More than blood: app-tracking reveals variability in heavy menstrual bleeding construct
Abstract Background Heavy menstrual bleeding (HMB) is associated with impaired quality of life and may signal serious health problems. Unresolved challenges in measuring menstrual bleeding and identifying HMB have hampered research and clinical care. Self-reported bleeding histories are commonly use...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | BMC Women's Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12905-023-02312-4 |
| _version_ | 1797836272014721024 |
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| author | Amanda A. Shea Fiorella Wever Cécile Ventola Jonathan Thornburg Virginia J. Vitzthum |
| author_facet | Amanda A. Shea Fiorella Wever Cécile Ventola Jonathan Thornburg Virginia J. Vitzthum |
| author_sort | Amanda A. Shea |
| collection | DOAJ |
| description | Abstract Background Heavy menstrual bleeding (HMB) is associated with impaired quality of life and may signal serious health problems. Unresolved challenges in measuring menstrual bleeding and identifying HMB have hampered research and clinical care. Self-reported bleeding histories are commonly used but these may be influenced by recall bias, personal beliefs regarding “normal” flow volume, and the experience of other physical symptoms or disruptions to daily life. The potential usefulness of menstrual-tracking mobile applications, which allow real-time user-entered data recording, for assessing HMB has not been studied. We evaluated recall bias in reported period duration, the relationship of tracked period duration and daily flow volume to subsequently reported period heaviness, variation in quality of life associated with increasing period heaviness, and the advantages and limitations of using app-tracked data for clinical and research purposes. Methods An online questionnaire was distributed to current users of Clue, a commercially available menstrual health tracking app, asking them to characterize their last period. We compared responses to the user’s corresponding Clue app-tracked data. The study sample comprised 6546 U.S.-based users (aged 18–45 years). Results Increasing reported heaviness was associated with increasing app-tracked period length and days of heavy flow, impaired quality-of-life (especially body pain severity), and disrupted activities. Of those reporting having had a heavy/very heavy period, ~ 18% had not tracked any heavy flow, but their period length and quality-of-life indicators were similar to those who had tracked heavy flow. Sexual/romantic activities were the most affected across all flow volumes. Compared to app-tracked data, 44% recalled their exact period length; 83% recalled within ± 1 day. Overestimation was more common than underestimation. However, those with longer app-tracked periods were more likely to underestimate period length by ≥ 2 days, a pattern which could contribute to under-diagnosis of HMB. Conclusion Period heaviness is a complex construct that encapsulates flow volume and, for many, several other bleeding-associated experiences (period length, bodily impairments, disruptions of daily activities). Even very precise flow volume assessments cannot capture the multi-faceted nature of HMB as experienced by the individual. Real-time app-tracking facilitates quick daily recording of several aspects of bleeding-associated experiences. This more reliable and detailed characterization of bleeding patterns and experiences can potentially increase understanding of menstrual bleeding variability and, if needed, help to guide treatment. |
| first_indexed | 2024-04-09T15:06:09Z |
| format | Article |
| id | doaj.art-456d90fbb7d445d6ba0c728847db9058 |
| institution | Directory Open Access Journal |
| issn | 1472-6874 |
| language | English |
| last_indexed | 2024-04-09T15:06:09Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Women's Health |
| spelling | doaj.art-456d90fbb7d445d6ba0c728847db90582023-04-30T11:26:59ZengBMCBMC Women's Health1472-68742023-04-0123111310.1186/s12905-023-02312-4More than blood: app-tracking reveals variability in heavy menstrual bleeding constructAmanda A. Shea0Fiorella Wever1Cécile Ventola2Jonathan Thornburg3Virginia J. Vitzthum4Clue by BioWink GmbHUniversity of AmsterdamClue by BioWink GmbHIndiana UniversityIndiana UniversityAbstract Background Heavy menstrual bleeding (HMB) is associated with impaired quality of life and may signal serious health problems. Unresolved challenges in measuring menstrual bleeding and identifying HMB have hampered research and clinical care. Self-reported bleeding histories are commonly used but these may be influenced by recall bias, personal beliefs regarding “normal” flow volume, and the experience of other physical symptoms or disruptions to daily life. The potential usefulness of menstrual-tracking mobile applications, which allow real-time user-entered data recording, for assessing HMB has not been studied. We evaluated recall bias in reported period duration, the relationship of tracked period duration and daily flow volume to subsequently reported period heaviness, variation in quality of life associated with increasing period heaviness, and the advantages and limitations of using app-tracked data for clinical and research purposes. Methods An online questionnaire was distributed to current users of Clue, a commercially available menstrual health tracking app, asking them to characterize their last period. We compared responses to the user’s corresponding Clue app-tracked data. The study sample comprised 6546 U.S.-based users (aged 18–45 years). Results Increasing reported heaviness was associated with increasing app-tracked period length and days of heavy flow, impaired quality-of-life (especially body pain severity), and disrupted activities. Of those reporting having had a heavy/very heavy period, ~ 18% had not tracked any heavy flow, but their period length and quality-of-life indicators were similar to those who had tracked heavy flow. Sexual/romantic activities were the most affected across all flow volumes. Compared to app-tracked data, 44% recalled their exact period length; 83% recalled within ± 1 day. Overestimation was more common than underestimation. However, those with longer app-tracked periods were more likely to underestimate period length by ≥ 2 days, a pattern which could contribute to under-diagnosis of HMB. Conclusion Period heaviness is a complex construct that encapsulates flow volume and, for many, several other bleeding-associated experiences (period length, bodily impairments, disruptions of daily activities). Even very precise flow volume assessments cannot capture the multi-faceted nature of HMB as experienced by the individual. Real-time app-tracking facilitates quick daily recording of several aspects of bleeding-associated experiences. This more reliable and detailed characterization of bleeding patterns and experiences can potentially increase understanding of menstrual bleeding variability and, if needed, help to guide treatment.https://doi.org/10.1186/s12905-023-02312-4Heavy menstrual bleedingPeriod heavinessMenstrual healthPeriod trackingMobile applicationMhealth |
| spellingShingle | Amanda A. Shea Fiorella Wever Cécile Ventola Jonathan Thornburg Virginia J. Vitzthum More than blood: app-tracking reveals variability in heavy menstrual bleeding construct BMC Women's Health Heavy menstrual bleeding Period heaviness Menstrual health Period tracking Mobile application Mhealth |
| title | More than blood: app-tracking reveals variability in heavy menstrual bleeding construct |
| title_full | More than blood: app-tracking reveals variability in heavy menstrual bleeding construct |
| title_fullStr | More than blood: app-tracking reveals variability in heavy menstrual bleeding construct |
| title_full_unstemmed | More than blood: app-tracking reveals variability in heavy menstrual bleeding construct |
| title_short | More than blood: app-tracking reveals variability in heavy menstrual bleeding construct |
| title_sort | more than blood app tracking reveals variability in heavy menstrual bleeding construct |
| topic | Heavy menstrual bleeding Period heaviness Menstrual health Period tracking Mobile application Mhealth |
| url | https://doi.org/10.1186/s12905-023-02312-4 |
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