When You Should (And Shouldn't) Use Apple's Cycle Tracking Feature
This week iOS 13 and Apple Watch 5 were released, and with it lots of exciting new features for Apple users including menstrual cycle tracking in the Health app. All Apple users now have access to this tracking app, enabling them to input the dates and details of menstrual bleeding, cervical fluid observations, OPK results, BBT and physical symptoms throughout their cycle. Users can enable or disable the prediction features for both their next period and likely fertile window.
Exciting? Yes, but...
While it will be an awesome awareness raising tool because of it's widespread reach and undoubtedly encourage more people to dive into cycle tracking, it is important not to overestimate the capacity of this app to accurately predict your fertile window.
Our bodies are so complex and responsive to life events. You cannot predict ovulation based on past cycles. Full stop. Many FemTech apps used algorithms that are basically glorified versions of the rhythm method, dressed up with twenty-first century technology.
Cycle over cycle, women will often see patterns emerging but these can be thrown off in any given cycle by factors like positive or negative stressors (travel, exams, moving, wedding planning, grief etc), diet and lifestyle changes, supplements, medications and more.
Don’t expect any period tracker app to take these factors into account yet. It is so important that their limitations be recognized and women learn the science behind Fertility Awareness Based Methods (FABM) if they are looking to pinpoint ovulation and predict their next period.
There are lots of great resources to help you do this, but for those serious about learning how the body works, it’s always best to work with a trained FABM instructor who can teach you a studied and reliable method, like Billings, Marquette, Symptothermal or Creighton. Learning an evidence-based FABM eliminates the need for predictions of any sort. You’ll be able to understand for yourself what you’re seeing and know what it means.
So, who should consider using it and who should not?
Apple Health’s menstrual cycle tracking feature may be a good fit for you if:
You're a FABM user with paper chart and want a free digital back-up for your data
You are interested in sharing your cycle data with Apple as part of what will likely become the largest medical study on menstrual cycles to date
You want a free period tracker to record menstruation and general health information for yourself and your medical team
Don’t use the cycle tracking feature as your only or primary method of cycle tracking if:
You are interested in tracking to achieve or avoid pregnancy;
You need accurate predictions, especially with reference to your fertile window;
You are on an infertility journey and want to understand your cycles better (again, learn Creighton!);
You don’t already own Apple technology...if you don’t have an iPhone or Apple Watch, don’t invest in one specifically for this feature. Your money would be better spent learning a FABM alongside a trained instructor; or
You are postpartum, annovulatory or pre-menopausal.
I will be the first to say that I love Apple technology and am excited to see them spreading the word about the importance of viewing the menstrual and ovulation cycle as a vital sign. I hope that their research helps to further normalize menstrual health advocacy and FABMs, and to educate medical professionals about the opportunities for using this data for health monitoring, to time medical tests and inform diagnoses.
So, explore the app, but please don’t put your trust in it (or any other app that makes predictions) especially if you’re trying to conceive or avoid a pregnancy. In fact, Apple themselves advise users not to use the app as birth control.
Their aim at present is two-fold: first, to provide menstruators with a built-in tracking system to monitor changes to their cycle and catalyze conversations with their personal care providers and secondly, to collect data. Apple will be embarking on a large research study on the menstrual cycle in partnership with Harvard School of Public Health and the NIH (Apple Keynote September 2019 0:34:18). Starting later this fall, users will be able to opt into the research project through the Apple Research app, giving the company permission to use their encrypted data as part of this large scale study. Your menstrual health information will be encrypted and would not be traceable back to you. To date, that’s all the info made available to the public.
The Bottom Line
I'm excited that Apple is finally jumping on-board the cycle tracking train and making all the features in Health free. There is a huge opportunity here to educate women about the importance of ovulation and normalize charting and menstrual health education.
And once you start tracking and get excited about this stuff, plan to connect with a FABM instructor who can teach you how to interpret your bio markers and really use the data to achieve or avoid pregnancy and monitor your health!
Are you a Creighton Model user who wants to contribute your data to research? Talk to your FCP about ongoing research projects through the Saint Paul VI Institute! The Institute is particularly interested in pregnancy charts for an ongoing research project, so if you’re expecting, consider continuing your charting routine and submitting your chart to further Creighton Model research efforts.