How self-tracking and engagement with personalized health content shape self-reported menstrual health experiences in a women’s health app

How self-tracking and engagement with personalized health content shape self-reported menstrual health experiences in a women’s health app | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article How self-tracking and engagement with personalized health content shape self-reported menstrual health experiences in a women’s health app Davinny Sou, Magdalena Fuchs, Lakmal Meegahapola, Andreas Peintner, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7019879/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Menstrual health remains underrecognized and underserved in public health, despite its fundamental role in the overall well-being of nearly half the global population. Limited menstrual health literacy further contributes to suboptimal symptom management and awareness. While the growing adoption of menstrual health tracking apps offers promising opportunities to support symptom management and improve well-being, prior research has largely focused on cross-sectional analyses or self-tracking behaviors alone. However, empirical knowledge remains limited regarding how engagement with in-app health content – such as educational articles tailored to users’ self-tracked symptoms – relates to menstrual health experiences over time. To address this gap, we conducted a longitudinal observational study employing linear mixed-effects modeling to examine associations between users’ health tracking consistency, their interactions with personalized health content recommended via an artificial intelligence (AI)-based system, and their self-reported menstrual health experiences. We analyzed data from 2,015 menstruating individuals (aged 18–49 years) collected over five months via a women’s health app. Individuals who tracked their health more consistently across distinct months reported, on average, lower levels of negative menstrual health experiences (e.g., low energy) (β = -0.06, p bonferroni = 0.003, 95% CI [-0.08, -0.03]). However, individuals who engaged more frequently with personalized health content reported, on average, higher levels of positive menstrual health experiences (e.g., high energy) (β = 0.15, p bonferroni < 0.001, 95% CI [0.13, 0.18]). While our work offers important real-world insights, future work should leverage experimental designs or randomized controlled trials to establish which intervention components (e.g., personalized educational articles, consistent self-tracking) effectively support menstrual health and well-being at scale. Health sciences/Health care Health sciences/Medical research Full Text Additional Declarations Competing interest reported. D.S., M.F., T.K. and M.N. are affiliated with the Centre for Digital Health Interventions, a joint initiative of the Institute for Implementation Science in Health Care, University of Zurich, the Department of Management, Technology, and Economics at ETH Zurich, and the Institute of Technology Management and School of Medicine at the University of St.Gallen. Centre for Digital Health Interventions is funded in part by CSS, a Swiss health insurer, Mavie Next, an Austrian health insurer, and MTIP, a Swiss digital health investor. T.K. was also a cofounder of Pathmate Technologies, a university spin-off company that creates and delivers digital clinical pathways. M.F.’s research position is funded by CSS. However, neither CSS, Mavie Next, MTIP, nor Pathmate Technologies were involved in this research. O.I. is an unpaid medical and science advisor at femble GmbH. A.P. is employed by femble GmbH. L.M. and C.J. are affiliated with the Department of Health Science and Technology at ETH Zurich and the Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland. L.M.’s research is funded by the Swiss Personalized Health Network (SPHN) project IICU and the Novartis Foundation. However, neither SPHN nor the Novartis Foundation was involved in this particular research. Supplementary Files npjfemcysupplementalmaterial.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7019879","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":480021361,"identity":"5d083fe0-adc3-40d9-9381-854052dbbf02","order_by":0,"name":"Davinny Sou","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAr0lEQVRIiWNgGAWjYDCCA2DShoFBAkgxNhCvJY2Bh1Qth0nQwnf8jPGHj23n5eyl2x8w/NxBhBbJMzlmkjPbbhvzyBxIYOw9Q4QWgwNpacy8bbcTeyQSDjAzthGj5fyz5M+8befqeyQSG4jUciP5gDRv24EEHolkBuK0SN54fExyxrlkw54baQwHe4nRwnc+sfnDhzI7efYZ6Q8f/CRGCwo4QKqGUTAKRsEoGAU4AACFVjhngvDM6gAAAABJRU5ErkJggg==","orcid":"","institution":"ETH Zurich","correspondingAuthor":true,"prefix":"","firstName":"Davinny","middleName":"","lastName":"Sou","suffix":""},{"id":480021362,"identity":"74c58c89-aa66-4b73-9d86-2910e62f9585","order_by":1,"name":"Magdalena Fuchs","email":"","orcid":"","institution":"ETH Zurich","correspondingAuthor":false,"prefix":"","firstName":"Magdalena","middleName":"","lastName":"Fuchs","suffix":""},{"id":480021363,"identity":"dea9f64f-50d7-4d63-b841-090720288d43","order_by":2,"name":"Lakmal Meegahapola","email":"","orcid":"","institution":"ETH Zurich","correspondingAuthor":false,"prefix":"","firstName":"Lakmal","middleName":"","lastName":"Meegahapola","suffix":""},{"id":480021364,"identity":"e4afdc92-8f7e-4df5-9f7a-9d3b7f9717ba","order_by":3,"name":"Andreas Peintner","email":"","orcid":"","institution":"Universität Innsbruck","correspondingAuthor":false,"prefix":"","firstName":"Andreas","middleName":"","lastName":"Peintner","suffix":""},{"id":480021365,"identity":"f26ff5da-0f30-4642-8edf-1c0b9a28c553","order_by":4,"name":"Catherine R. 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D.S., M.F., T.K. and M.N. are affiliated with the Centre for Digital Health Interventions, a joint initiative of the Institute for Implementation Science in Health Care, University of Zurich, the Department of Management, Technology, and Economics at ETH Zurich, and the Institute of Technology Management and School of Medicine at the University of St.Gallen. Centre for Digital Health Interventions is funded in part by CSS, a Swiss health insurer, Mavie Next, an Austrian health insurer, and MTIP, a Swiss digital health investor. T.K. was also a cofounder of Pathmate Technologies, a university spin-off company that creates and delivers digital clinical pathways. M.F.’s research position is funded by CSS. However, neither CSS, Mavie Next, MTIP, nor Pathmate Technologies were involved in this research.\nO.I. is an unpaid medical and science advisor at femble GmbH. \nA.P. is employed by femble GmbH.\nL.M. and C.J. are affiliated with the Department of Health Science and Technology at ETH Zurich and the Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland. L.M.’s research is funded by the Swiss Personalized Health Network (SPHN) project IICU and the Novartis Foundation. However, neither SPHN nor the Novartis Foundation was involved in this particular research.","formattedTitle":"How self-tracking and engagement with personalized health content shape self-reported menstrual health experiences in a women’s health app","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7019879/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7019879/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eMenstrual health remains underrecognized and underserved in public health, despite its fundamental role in the overall well-being of nearly half the global population. Limited menstrual health literacy further contributes to suboptimal symptom management and awareness. While the growing adoption of menstrual health tracking apps offers promising opportunities to support symptom management and improve well-being, prior research has largely focused on cross-sectional analyses or self-tracking behaviors alone. However, empirical knowledge remains limited regarding how engagement with in-app health content \u0026ndash; such as educational articles tailored to users\u0026rsquo; self-tracked symptoms \u0026ndash; relates to menstrual health experiences over time.\u003c/p\u003e\u003cp\u003eTo address this gap, we conducted a longitudinal observational study employing linear mixed-effects modeling to examine associations between users\u0026rsquo; health tracking consistency, their interactions with personalized health content recommended via an artificial intelligence (AI)-based system, and their self-reported menstrual health experiences. We analyzed data from 2,015 menstruating individuals (aged 18\u0026ndash;49 years) collected over five months via a women\u0026rsquo;s health app. Individuals who tracked their health more consistently across distinct months reported, on average, lower levels of negative menstrual health experiences (e.g., low energy) (β = -0.06, \u003cem\u003ep\u003c/em\u003e\u003csub\u003e\u003cem\u003ebonferroni\u003c/em\u003e\u003c/sub\u003e = 0.003, 95% CI [-0.08, -0.03]). However, individuals who engaged more frequently with personalized health content reported, on average, higher levels of positive menstrual health experiences (e.g., high energy) (β\u0026thinsp;=\u0026thinsp;0.15, \u003cem\u003ep\u003c/em\u003e\u003csub\u003e\u003cem\u003ebonferroni\u003c/em\u003e\u003c/sub\u003e \u0026lt; 0.001, 95% CI [0.13, 0.18]). While our work offers important real-world insights, future work should leverage experimental designs or randomized controlled trials to establish which intervention components (e.g., personalized educational articles, consistent self-tracking) effectively support menstrual health and well-being at scale.\u003c/p\u003e","manuscriptTitle":"How self-tracking and engagement with personalized health content shape self-reported menstrual health experiences in a women’s health app","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-08 13:21:18","doi":"10.21203/rs.3.rs-7019879/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"19541498-649a-4080-bb9f-05167ac3bb92","owner":[],"postedDate":"July 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":50972048,"name":"Health sciences/Health care"},{"id":50972049,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2025-09-29T18:08:32+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-08 13:21:18","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7019879","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7019879","identity":"rs-7019879","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}