Features of Period-Tracking Apps
Menstrual apps or period-tracking apps are a type of health-tracking mobile application. Most of the period-tracking apps feature an interface with numerical illustrations or a calendar with a countdown until the beginning of the next period or ovulation. They allow users to track and analyze menstrual cycles, monitor ovulation, and related data, such as period-related symptoms, tracking mood swings, food cravings or pain. Users can add additional information about their sex life, use of contraceptives, water intake, or exercise.
After collecting all the data, the apps provide users with an analysis about the average lengths of the cycles or changes in factors such as body weight and mood. People can use period-tracking apps for different reasons. In the study done by Levy and Romo-Avilés, participants stated the apps enabled them to be better prepared for their future periods, support family planning and gain more insight into their menstrual symptoms and emotions.
According to scholars Novotny and Hutchinson, period-tracking apps are marketed as “empowering female users by providing seemingly quantitative health information through affordable and accessible methods”. Essentially, period-tracking apps afford users the opportunity to gain more knowledge and awareness about their menstrual cycles, bodies and reproductive health.
Image Source: GooglePlay Store.
The Problem with Data Collection Practices
While there are a lot of benefits of using period-tracking apps, they raise some privacy, security and ethical concerns. The apps serve to equip their companies with the abundance of collected data for profit, data users may not necessarily want to share with these big companies. The period-tracking apps operate in the discourse of the “quantified-self movement”. Ajana, an international scholar and media practitioner, states that this movement can be broadly understood as “a culture of measuring and analyzing” our daily activities through the use of digital technologies. This movement is rooted in the belief that quantifying our bodies and health will help people improve their well-being and increase productivity. The culture of the “quantified-self” enables data collection and close monitoring of daily activities that benefits the apps.
Through self-reporting, users of period tracking apps input personal data about their bodies. As Felizi and Varon, founders of Chupadados, illustrate in their article, using period tracking apps means potentially sharing “if you went out, drank, smoked, took medication, got horny, had sex, had an orgasm and in what position, what your poop looked like, if you slept well, if your skin is clear, how you feel, and if your vaginal discharge is green, has a strong odor or looks like cottage cheese”. Once your personal information is in the data ecosystem it’s hard to find out who will receive it or what will happen to it.
Eve Period-Tracker. (Image Source: GooglePlay Store)
There are several issues with the way health-related apps such as period tracking apps manage data. According to Rosato, a finance and health journalist at Consumer Reports, period tracking apps are not covered by health policies such as Health Insurance Portability and Accountability Act (HIPAA) aimed to protect personal health data in the U.S. Without legal accountability, period tracking apps can use collected data as they see fit. Rosato states that they can share the data with companies who work on optimizing design and usability of mobile apps. Period tracking apps might also share users’ data with advertising agencies to allow them to target their audiences more efficiently. They can sell this data to different stakeholders from big digital platforms such as Facebook and Google to smaller companies. Rosato paints a gruesome picture where data collection companies track and compile personal information to build a profile on users and sell it to advertisers.
It is important to note that data collection is not a neutral process. For Ajana, tracking apps might also result in discrimination of people based on various methods of categorizing and analyzing data. Big data sets always require analysis and interpretation. People are being profiled, sorted and categorized into categories. As a result, Ajana argues that this data can lead to the exclusion of certain people from accessing public and healthcare services.
Case Studies on Several Period-Tracking Apps
Every app’s privacy policy is a legal agreement that details how the app will collect, use and store the user’s personal information. These policies will vary with respect to the content of their terms, how the policy is actually structured and how easy it is on the user’s part to decipher information. By critically examining how period tracking apps collect and process personal data, we can hold them accountable for the information they receive and process. We will discuss three popular period-tracking apps (Clue, Flo and BabyCenter) and take a closer look into their general data collection practices and how they have changed their privacy policies over the past few months.
Clue
Clue Period-Tracker, Ovulation. (Image Source: Apple Store)
Clue offers general period-tracking practices such as period and fertile window predictions, as well as other features such as analyzing personal patterns during ovulation and PMS (e.g. cramps, skin, mood). The website and app also offer resources and articles on a variety of topics related to hygiene and sexual health, such as menstrual products, birth control and fertility.
Clue’s privacy policy states that it uses third-party tools to “process usage data and minimal personal data on Clue’s behalf”. This allows the app to contact users and analyze their interactions with the app. While users can restrict the data transmitted to third-party tools under “Settings”, it is not clear how much data is still being shared, which poses risks to data leakage and problems with transparency. The app also states that it shares (anonymous) user data to “carefully vetted researchers” for scientific research into health studies, and does so under the German Data Protection Act. Users can withdraw their consent by emailing the app, but cannot change this in the settings. While users can read about ongoing collaborations with researchers, it is not mentioned whether they will be notified about specific studies that use their data. This seems to pose a problem with participant consent.
Clue also shares a “minimal” amount of data with several advertising networks (such as Google Analytics, Adjust, Apptimize, Amplitude) to personalize ads for users and suggest the app to other people through these networks. In October 2019, the app provided some details about their approach to digital advertising, stating that at minimum, the networks required minimum information about how much the user uses the app, and whether they bought something through the app. Personal health data is not sent to these networks; however, Clue stated that they wished for more transparency on how advertising data is utilized. As well, Eva Blum-Dumontet, a senior research officer at Privacy International, disagrees with Clue and states that sensitive health data does, in fact, end up with third-party advertising networks. It is also worth noting that in March 2020, the app stopped sharing this data with Facebook after multiple users expressed their discomfort.
Flo
Flo: Health & Period-Tracker. (Image Source: Apple Store)
Flo is yet another period-tracking app that offers services such as resources for pregnancy development and other health and lifestyle content, but not without controversy. In February 2019, The Wall Street Journal revealed that Facebook Analytics was collecting personal health data from this app (such as menstruation cycles and whether users were trying to get pregnant) to personalize ads for users. Flo later dropped Facebook as an ad-tracking partner.
As of now, Flo states in their privacy policy that their current advertising partner AppsFlyer may not receive any health data, but only unique identifiers (such as advertiser IDs), age group, subscription status (on the app) and application use from users. Users cannot opt out of sharing information from the app settings, but must either email the app support or adjust device settings. Like Clue, Flo also uses anonymized user data for research, but unlike Clue, it does not provide direct links (from the private policy page) to the specific research projects it contributes to. Users must go to the “Collaborations” page on the website to browse these various projects. It also does not state whether users are made aware of which companies will use this data and when. This illustrates an issue with accessibility and transparency on the app’s part.
The privacy policy does provide a summary of key points, and lists information that isn’t explicitly input (like location). This seems like an improvement from the legal jargon previously used by this app.
BabyCenter
BabyCenter: Pregnancy Tracker. (Image Source: Apple Store)
BabyCenter is primarily targeted toward current and hopeful Canadian parents, offering period and pregnancy trackers, health and exercise advice and contraction timers. It also connects users to other parents-to-be through community forums.
BabyCenter’s privacy policy clearly lists all information that may be collected from users, including personal details, demographics, location, among others. This data collection is achieved through data that the user provides when signing up for the app, service data and third party information. BabyCenter states that it is managed by the company Everyday Health, but does not go into detail about the third party networks that it partners with, which once again details issues with transparency.
In 2019, Consumer Reports found that BabyCenter’s privacy policy was longer and more difficult to read and understand than Clue’s and Flo’s. The app also does not indicate how all types of data collection can be disabled or at least restricted (through the app settings or otherwise). However, unlike Clue and Flo, BabyCenter does not share any data with scientific researchers, but does use data for the purposes of research into user interactions with the app. Another advantage is that it can also be used without sharing the user’s name and email, respecting the user’s anonymity.
Understanding and Mitigating the Risks
Despite having a range of useful and insightful services, each examined app seems to have problems associated with their data collection practices, including the transfer of personal health data to large companies for profit (and risk of data leakage by doing so), and transparency associated with their privacy policies. There are also many concerns about the accuracy of these apps (for predicting fertility cycles and other services), and whether these services are worth the privacy risks.
Blum-Dumontet states that policies in apps need to be less “long-winded” and free of legal jargon. Researchers Novotny and Hutchinson also encourage that period apps take a more feminist approach to design that “addresses the issue of how users develop agency in their health decisions and remain empowered”. If the period tracking apps claim to “empower” users, their data collection practices and privacy policies need to be adjusted accordingly. To make policies more accessible, transparent and user-centered, Novotny and Hutchinson suggest including explanation points such as:
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What and how data is collected with visual examples of what that data looks like
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Where that data is stored with specific descriptions of storage vulnerabilities
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Which third parties (naming each one explicitly) have access to which parts of the user’s data, how long they will have access to it, and what they’ll do with the data (with visuals)
In addition, they argue that users should also have:
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Options for opting out of any and all of the data collection acts (as indicated above) at any time
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Full rights to own all data that they create while using the technology
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The ability to terminate their services, taking all their data with them (the app will not log or store data upon termination)
Further, Consumer Reports further offered advice for users on how to reduce the risks associated with these apps. Users can use privacy controls to limit the information collected by the app (for example, location data), enable password managers (and temporary emails), and limit ad tracking (which limits personalized ads and keeps conditions such as pregnancy private to others). There are also ways of keeping track of your period yourself (such as noting in the day your period starts and counting the length of one cycle), and logging in symptoms such as PMS, flow and mood changes without having to share with other people.
Despite limitations in the way certain information is constructed and made available, it seems as if the best solution for now is to thoroughly read the privacy policies of every app and analyze any risks before putting them to use. Hopefully, app developers will follow and adjust policies accordingly to benefit all.
Banner Image Credit: Some Cultures Treat Menstruation With Respect by Susan Brink (Purple Rain Illustrators) is licensed under CC BY-NC 4.0
