Period Neutrality
menstruation neutrality
Period Tracker Apps
OVERVIEW
Most period tracking apps have messaging that speaks to people that identify as cisgendered, heterosexual women. Period tracking apps also focus on fertility in a way that have led users to see them as “pro-pregnancy.” Is there a way to make language about periods and pregnancy more inclusive?
Clarifying health language and allowing users to opt-in and out of displays on their tracking charts will improve the experience for all users that track their periods.
ROLE
user research & experience design
PROJECT TYPE
case study - self-initiated
PROCESS
generative research
evaluative research
background
I have a background in WASH (water, sanitation, and hygiene), and over the years, I’ve thought about how we talk about menstruation. In international development work, hygiene projects were mostly focused in different countries where periods were heavily stigmatized. The focus was women and girls and ensuring access to hygiene products and private spaces to manage menstruation.
Even in the US, supporting period movements has been focused on cost and access. I’ve learned about eco- and cost-friendly pad products, encouraged people to donate menstrual hygiene products to shelters, and been vocal about supporting efforts to get rid of the period tax.
Those efforts were mostly focused on the product, but I wanted to think more about the experience of menstruation itself. So, I did what I always do - a keyword search on Twitter. I came across this tweet. (shared with permission)
That was really all I needed, and that tweet became the basis of my research. I wanted to find out:
Did people stop using period tracker apps because they were too heteronormative?
How good were period tracker apps at discussing fertility when the person had no chance or desire of getting pregnant?
What is the minimum viable product for people with periods to just store health data in an app?
process
discovery | exploratory research
lit review
To start, I spent a few days reading. I read:
what period tracking apps OB-GYNs liked, how fem tech wasn’t truly built for the female body, how period tracking apps have data sensitivity issues, how period tracking apps play on user’s anxiety, and a few personal stories about using period tracker apps for the first time.
survey
With all this in mind, I created a survey, and asked people who have or have had periods about their app preferences and motivations for using them (or not).
97 people with periods responded to the survey and were mostly between the ages of 18 and 34. Most people said they decided to start using a period tracker app because they had issues tracking their cycle in the past and an app made tracking convenient.
The two most commonly used period tracker apps were Clue and Flo.
Flo is “a smart and simple way to track your menstrual cycle. Flo is a women's period calculator that makes accurate and reliable predictions of menstruation, ovulation and fertile days using machine learning.”
Clue is developed by women and intends to be “scientific and straightforward.” It is currently, “the #1 doctor-recommended free period tracker app built in collaboration with top health researchers.”
I already use the Flo app. Here is how my cycle information is displayed there using the default theme setting.
Regular tracking day display on the Flo app
Ovulation day display on the Flo app
I downloaded Clue, and entered my information there as well. Here are the interface comparisons for the same days using the default theme setting. The UI for Clue is cleaner and more gender neutral.
Regular tracking day display on the Clue app
Fertile window display on the Clue app. The ovulation day is represented by the turquoise burst within the fertile window.
Both apps present the option to turn off the “fertile window” and “chance of getting pregnant” display.
Here is what the tracker looks like with those displays turned off.
In the Flo app, turning off the “chance of getting pregnant” option still leaves ovulation information.
In the Clue app, turning off the “fertile window” option leaves a blank space on the cycle chart, removing the fertile window and the ovulation day.
challenge
Showcasing ovulation + fertile windows only or none at all is a problem.
According to the American Pregnancy Association, ovulation is:
when a mature egg is released from the ovary, pushed down the fallopian tube, and is made available to be fertilized.
It makes sense to call this period a “fertile window”, and have ovulation days represented with another symbol, as ovulation doesn’t necessarily line up perfectly with peak fertility. The lack of custom options can be isolating for people that struggle with their gender identity or have no chance of getting pregnant due to sexual orientation.
Using period apps can elicit feelings as well. Most people said that tracking their period made them feel responsible, as entering data that they were able to reference was rewarding, while a good number said that they didn’t feel anything when tracking their period. Most of the respondents that didn’t have strong emotional responses to using an app were using the Clue app.
The people still using period tracking apps said they felt comforted using their period tracking apps because of the ability to match their PMS symptoms with stages in their cycle.
More feelings of anxiousness were felt by people that decided to stop using period apps. Despite these feelings, a lot of people also felt responsible using the applications. It is important to note that many people said they stopped using the apps because they had no desire to get pregnant or weren’t in sexual relationships at the moment.
Many people with periods cited other issues with period apps that made them discontinue use, including a lack of neutral messaging around pregnancy and gender bias.
goals
Create options to opt-in to certain ovulation and fertility messaging considering gender identity and sexuality.
design principle
preserve integrity of health information
user personas
The following three personas represent the user base for Clue and the Flo app.
Mia: identifies as a woman and just found out she is unexpectedly pregnant. She has been using period tracker apps for years, but finds the pregnancy messaging to be distressing.
Jordan: identifies as a heterosexual man and does not enjoy tracking his period, but he does it because it seems like the responsible thing to do. Seeing messages about pregnancy and fertility can be triggering.
Kelly: identifies as a heterosexual woman and sees menstruation as an experience that makes her feel feminine and in tune with her body.
Mia uses the Flo App.
Jordan uses the Clue app.
Kelly uses the Flo app.
user journey
I drafted a user flow to represent the people using period tracker apps, Clue and Flo.
heart: represents user Mia. She struggles with the pro-pregnancy messing on the app.
star: represents user Jordan. He seems to struggle with the definitions of ovulation and fertility and he doesn’t have the option to choose displaying one or the other.
triangle: represent user Kelly. She enjoys using the app for its feminine UI and user communities.
Clue onboarding selections
I decided to add to the onboarding experience for the Clue app, as their UI was the cleanest and the most preferred among participants. The app also struggles with how to represent ovulation and fertility leaving no information on the cycle chart at all if the “fertile window” is turned off.
Clue is currently working on a pregnancy mode, so the issues experienced with other period tracker apps and pregnancy were likely different with Clue, so I left that feature out of this design process.
An example of the current onboarding screen for Clue. When you click on the birth control link, it takes the user to a definition page.
An example of how words are defined in Clue.
A low fidelity sketch of how the ovulation opt in page would look.
A low fidelity sketch of what the ovulation definition page would look like.
A low fidelity sketch of how the fertile window opt in page would look.
A low fidelity sketch of how the fertile window definition page would look.
I added a window that would ask users about what information they preferred to see as well as definitions of ovulation and fertility during onboarding. I wanted to move the opt-in or opt-out option to the setup phase of using the app to provide more agency to the user on the front end.
I realized that some people said they didn’t want to track their periods using an app because they weren’t trying to get pregnant. While all period tracker apps do not recommend using them as a form of birth control, I think that heterosexual, cisgender women in sexual relationships that have periods would like having the option to see a rough estimation of their ovulation window. Clearly defining the terms this way is key.
I made the decision to not ask about gender and sexuality to influence display choices for many reasons.
Collecting sensitive identifying information is risky at a time where data breaches are frequent.
Assumptions about preferred display options given gender and sexuality may not be correct for many users.
Allowing users too many options on a health app might compromise the integrity of the health communication provided to users. It was important to make displays that were not subject to confusion.
testing
Providing more display options to choose from could be confusing and compromise the integrity of health communication, so I wanted to get feedback on how users felt about ovulation and fertility being represented this way.
How do you feel about being asked if you want to display ovulation or fertility information?
Is this confusing? Do you think you would have an idea of what option to select?
The people I shared the mockups with said that they felt the language was clear and they understood the selections. They felt informed about the display choices they were making. They did also want to have the option to opt in or out after onboarding, so that feature must also be added to the settings page.
This has the potential to reposition the app as an educational tool as well as a personal health tracker.
reflection
There were still people who were not properly represented in the solutions for this project. If given the opportunity, I think a series of focus group discussions would allow me to dig deeper into uncovering some of the challenges. A couple of users mentioned that entering data into the apps gave them satisfaction, and I would love to dig deeper to see if there were any health-related benefits for the user.
I don’t have any significant experience in graphic design, so a complete app redesign wasn’t going to be possible here. I don’t think a redesign would have been necessary. The additions to the onboarding process solved users issues and related to identity where messaging was the issue.
