A search on any smart phone app store for menstruation, ovulation, or fertility trackers results in hundreds of choices of free or low-cost apps. Similarly, an Internet search results in thousands of commercial, review, and blog sites about these apps. Yet, a MEDLINE literature search using MeSH terms: menstruation disturbances, fertility, and mobile applications, does not identify any publications about the actual use of phone apps in clinical practice; it only identifies publications about computer-based fertility tracking and issues in the development of phone apps (Fehring, Schneider, Raviele, Rodriguez, & Pruszynski, 2013; Uddin, 2013). How are healthcare providers, and particularly nurses, incorporating these popular women's health apps into practice?
The apps have lovely graphics designed to appeal to women and adolescents (pink is frequent) and app functions vary. Women can enter data about menstrual dates and amount of flow, menstrual cycle symptoms, emotions, pain, cervical mucus, basal body temperature (some have a thermometer that syncs with the phone app), and hormone test kit results, that all flow onto a calendar. Some apps provide options to enter custom notes. App software can process entered data to predict ovulation, the luteal phase, peak fertility, and pregnancy risk. The predictive modeling becomes more tailored to the women as she enters more cycle data. Women can enter dates of intercourse and on some apps track partners (choosing a separate icon for each partner). Some apps provide options to e-mail records to self or healthcare provider. Some apps trigger a reminder for anything from peak fertility, to time for a daily contraceptive pill, to time to change a tampon.
The promoted benefit of these apps is almost exclusively focused on fertility awareness. However in women's health, we value the menstrual history as more than just fertility planning. Menstrual history is a component of a comprehensive women's health assessment and is increasingly a variable in research on disease. Menstrual tracking contributes to assessments in conditions such as amenorrhea, dysmenorrhea, abnormal uterine bleeding, premenstrual syndrome, premenstrual dysphoric disorder, polycystic ovary syndrome, endometriosis, and anovulatory cycles.
These technology apps outpace clinical applications. Core nursing processes of assessment, documentation, and teaching need to incorporate these menstrual apps. Assessments need to incorporate patient-generated menstrual history data from the tracker tools. A menstrual-reproductive history (too often termed GYN history) has long been a standard part of a health history, but women are challenged to spontaneously recall data about even the last menstrual period on the health visit. Menstrual apps are user-friendly tools women can use to consistently record and recall menstrual data. Documentation of the health history is improved if the woman e-mails or shares the tracker data with her provider.
The questions women and teens ask in online chats and in women's magazines confirm misinformation about the menstrual cycle. Tracker data can be used to teach the physiology of the menstrual cycle and promote health literacy. What is a typical menstrual period like? Tracking can help women identify what is typical for them and what is not. When should a woman call a provider about changes? Is menstrual tracking effective for contraception? Women's health nurses should be familiar with apps in order to teach women about selecting among the many available apps. What functions are available on the app? How easy is it to enter data? What screens are user-friendly with effective data visualization?
Explore menstrual apps for smart phones, incorporate these tools in your nursing practice, and disseminate your work for other nurses.
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