CHIȘINĂU, Republic of Moldova – „I used an app before but forgot to enter the dates, but with this watch you can easily see every day of your menstrual cycle. I think it's important to know our bodies from adolescence and to talk openly about topics that were once taboo – including our menstrual cycles,” said Nina Chiriac, aged 18.

Like many girls around the world, Nina often has questions about her menstrual health. In some countries, the topic remains taboo despite the reality that each day, some 800 million people between the ages of 15 to 49 are menstruating.

Without access to accurate, trustworthy information, girls may not understand what’s happening to their bodies, leaving them vulnerable to increased pain, unsanitary conditions, social exclusion or unplanned pregnancy. In some cases, menarche may even lead to child marriage or sexual violence because it is believed to signal that a girl is ready for motherhood or sexual activity.

For participants of a new UNFPA pilot programme on menstrual health awareness, answers to their questions can be found around their wrists. In June of 2022, the UNFPA London office initiated a partnership with UK-based femtech (a category of products and services that use technology often to focus on women's health) start-up IMMI to provide 250 girls and young women aged between 13 and 25 years old with smart watches to track their menstrual cycles. The six-month trial took place in the Republic of Moldova and Burkina Faso, and is linked to UNFPA’s work with governments to implement comprehensive sexuality education in schools and through community-based training and outreach.

How knowledge empowers

The results of the trial have shown a significant increase in participants’ knowledge of their period start dates, the duration of their periods, and the timing of their fertile windows. Over the six months of the trial, the proportion of women and girls who said they knew the expected start date of their period leaped from 58 per cent to 81 per cent in the Republic of Moldova. Awareness of fertility windows almost doubled in the Republic of Moldova, from 35 per cent to 68 per cent.

While keeping track of fertility windows is particularly important for women and girls hoping to avoid pregnancy but lacking access to contraception, the programme itself does not promote fertility awareness as a method of contraception; rather, it has provided participants with an opportunity to learn about the full range of modern forms of contraception available, in addition to vital information on sexual and reproductive health.

„In Moldova the topic of menstrual health is still taboo and isn’t sufficiently discussed in families and schools”, said Ludmila Sîrbu, who works on UNFPA’s youth programmes in the Republic of Moldova. „The trial with IMMI was a great way to increase girls’ access to sexuality education”.

In the Republic of Moldova, the adolescent pregnancy rate remains one of the highest in the European region, at 26.2 births per 1,000 girls aged 15 to 19 (versus 9 births per 1,000 girls in the European Union).

The trial was paired with existing UNFPA-led support programmes to improve girls’ knowledge of menstrual and reproductive health, with a focus on understanding how to track their periods and ovulation, how to manage their periods safely, and how to reject myths around menstruation. This wrap-around infrastructure was vital to ensure participants could get the full benefit of the watch.

And the watch had advantages beyond menstrual cycle tracking, with many girls reporting improved sense of agency, body literacy and overall self-esteem and mental health. By the end of the six-month pilot, three quarters of those in the Republic of Moldova reported a higher sense of confidence and an overall positive effect on their life.

Safety by design

Central to the design of the IMMI watch is user safety and personal data autonomy. In fact, this is the first battery-powered digital watch to track users’ menstrual cycles without an app. All data collected is stored on the watch itself and can be wiped at any time, a functionality which ensures confidentiality and full user control. As the watch has no Bluetooth or WiFi capabilities, it can also be used in remote areas with little or poor Internet connectivity.

These considerations reflect rising safety concerns over period tracking apps, many of which allow third-party tracking and may pose a safety risk by selling private data, particularly in countries with restricted access to reproductive health care. The potential for period tracking apps to pass into the hands of violent partners also presents a new avenue through which abusers can exert control or limit the reproductive autonomy of others.

When tech products are designed with such risks in mind, women and girls can reap the benefits. Sarah Cottee, founder of UK-based IMMI, said: „Innovation is key if we are going to move the needle on systemic barriers girls face in gaining knowledge of their own bodies”.