Digital Fertility Awareness Apps vs Menstrual Trackers

When it comes to understanding fertility and menstrual health, technology has become both a blessing and a source of confusion. Many people around the world turn to digital health apps for insights into their menstrual cycles, believing they are equipping themselves with reliable tools to manage fertility or avoid pregnancy. However, there is a significant misunderstanding between fertility awareness methods (FAMs) and the use of menstrual tracking apps. To highlight this confusion, let’s examine two diverse contexts: Brazil and the United Kingdom.

Fertility awareness methods are science-backed practices where individuals track specific signs of fertility, such as basal body temperature (BBT), cervical mucus, and cycle length, to either achieve or avoid pregnancy. The only digital example is Natural Cycles which is FDA approved in the United States, Europe and Australia as a Class II medical device for contraception. These require daily tracking, education, and adherence to specific protocols. Digital fertility apps can be linked with wearables to measure basal temperature changes.  Natural Cycles when used correctly has a similar efficacy to the contraceptive pill.

Menstrual trackers, on the other hand, are apps designed to record menstrual dates, predict ovulation, and estimate fertile windows using algorithms. While convenient, these apps are often based on generalised data and may not account for individual variability. Examples include Flo and Clue app, with many more companies adding cycle tracking to their existing software. 

The problem lies in the assumption that all menstrual tracking apps are reliable tools for fertility management which can lead to unwanted consequences, particularly in countries like Brazil and the UK, where cultural, educational, and systemic factors vary widely.

The Case of Brazil: Trusting the Apps

In Brazil, where contraceptive access can be inconsistent and sex education varies greatly, menstrual tracking apps have gained immense popularity. Many Brazilian women use apps like Flo and Eve to avoid pregnancy, believing they function as accurate fertility awareness tools. This confusion is exacerbated by limited access to formal fertility education and the stigma surrounding discussions of sexual health.

Apps like Natural Cycles, which is FDA-approved and CE-certified as a contraceptive, do blur the lines between trackers and fertility methods. While it uses basal body temperature and an algorithm for precise predictions, it still requires proper education to be effective. However, its cost (at the time of writing $99 annually, plus a thermometer) makes it inaccessible to many in Brazil.

In a country where Christian influence shapes reproductive health policies, misinformation can thrive. Public health campaigns often fail to differentiate between tools like Natural Cycles and casual apps like Period Tracker, leaving users vulnerable to misconceptions.

The UK: Technology confusion

In the UK, menstrual tracking apps are also widely used but often as a supplementary tool rather than a primary contraceptive method. In the context of hormonal contraception, they don’t track menstruation, just withdrawal bleeding or spotting.

With free access to contraceptives through the NHS, British users generally have more options. However, confusion still persists and with the rise of hormonal hesitancy more individuals are turning to non-hormonal options. Recent reports from the British Pregnancy Advisory Service suggested a 14% drop in contraception use in those accessing abortion.  Potential side effects of hormonal contraception being a key reason for people looking for other options.  We are looking to answer some of these fears with The Hormone Effect app which is funded by South Yorkshire Digital Health Hub.

Interestingly, the UK’s openness to discussing reproductive health has led to a rise in apps designed with evidence-based practices, such as Kindara and Fertility Friend. These apps allow users to input BBT and cervical mucus data, aligning more closely with FAMs. However, their proper use still hinges on user education—a gap even in a country with strong healthcare systems.

The Role of Misinformation

Both Brazil and the UK face challenges rooted in misinformation. Many apps market themselves as solutions for everything from period tracking to pregnancy prevention, blurring the distinction between trackers and FAMs. 

Moreover, the algorithms used by these apps are only as good as the data entered. A slight irregularity in cycle length can throw off predictions, leading to risky assumptions. This lack of personalisation underscores why fertility awareness methods, which rely on daily biological observations, remain more reliable for contraception or conception.

To address this confusion, governments, app developers, and health educators must work together with public health campaigns to prioritise education about fertility awareness methods, differentiating them from apps. Schools must include practical lessons on reproductive health to empower young people. Developers must clarify what their apps can and cannot do. This means clear messages and warnings not to use menstrual trackers as contraception.  Making evidence-based tools affordable in countries like Brazil could bridge gaps in accessibility. Governments and NGOs could subsidise such tools to expand access.

Addressing cultural stigmas is crucial. In Brazil, open dialogue about reproductive health must become normalised to counteract the influence of misinformation and taboos. The confusion between fertility awareness methods and menstrual trackers is not just a technological issue, it is a societal one. As Brazil and the UK illustrate, the consequences of this misunderstanding range from unplanned pregnancies to prolonged struggles with conception. By prioritising education, improving app transparency, and addressing cultural barriers, we can empower individuals to make informed choices about their reproductive health. After all, technology should enhance—not complicate—our understanding of our bodies.

By prioritising education, improving app transparency, and addressing cultural barriers, we can empower individuals to make informed choices about their reproductive health.