed, giving a completion rate of 88.0%. Respondents were aged between 14-54, with a mean age of 26.0 (±7.81). When asked what was the best thing about using the app, 29.7% (98/330) respondents selected ‘To know when I’m ovulating’. The majority of respondents sexual activity was not influenced by their app’s predicted dates (65.5%, 216/330). However, a total of 17.0% (56/330) of respondents stated that it was, with 10.9% (36/330) stating they avoided having sex on fertile days predicted by the app. Respondents were asked if their period ever started earlier than the app predicted; 54.9% (189/330) said it had and 72.1% (238/330) said it had started later than predicted. When asked how they felt if their period arrived earlier or later than expected, thematic analysis of responses when periods started earlier revealed 4 themes: feeling unaffected, being frustrated/unprepared, feeling anxious/stressed, and feeling confused/intrigued. Thematic analysis when their period arrived later than expected revealed 6 themes: anxious/concerned about pregnancy, disappointed about pregnancy, seeking advice/informing healthcare professionals, thoughts about the menopause, feeling unaffected and being better prepared. Limitations, reasons for caution All surveys have a selection bias. The survey was only promoted on social media of two of the authors. As the survey was in English, the women who answered the survey were mainly UK residents who were highly educated. Wider implications of the findings Period tracker apps need to be clearer of their intended use and reliability, especially for period and ovulation prediction. Inaccurate predictions can affect the users’ health and behaviour. This study calls for period tracker app companies to update their apps to provide transparency about their intended use and capabilities. Trial registration number NA

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