Fertility awareness based contraceptive apps: a case study in the digital age

Background Fertility awareness based (FAB) contraceptive mobile applications (apps) rely on women logging their menstrual cycle data to predict non-fertile days. Paid social media advertisements for these apps have led to hundreds of thousands of downloads. This rapidly expanding market lacks quality assurance, reflective of wider issues surrounding innovation versus regulation of digital health interventions.

Aim To present the results of a literature review carried out to bring together data on FAB contraceptive apps, to better understand the validity of evidence for their use as contraceptive methods. This is combined with context on the climate of advertising and regulation, to illustrate the challenges of innovation in the digital age.

Method Databases Medline and Embase were searched according to the strategy: ‘fertility-based awareness AND app^*’. Eight articles were included in the final thematic analysis.

Results This study found apps being used for contraception that were not developed for this purpose; apps inaccurately reporting reliability for preventing pregnancy; there is a need for further training for women using FAB contraceptive apps; and there are limitations of current evidence base and challenges to improving this. In the context of poor regulation and advertising loop holes there is significant risk of misleading users of FAB contraceptive apps.

Conclusion The limited evidence on FAB contraceptive apps should be applied to the public with caution. Incongruities between women’s understanding and expectations of FAB apps compared to reality demonstrate the need for robust regulation around paid advertising, issues echoed elsewhere with other digital health interventions.