Users' Perspectives on Multimodal Menstrual Tracking Using Consumer Health Devices

TL;DR

This study addresses the limited scope of current menstrual trackers by investigating multimodal menstrual tracking that combines conventional signals (daily diaries) with unconventional signals from consumer devices (hormone data, continuous glucose monitoring, and wearables) over three months with 50 participants. The authors employ longitudinal surveys and interviews, analyzed via thematic coding, to reveal how additional signals broaden users’ conceptions of menstrual health, influence routines, and foster more nuanced understandings of cycle phases beyond bleeding. Key contributions include design implications for future trackers—highlighting fine-grained phase predictions, seamless integration of passive data, and privacy-conscious features that accommodate diverse user needs—and empirical evidence that unconventional signals can support healthier attitudes and proactive health management. The work suggests practical impact for building holistic menstrual health tools that promote better planning, communication, and autonomy while addressing stigma associated with menstrual data.

Abstract

Previous menstrual health literature highlights a variety of signals not included in existing menstrual trackers because they are either difficult to gather or are not typically associated with menstrual health. Since it has become increasingly convenient to collect biomarkers through wearables and other consumer-grade devices, our work examines how people incorporate unconventional signals (e.g., blood glucose levels, heart rate) into their understanding of menstrual health. In this paper, we describe a three-month-long study on fifty participants' experiences as they tracked their health using physiological sensors and daily diaries. We analyzed their experiences with both conventional and unconventional menstrual health signals through surveys and interviews conducted throughout the study. We delve into the various aspects of menstrual health that participants sought to affirm using unconventional signals, explore how these signals influenced their daily behaviors, and examine how multimodal menstrual tracking expanded their scope of menstrual health. Finally, we provide design recommendations for future multimodal menstrual trackers.

Figures (4)

• Figure 1: Participants engaged with a diverse range of data collection methods that differed in their availability and the degree to which people recognized the connection between the corresponding data and their menstrual health. We use these two dimensions to differentiate conventional and unconventional menstrual health signals.
• Figure 2: The protocol that participants followed over the three-month data collection period. Participants engaged in a daily routine that involved using three devices and reflecting on their experiences with a daily diary. Every other week, researchers interviewed participants to review their progress and experiences.
• Figure 3: (left) Fitbit's companion smartphone app page for examining trends in heart rate. The app has a separate page for each data stream to support in-depth analysis of a specific signal. (middle) Dexcom's companion smartphone app shows statistics of the user's glucose level over a selected timeframe. (right) Mira's companion smartphone app shows the user's LH and E3G levels over time. At the bottom, the app provides predictions for the start and end dates of different menstrual phases (ovulation in pink, menstruation in blue).
• Figure 4: By interacting with hormone data, participants expanded their purview of the menstrual cycle beyond menstruation. They discovered that fluctuations in passively tracked signals aligned with these other phases, leading them to identify events and trends that may be linked with other menstrual phases or their cycle as a whole. This motivated participants to log more self-reported data to better understand observed symptoms.