Article: Thursday, 29 May 2025
In a striking example of interdisciplinary research innovation, two PhD candidates collaborated to address ethical concerns about algorithm-driven period and fertility tracking technologies and attracted widespread media attention. Maria Carmen Punzi and Tamara Thuis from Rotterdam School of Management, Erasmus University (RSM) carefully examined and described period-tracking technologies that they say could do more to empower rather than discriminate against users if ethical risks are taken seriously. They mapped a way forward for more research and outlined what this means for technology companies. Their paper Mapping ethical concerns in algorithm-driven period and fertility tracking technologies reveals complexities that go beyond the usual privacy issues – these include the biases and societal influences that affect the quality of advice from algorithms. The research has been published in the reproductive health journal Contraception and their work has been featured in the Netherlands’ AD newspaper.
Algorithm-driven period and fertility tracking apps provide an alternative to hormonal birth control and provide insights about menstrual cycles. The debate around period-tracking apps tends to stick to data privacy and falls into two extreme camps: social media influencers promoting them as perfect hormone-free alternatives to birth control, or critics blaming women for ‘naively trusting’ technology when unplanned pregnancies occur. The researchers noticed these conversations lacked nuance and failed to address the role of the organisations creating the apps.
“We found it striking that the media focused their attention on the societal and individual consequences when the algorithm fails – like more unwanted pregnancies, abortions, and potential misuse of users’ data in locations where reproductive rights are restricted. There was not so much attention paid to the organisations developing and implementing the algorithms and the apps”
“As passionate and engaged researchers in the fields of menstrual health and AI ethics in organisations, we felt a strong drive to combine our fields of expertise and engage in this conversation.”
Maria Carmen and Tamara identified, mapped and analysed ethical concerns in period and fertility tracking technologies driven by algorithms.
In the article in AD, the researchers point out that app predictions are based on averages and not users’ own cycles and that an app can never really know what’s going on in your body; cycles change with age, with stress or through pregnancy. Natural variations can be interpreted as abnormalities by the apps, and these interpretations can cause uncertainty for the user.
They had three concerns about the evidence used by the apps to generate recommendations:
Recommendations are based on uncertain, incomplete or probable information
Lack of transparency about how and what type of input data is used
Potential biases in the input data reflecting tracking behaviors or societal, historical patterns
And two concerns about how recommendations from the apps affect behaviour:
Outcomes can generate particular risks for marginalised populations
The technologies can change how users perceive their bodies and take action around them
Finally, the researchers had a general concern about traceability and the difficulty in identifying who is responsible when algorithmic recommendations cause harm: is it the user herself, the app developers, or the organization behind the app?
What the researchers found shows the importance of being careful with making claims about algorithms that involve assumptions, knowledge that’s opaque, or information that’s unknown.
“There needs to be more caution about developing products or services that reflect cultural and societal norms in their technical designs and features. Technologies are not neutral, so societal beliefs seep into companies and products when they deal with topics that are societal taboos such as menstruation, sex, or contraception. These norms must be challenged.”
The researchers say it’s important for app makers to acknowledge the diversity and contexts of the circumstances of every user, and how these might influence the quality of data that users input and the recommendations that are generated as a result. Companies behind these apps should be transparent about the risks and limitations, privacy policies, and how data is used so users can make properly informed choices.
The ethical concerns raised in the paper are more subtle than those normally discussed in mainstream media. “Ethical concerns came to the surface about what the tech organisations do, how users interact with the technology in the app, and how apps reinforce and shape beliefs about menstruation, fertility and the body. Studies have not yet looked at the implications of these technologies where they intersect individual, organisational and societal levels. We have exposed the risks and the necessary actions for an ethical, forward-looking evolution of these technologies and show that organisations developing the apps must ensure they contribute to health equity rather than reinforcing existing biases and discrimination.”
The researchers recommended action on three levels:
The researchers made recommendations for organisations developing period-tracking technologies:
“We live in a time when reproductive rights are at risk and women are increasingly looking for alternatives to hormonal birth control. It is essential that we pay attention to the ethical development and implementation of innovation when it applies to contraception. The influence of algorithms on users’ experience of their menstrual cycle and fertility is sometimes invisible but can still change behaviour related to it,” said the researchers.
You can read the full paper, including the outline of what this means for technology companies in Mapping ethical concerns in algorithm-driven period and fertility tracking technologies.
Science Communication and Media Officer
Rotterdam School of Management, Erasmus University (RSM) is one of Europe’s top-ranked business schools. RSM provides ground-breaking research and education furthering excellence in all aspects of management and is based in the international port city of Rotterdam – a vital nexus of business, logistics and trade. RSM’s primary focus is on developing business leaders with international careers who can become a force for positive change by carrying their innovative mindset into a sustainable future. Our first-class range of bachelor, master, MBA, PhD and executive programmes encourage them to become to become critical, creative, caring and collaborative thinkers and doers.
