Updated: Oct 23
In this article you will understand the reasons for using a period tracker, the benefits of using a period tracker and the best period tracker apps available on the market in 2020.
Using a period tracker or menstrual cycle tracker involves to describe noting down and reviewing information about your:
Period (the time when you experience a vaginal bleed) and associated events or symptoms.
Menstrual cycle (which includes your period plus the days after your period between your next bleed. The period signals the start of your menstrual cycle) and associated events or symptoms.
Period tracking can be done using a menstrual cycle planner, by writing on pieces of paper, using a journal, a spreadsheet or mobile app; whatever suits you best.
Since Your Trusted Squad focuses on using Tech for Health, I will be focusing on Mobile apps in this article.
The main take home message is that Period Tracking help you understand your menstrual and reproductive health which is empowering. Period tracking alone isn’t quite enough; you will also require general knowledge about how the reproductive system works, the common issues and problems to look out for and how to manage them.
This article is intended for you if you menstruate or if you know people who menstruate.
Yes, it’s another article which everyone should read. Why is that?
For starters, periods almost affect everyone!
Periods affect you
· If you have them (of course!)
· If you have a partner who has periods.
· If you have a child who has periods.
· If you live with someone who has periods.
Your child may be experiencing pain during menstruation or be confused as to what's happening with their body, your partner may have a heavy flow and want to avoid sex when they are bleeding, your lovely friend may have bled on the dining chair in your home (yes, these things happen).
Considering how many people have them, which is a considerable percentage of the population, it’s sad that people feel uncomfortable talking openly about them.
If you do not have periods, please share this article with someone you know who does.
Over the last 15 years I have seen patients in sexual health clinics, family planning clinics, antenatal and postnatal, gynaecology clinics and wards and in General Practice. So many of the patients I’ve seen have been unaware of how their bodies work.
These people may include your friends, your children, your colleagues and many do not openly discuss any problems they may be experiencing.
So, please help them by encouraging them to use tools that can help them become better informed so they can understand their bodies better, use self-care appropriately and seek help when they need it.
Benefits of period tracking
Period and Menstrual cycle tracking can be used to:
1. Better understand your period, menstrual cycle and associated symptoms. Additionally, entering information into a menstrual calendar can help estimate when your next period is due.
2. To gain information on the reproductive aspects of your cycle. Period tracking can provide an estimate of the most ‘fertile’ time during your cycle. This estimated fertile time covers the number of days that you are most likely to ovulate and therefore have the higher chances of conception if you have sexual intercourse during this time.
Knowing your most fertile time of your menstrual cycle can be used to help guide people who are trying to conceive and become pregnant. This information can also be used to minimise risks of or prevent pregnancy e.g. for natural birth control methods or in calculations by healthcare professionals for choosing most appropriate emergency contraception etc.
Before you start; decide on the reason why you are tracking your period so that you can ensure you use the right type of period tracker and collect the right information
Why is tracking your menstrual cycle important?
By tracking your menstrual cycle, you will get to understand your own menstrual cycle. You will:
Understand what is normal for you e.g. The number of days of your menstrual cycle, the variability of the cycle length, symptoms you may experience regularly e.g. pain on day 1 of the cycle.
Be able to identify when things are different or unusual i.e. random changes, occasional changes or persistent changes that require attention and medical advice.
Be able to estimate when your next period is due to start. This can be useful knowledge for when you want to arrange trips, events, start contraception, know if you’ve missed a period and may be pregnant.
Share relevant information to a healthcare professional. If you consult with a doctor for a sexual or reproductive issue, because you are pregnant or because you have abdominal or pelvic pain they will ask for the date of ‘first day’ of your most recent period and will either calculate whether you could be pregnant or, if you are already pregnant, calculate the duration of your current pregnancy.
Identify if there is a problem at an earlier stage that you would have if you hadn’t been keeping a menstrual cycle diary. Knowing about your menstrual cycle PLUS having knowledge about the menstrual and reproductive cycle, which can be gained from books or podcasts, will help you manage your cycle and identify worrying or concerning symptoms that require consultation with your Doctor (Family Physician/GP, Family planning Doctor or Gynaecologist).
For this reason, I recommend* reading ‘The Gynae Geek’ by Dr Anita Mitra, for a really good, simple to read overview of, what she calls ‘Down there’ healthcare. In her book Dr Mitra covers anatomy of the female reproductive organs and genital region, how the menstrual cycle is regulated by hormones and information about periods, sexual health and fertility.
I also recommend* the book Fix your period by Nicole Jardim which is also easy to read. I would read this alongside or before you start tracking your menstrual cycle to get a good understanding of your menstrual cycle and how dietary and lifestyle changes can improve your menstrual health.
I have struggled with endometriosis for years and making lifestyle and dietary changes has helped my fatigue, pain and general wellbeing. I made these changes after consulting with a Functional Medicine Practitioner but most of these dietary and lifestyle changes are written in this book so starting with this first is a more affordable option.
Knowing and understanding how your own body works can be so empowering. It can give you confidence to speak up and get help especially when you know something is wrong.
I want to emphasise how helpful it is to have any symptoms and events you are experiencing documented on paper or via app especially if you are having concerns and want to get medical advice from a healthcare professional.
Unless you have superb memory, you won’t remember exactly how often last month you had the bloating symptom, the tiredness, the pain and the date your last period started/ended unless it’s noted down somewhere. You won’t be able to recall the patterns over months or even years.
Tracking your period should be done over a period of time. Depending on the reasons why you are doing it, the minimum period of time tracking will should be done over a 3 to 6 month period.
However tracking can become part of your routine lifestyle habits and can be done over a number of years.
In adolescents whose periods have just started, the menstrual cycle can take a number of years to develop a patter but it’s a good time to get started in the habit of tracking and exploring the body.
Keeping a menstrual cycle diary tracking in adolescence can help identify whether there are any problems that need to be reviewed by a healthcare professional.
To really understand your period and menstrual cycle it will take time. So, start slowly with small steps and build your confidence and knowledge.
Information you can collect for monitoring your menstrual cycle
Tracking for Health
· Period start date – note the start of your period (the first day you experience a proper blood flow which is day 1 of your cycle)
· Period flow-is the flow light, moderate, heavy
· Each day that you that you bleed – this is the length of your period
· The length of your whole menstrual cycle- this covers the time from day 1 of your period right until the last day before your next period starts.
· Any additional bleeding outside of your period e.g. spotting before, at the end of, after your period, during the cycle
· Any additional symptoms during your menstrual cycle such as
Pain or cramping in your lower abdomen/pelvic area
Pain or cramping in the rest of your abdomen
Migraines with or without visual changes
Change in libido
With time, tracking your menstrual cycle becomes habit and a natural part of your routine. You will understand if you do or do not experience pain around the time you ovulate. You will know if you have premenstrual symptoms and be able to take measures to improve or relieve your symptoms.
Polycystic Ovarian Syndrome (PCOS), Endometriosis, Menstrual migraines, Perimenopause and Menopause can be detected at early stages by menstrual cycle tracking and discussing your symptoms with a GP or Gynaecologist.
Tracking for fertility or contraception
If you are tracking your menstrual cycle as a mode of contraception using Fertility Awareness based Methods or to understand when you ovulate if you are trying to conceive, you will also check one or more of below:
· Your temperature in the morning
· The consistency of cervical mucus
· The position of your cervix
Again, the more you get familiar with examining yourself, the more used you become to checking what is normal for you. You can receive teaching and support on Fertility Awareness Methods from a specialist teacher in Fertility Awareness so you can gain confidence and have the opportunity to ask questions .
Period tracker apps
A Period tracker app or menstrual app is mobile app used for the purpose of tracking the menstrual cycle.
"Menstrual apps commonly offer three main functions
1) the tracking of menstrual cycle-associated factors such as mood swings, pain, sleeping patterns, intake of medication and contraceptives, sex life, vaginal discharge, food cravings and exercise
2) a menstrual calendar where period and ovulation dates as well as days on which additional data have been entered by users are highlighted in specific ways
3) an analysis screen with graphs, tables or numerical depictions that provide users with statistical information such as average cycle lengths or changes in body weight, mood, body temperature etc.
A few menstrual apps offer access to online forums, some provide medical information via links and pop-up windows, and several facilitate user interaction with healthcare professionals, other users or their intimate partners."
Levy and Romo-Avilés, September 2019
Why use a period tracker app
In addition to the benefits found earlier in the article, within the section ‘Why is tracking your menstrual cycle important?’
1. Your phone is almost always with you and therefore the data will be available and easily accessible. This can be handy if you have to unexpectedly see a doctor or if you visit the doctor but forget your diary at home or don’t carry your menstrual cycle planner with you.
2. The app can help predict and alert you as to when your next period is due to start.
3. With the right consents, your data can be used to gain greater understanding of womxns health and can be used for research purposes to which can help develop better treatments and products.
4. Most are easy to use and easy to review the information. This is particularly useful if you are experiencing problems because you easily can look back at previous data and compare.
5. With the right app it’s easy to enter information and you can receive reminders.
Highest rated period tracker apps
The apps below have been reviewed by Orcha, the UK based organisation that specialises in the evaluation of health apps using a comprehensive review process. The apps were found under the 'Period tracking' category.
Orcha provide a total score as well as providing scores based on three domains; data privacy, clinical assurance and user experience.
Scores of 65% or more fall within the Green and satisfactory category, scores of 45-65% fall within the Amber category with advice to the developers to make improvements.
Scores under 45% fall within the Red Category and are deemed to require immediate attention as they could be unhelpful or unsafe.
Orcha’s reviews are independent and they do not charge for their reviews.
The best overall period tracking app: Natural Cycles
£6.99 GBP/Month. Thermometer not included so you will need to buy one.
£49.99 GBP/Year which includes a free thermometer.
Natural Cycles received the highest total score by a considerable distance with an Orcha score of 88%. The app was last reviewed by Orcha in May 2020.
This app has been designed to be a form of natural and hormone-free contraceptive using fertility awareness principles.
It is the only app in this article to have received regulatory approval to be a software medical device. This means the company has had to submit evidence to the Medicines and Healthcare Products Regulatory Agency (MHRA) and US Food and Drug Administration (FDA) respectively, to support that the contraceptive device is effective and safe. As a result of the approval the app is CE marked and FDA approved as a contraceptive method in Europe and the US respectively.
Natural Cycles state that outside of the USA and Europe the app can be used as a fertility tracker but not as a contraceptive method. The app can also be used as a period tracker for health, predicting your menses, symptoms of PMS (Pre Menstrual Syndrome) and highest fertile time in your cycle.
A screenshot of Orcha’s feedback on data privacy for Natural Cycles has been included below. Natural cycles received a score of 68.6% for the Android app and 68.4% for iOS version.
*Advice on how to protect your data can be found in the information resources section at the end of the article*
Clue Plus requires subscription- Prices in the UK vary from GBP 0.99 for one month to GBP £40 for the year. Unfortunately, the pricing wasn’t very clear on their website, the App store or Google Play.
Clue strongly emphasises its strengths as an easy to use app for period tracking for understanding your menstrual and general health. The app offers predictions and reminders for PMS symptoms due in your cycle, as well as when you are estimated to ovulate. You can also set reminders to take your contraceptive medication. The iOS app integrates with Health App and is available on Apple Watch.
Clue is not to be used for contraception or to help increase your chances of becoming pregnant therefore it is not classified as a software medical device and does not require regulatory approval (it does not require CE marking or FDA approval).
Orcha, who last reviewed the app in June 2020, gave the Android app total scores of 68% and the iOS version 65%. Therefore the app was at the border of the satisfactory level.
Reasons given for the lower scores were related to Clinical Assurance stating there was lack of evidence or clarity provided on the ongoing quality assurance of the app from a relevant healthcare professional and that it wasn’t clear whether the app had been involved in any testing to demonstrate its ‘real world’ effectiveness or end user testing as part of its design and development.
Clue is not intended for use as a contraceptive method or to improve chances of pregnancy, therefore it is not classified as a Medical Device and does not require regulatory approval (it does not require CE marking or FDA approval).
A screenshot of Orcha’s feedback on Data privacy for Clue app has been included below. Clue received Data Privacy scores of 80.8% for their Android and 81.8% for the iOS app.
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