Flo

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The Flo App is a period and cycle tracking mobile app for women that can be used on iOS and/ or Android devices.[1]. It is known for using AI to conduct some of the features on its app. The features include tracking period cycles, predict cycles, and discover cycle patterns. It’s kind of like an all in one platform for all reproductive health and menstrual needs.

The Flo App is a reproductive health mobile app for women that can be used on iOS and/ or Android devices.[2]. It is known for using AI to conduct some of the main features on the app and provide users with reproductive health information and education. The Flo app allows users to track their period cycles, predict cycles, and discover cycle patterns as well as help users with their reproductive or pregnancy goals. According to Flo, their goal with this app that personalizes the user experience, is to give women good resources and a community to learn from about reproductive health so they can prioritize their menstrual health.[3]. A lot of what users track is very private information such as how often they have sex, their sex drive, and symptoms from their periods such as vaginal discharge. A lot of Flo users have found that tracking their personal information allows them to understand their overall reproductive health better. The Flo App has faced controversy regarding ethical concerns with user privacy as well as accuracy with the information the app gives to its users. The Flo App has defended their action of sharing user data with other companies. Flo consists of a free version as well as a premium version. They have the options of a monthly and yearly subscription. [4].


History

The Flo App launched in April 2015. Since the beginning, Flo app has stated that the purpose of the Flo App is to give women resources for their menstrual health. The founders of the app are Dmitry and Yuri Gurski.[5]. Flo reached one million installs within June 2016. As of 2020, it’s stated that 15 million women got pregnant with the help of the Flo App. As of 2021, the results of a survey with American OB-GYNs showed that the Flo app is the #1 OB-GYN recommended period and cycle tracking application.[6].

There are multiple features that users can use on the Flo app. These include: the menstrual tracker, ovulation calculator (a tool that allows users to predict their fertile window), pregnancy calendar, lifestyle & fitness tracker, reminders (such as reminding a user to take their birth control pill), and a health report feature. [7]. Flo has added some features since its initial launch, this includes a community section for the users to ask and answer questions. Flo has also added features to help analyze if users have a medical issue based on things such as symptoms that occurred during their period. In 2018, Flo implemented an algorithm that analyzes user data and figures out whether or not users might have Polycystic Ovary Syndrome. This feature is called the PCOS Health Assistant. Flo users can also get assistance from professionals in the medical field if they have concerns about medical issues. Additionally, Flo has health articles reviewed by OB-GYNs that users can refer to when they need medical advice or if they are concerned about any period symptoms. This takes away time that users would spend looking for medical help online where there’s so many sources, and they have to go through all of them to find a reliable one.

Features If a user decides to purchase Flo premium, they have access to more features that relate to learning more about their reproductive health. With the premium version, users have the permission to look at all the video courses and expert content Flo has to offer. Additionally, users have access to a daily well-being plan. This feature gives users insights that will help with making their well-being better by tracking other patterns in the user’s body other than the user’s reproductive system. The premium version also allows users to have unlimited access to the Flo Health Assistant. The Flo Health Assistant allows users more opportunity to get more personalized information and help. Users can receive cycle reports from the Flo Health Assistant as well as chat with the Flo Health Assistant whenever they want. [8].


Cycle Predictions

For Flo to begin predicting the user’s next period and ovulation cycle, the user must provide the dates of their most recent period. The user can do this when they are first setting up their Flo account. Flo advises users to also add their periods for the last 12 months in order to have more accurate predictions. From this feature, users receive a daily cycle story which displays information about where they are during their period and symptoms they may have. Users can also see Flo’s fertility prediction for each day. This allows users to see what are the days in the month that they are most likely to get pregnant, and can help users with the goal of getting pregnant or not getting pregnant achieve their goal. [9].

Symptom Logging

Flo allows users to log their symptoms every day. These symptoms can consist of symptoms that a user experiences during their menstrual cycle, ovulation cycle, contraceptive use, or birth control use. The purpose of logging symptoms is for Flo to analyze the symptoms and observe how a user’s cycles, contraceptives, or birth control methods may have affected their symptoms. Additionally, if Flo identifies concerns within some of the user’s symptoms, the user can see if it’s something they should look further into by consulting a doctor. By logging symptoms, the user can track how their body feels over time and adjust their lifestyles accordingly so they can feel the healthiest. [10].

Reminders The custom reminders are one of the personalization functions of Flo. The user can make reminders for themselves based on their own personal goals or interests. This consists of reminders such as contraceptive reminders, birth control reminders, and when reminders for when a user’s next menstrual cycle is predicted to start. The purpose of birth control reminders is to help user’s remember what time and date to take their birth control. [11].


Secret Chats

Secret Chats is a resource for users to share their personal experiences as well as read about experiences from other users. Users can remain anonymous when posting anything including comments or questions. Secret Chats provides the opportunity for users to learn about reproductive health through the perspectives of many other women. The content posted on Secret Chats must follow the Secret Chat Rules. [12].

Follow my Pregnancy

The Follow my Pregnancy feature allows pregnant users to learn more about their pregnancy and understand each stage of their personal pregnancy journey. Resources include insights into what physical symptoms to expect during each day of the pregnancy journey as well as information on details about the baby and gestational stage calculation. A picture of what the baby is predicted or expected to physically look like is depicted for each day respectively. [13].


Collaborations

Flo has had collaborations and partnerships with multiple universities. Researchers from the University of Adelaide, Jessica Grieger and Robert Norman, had a collaboration with Flo on a study that analyzes how lifestyle and demographic factors affect menstrual cycles based on data from 1.5 million Flo users. [14]. They even have their research articles medically reviewed by OB-GYN professionals. They found that the older a user got, their menstrual cycle typically shortened and the average menstrual cycle is around 28 days [15]. Additionally they found that BMI is unlikely to be the major factor for irregularities in a menstrual cycle. Stress and age were found to be the main contributors to affecting how long a person’s menstrual cycle is. Weight and drinking/ smoking habits were found to not be much of a contributor compared to stress and age [16].

Flo conducted another study with Northwestern University. They found that the three main signs as risk factors of PCOS were hirsutism, high blood glucose, and high levels of both cholesterol and glucose [17].

Ethical Concerns

Privacy Concerns A big controversy that Flo has faced is that the public found out that user information has been sent to platforms such as Facebook from Flo without users’ knowledge and permission. [18]. The information the user tells the Flo app can be very personal and private. This brings up the concern that users’ private information regarding the history of their reproductive health will be exposed to the public. There’s concerns that users will feel violated or anxious that this private information has been shared outside the Flo app. The Federal Trade Commission filed a complaint against Flo for their actions of sharing user information to other companies that have functions such as advertising. Flo expressed that the user information they shared was not utilized for advertising purposes. [19]. This raises user concerns on whether or not the app is being beneficial to its target audience, women. In the end, Flo settled the Federal Trade Commision charges. Flo expressed that the user information they shared would ultimately benefit the users experience on the app. [20].


There are arguments that although the sensitive data could have privacy concerns, there is also a huge opportunity of this data being used for beneficial research purposes and understanding the health of women.[21]. Within healthcare, there has not been a lot of research focused on improving women’s health. Since the Flo app has been created, there have been multiple studies done using information from Flo to understand women's health issues, their symptoms, and patterns. There was a study done using the Flo app to understand more about PCOS.[22].

The Flo app can be labeled as a Femtech technology. Some express that Femtech promotes itself as technology that prioritizes women empowerment, but there aspects of this technology that aren’t empowering.[23]. Women’s data being shared without their consent is an example of taking away power from the woman rather than giving the woman power.

Accuracy

There have been some users who have expressed concern over the information given to them by Flo, as they believe they received an incorrect diagnosis or overdiagnosis. There is one instance in 2019 where a user was told by Flo that they have a possibility of having PCOS when in reality her symptoms were most likely caused by other factors. [24]. Medical professionals have not reached a solid agreement on if users should have complete faith in the advice given to them by health apps. In the PCOS questionnaire on the Flo app, if Flo states that the user’s symptoms may be concerning, the Flo app recommends users to consult a medical professional for further information.


References

  1. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  2. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  3. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  4. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  5. McShane, Julianne (2021, January 15). More than 100 million women use Flo, a period-tracking app. here's why some are deleting it. The Lily Retrieved February 11, 2022, from https://www.thelily.com/more-than-100-million-women-use-flo-a-period-tracking-app-heres-why-some-are-deleting-it/
  6. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  7. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  8. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  9. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  10. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  11. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  12. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  13. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  14. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  15. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  16. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  17. Flo - Ovulation Calendar, period tracker, and Pregnancy App. Flo.health - #1 mobile product for women's health. (n.d.). Retrieved January 28, 2022, from https://flo.health/
  18. Schechner, Sam and Secada, Mark. (2019, Feb 22) You Give Apps Sensitive Personal Information. Then They Tell Facebook The Wall Street Journal, Dow JOnes & Company, https://www.wsj.com/articles/you-give-apps-sensitive-personal-information-then-they-tell-facebook-11550851636
  19. Gupta, Alisha. Singer, Natasha. (2018, January 28) Your app knows you got your period. Guess who it told? The New York Times https://www.nytimes.com/2021/01/28/us/period-apps-health-technology-women-privacy.html
  20. Gupta, Alisha. Singer, Natasha. (2018, January 28) Your app knows you got your period. Guess who it told? The New York Times https://www.nytimes.com/2021/01/28/us/period-apps-health-technology-women-privacy.html
  21. Gupta, Alisha. Singer, Natasha. (2018, January 28) Your app knows you got your period. Guess who it told? The New York Times https://www.nytimes.com/2021/01/28/us/period-apps-health-technology-women-privacy.html
  22. Jain, T., Negris, O., Brown, D. et al. (2021) Characterization of polycystic ovary syndrome among Flo app users around the world. Reprod Biol Endocrinol 19, 36 . https://doi.org/10.1186/s12958-021-00719-y
  23. Gilman, Michele. (2021) Periods for profit and the rise of menstrual surveillance. Columbia Journal of Gender and Law. https://heinonline.org/HOL/LandingPage?handle=hein.journals/coljgl41&div=13&id=&page=
  24. Singer, Natasha. (2019, October 27) Period-Tracking Apps say you may have a disorder. What if they’re wrong? The New York Times https://www.nytimes.com/2019/10/27/technology/personaltech/health-apps-hormonal-disorder-pcos.html