WOMEN'S HEALTH
Fertility tracking has increased in some states post-Dobbs
Finding suggests need for education about tech’s reliability
Ohio State University
COLUMBUS, Ohio – The use of fertility-tracking technology increased in some states after the U.S. Supreme Court overturned Roe v. Wade despite warnings that reproduction-related data might not be secure, a new study has found.
Data from surveys conducted in Arizona, Iowa, New Jersey, Ohio and Wisconsin showed that before the 2022 decision in Dobbs v. Jackson Women’s Health Organization, over one-third of women in those states reported using apps or websites to track their menstrual cycles and sexual activity. In the year after the ruling, the proportion of survey participants using fertility trackers grew to almost half.
The survey samples consisted of different groups of people, so this result doesn’t rule out the possibility that some users did quit the apps to protect their personal data. The findings likely reflect an uptick in use of technologies aimed at improving women’s health – known as “Femtech” – in general, said lead author Emily Neiman, a clinical instructor of practice in the College of Nursing at The Ohio State University.
While there are still uncertainties about privacy policies related to period tracking, Neiman said, the findings may have a broader implication: the need for users to consider whether they can trust technology to accurately predict or prevent pregnancy. The survey showed fewer users were tracking fertility for the purposes of becoming pregnant post-Dobbs – which may suggest they’re more likely to be counting on the apps for pregnancy prevention.
“I think the lay person understanding of what information an app gives you and the reliability of that information is not great,” Neiman said. “I do think there are a lot of people out there recording when they have their period and relying on an app to tell them they’re not fertile so it’s OK to have unprotected sex – and they don’t want to be pregnant. And that would not be my advice.”
The research was published earlier this month in the journal Contraception.
The use of apps and websites to track periods and fertility is common: As of 2019, nearly one-third of people with the capacity to get pregnant had used the internet or a smartphone to track fertility or menstrual cycles, according to a Kaiser Family Foundation national survey.
But the technology offerings vary widely, and the free versions of the most popular apps aren’t likely to help with charting things like cervical mucus, basal body temperature, the position of the cervix or hormone levels that indicate ovulation is imminent, said Neiman, also a certified nurse-midwife. Technologies that improve fertility awareness accuracy tend to be expensive and time-intensive to use.
Neiman pursued the research question after seeing news coverage and social media posts following Dobbs warning users they should delete their period trackers to avoid the possibility that their personal data could be used against them.
“I wanted to see if that actually happened,” she said. “I did think people would be more concerned about privacy and that we might see a decrease in use. I was kind of surprised to see that it had increased.
“It doesn’t seem like people heeded the advice to stop using fertility trackers, and there could be a number of reasons for that. Potentially, more people are using tracking to recognize a pregnancy as early as possible so they have the most options or so they can seek prenatal care early, but there may be fewer people planning pregnancy now that there are these restrictions around abortion.”
Neiman and colleagues used data from the Surveys of Women, which questioned women aged 18-44 about reproductive health in the five states. The analysis compared the prevalence of the use of period- or fertility-tracking technologies and reasons for their use before and after the June 24, 2022, court ruling that the Constitution does not confer a right to abortion.
The study samples ranged from 2,077-2,521 before the decision and 2,145-2,448 post-Dobbs. Results showed that user prevalence increased overall and in all states but Wisconsin, where the prevalence was unchanged. The only change among participants’ reasons for using the technology was that fewer reported they charted fertility to improve the chances they’d get pregnant.
Assuming that period trackers continue to grow in popularity, Neiman said, the onus is on users to fully understand potential limitations of app fertility predictions and on clinicians to broach the subject of Femtech use in conversations with patients.
“I would say that most users of the free versions of apps that are most easily accessible are just tracking their symptoms, when they have sex and the dates of their periods. So it can give you a rough estimate of when you ovulate or when you’re going to start your period,” she said.
“I don’t think the necessary level of detail is there and that people’s understanding is good enough to rely on that. As providers and public health professionals, we could be doing a better job of educating around the reliability of the information they’re getting from these technologies to help people who are trying to prevent unwanted pregnancies.”
This study was supported by grants to several research centers from an anonymous donor.
Co-authors include Abigail Norris Turner and Maria Gallo (now at the University of North Carolina) of Ohio State; Marta Bornstein of the University of South Carolina; and Megan Kavanaugh of the Guttmacher Institute.
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Contact: Emily Neiman, Neiman.3@osu.edu
Written by Emily Caldwell, Caldwell.151@osu.edu; 614-292-8152
Journal
Contraception
Method of Research
Data/statistical analysis
Subject of Research
People
Article Title
Use of period- or fertility-tracking technologies pre- and post-Dobbs
Rice-BCM research enables detection of hazardous chemicals in human placenta with unprecedented speed and precision
Light-based detection and machine learning are a powerful health screening duo
Rice University
image:
Peter Nordlander (from left), Oara Neumann, Melissa Suter, Bhagavatula Moorthy, Ankit Patel and Naomi Halas
view moreCredit: (Photo by Jeff Fitlow/Rice University)
HOUSTON – (Feb. 10, 2025) – Rice University scientists and collaborators at Baylor College of Medicine (BCM) have demonstrated a new method for detecting the presence of dangerous chemicals from tobacco smoke in human placenta with unprecedented speed and precision.
The research team used a combination of light-based imaging techniques and machine learning (ML) algorithms to identify and label polycyclic aromatic hydrocarbons (PAHs) and their derivatives (PACs) ⎯ toxic compounds generated through the incomplete combustion of organic materials. Exposure to these chemicals during pregnancy can result in negative health outcomes such as preterm birth, low birth weight and developmental problems.
“Our work addresses a critical challenge in maternal and fetal health by improving our ability to detect harmful compounds like PAHs and PACs in placenta samples,” said Oara Neumann, a Rice research scientist who is the first author on a study published in Proceedings of the National Academy of Sciences. “The findings reveal that machine-learning-enhanced vibrational spectroscopy can accurately distinguish between placental samples from smokers and nonsmokers.”
The new method was used to analyze the placentas of women who reported smoking during pregnancy and self-reported nonsmokers, confirming that PAHs and PACs were present only in the samples collected from smokers. The findings offer a critical tool for environmental and health monitoring, enabling the identification and labeling of harmful toxins associated with smoking as well as other sources such as wildfires, conflagrations, Superfund sites and other high-pollution environments and contaminated products.
“Measuring levels of environmental chemicals in the placenta can give us insight into the exposures that both mom and baby experienced during pregnancy,” said Melissa Suter, an assistant professor of obstetrics and gynecology at BCM. “This information can help us understand how these chemicals can affect the pregnancy and the baby’s development and help scientists inform public health measures.”
The research relied on surface-enhanced spectroscopy, a method that uses specially designed nanomaterials to amplify the way that specific light wavelengths interact with targeted compounds. In this case, the researchers leveraged the special optical properties of gold nanoshells designed in the Nanoengineered Photonics and Plasmonics research group led by Naomi Halas , University Professor and the Stanley C. Moore Professor of Electrical and Computer Engineering at Rice.
“We combined two complementary techniques ⎯ surface-enhanced Raman spectroscopy and surface-enhanced infrared absorption ⎯ to generate highly detailed vibrational signatures of the molecules in the placental samples,” said Halas, who is the corresponding author on the study.
Halas together with Peter Nordlander, the Wiess Chair in Physics and Astronomy and professor of electrical and computer engineering and materials science and nanoengineering at Rice, have made significant contributions to plasmonics, the study of light-induced collective oscillations of free electrons on the surface of metallic nanoparticles. Surface-enhanced spectroscopy leverages plasmonics to make possible the in-depth study of molecular structures with very high resolution at the trace concentrations found in biological and environmental samples.
The integration of ML algorithms ⎯ characteristic peak extraction (CaPE) and characteristic peak similarity (CaPSim) ⎯ revealed subtle patterns in the data that would otherwise have gone undetected. CaPE identified key chemical signatures from the complex datasets, while CaPSim matched these signals to known PAH chemical signatures. This outcome showcases the transformative impact of computational tools for medical and public health applications.
Ankit Patel, assistant professor of electrical and computer engineering at Rice and assistant professor of neuroscience at BCM, said that ML served to “tune out the ‘noise’ in the data.”
“It’s like the so-called ‘cocktail-party effect,’” Patel said. “Picture a noisy and crowded room with lots of people talking at once. We are able to focus our attention on a particular conversation only by tuning out the rest ⎯ in the same way, machine learning is able to parse through the spectral data associated with PAHs and PACs much more effectively than humans can.”
Subsequent experiments validated the research findings, confirming that the new method provides a functional alternative to traditional, more labor- and time-intensive techniques. Beyond smoking-related exposure, the research could enable monitoring exposure to environmental toxins after natural disasters or industrial accidents, equipping health care providers with a faster and more reliable way to assess risk and potentially improve fetal and maternal health outcomes.
“This new method offers an unprecedented level of detail,” said Bhagavatula Moorthy, the Kurt Randerath MD Endowed Chair and Professor of Pediatrics and Neonatology at BCM. “This research lays the groundwork for expanding ultrasensitive PAH- and PAC-detection technology in biological fluids such as blood and urine as well as in the environmental monitoring of PAHs, PACs and other hazardous chemicals in air, water and soil, thereby aiding in human risk assessment.”
Other Rice co-authors include computer science doctoral alum Yilong Ju, who developed the ML algorithm, and Andres Sanchez-Alvarado, an electrical and computer engineering Ph.D. student in the Halas research group who was part of the team that conducted the experiments.
The research was supported by the National Institutes of Health (P42ES027725), the Welch Foundation (C-1220, C-1222) and Rice’s Smalley-Curl Institute. The content herein is solely the responsibility of the authors and does not necessarily represent the official views of the funding organizations and institutions.
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This news release can be found online at news.rice.edu.
Follow Rice News and Media Relations via Twitter @RiceUNews.
Peer-reviewed paper:
Machine Learning-enhanced Surface-Enhanced Spectroscopic Detection of Polycyclic Aromatic Hydrocarbons in Human Placenta | Proceedings of the National Academy of Sciences | DOI: 10.1073/pnas.2422537122
Authors: Oara Neumann, Yilong Lu, Andres Sanchez-Alavarado, Guodong Zhou, Weiwu Jiang, Bhagavatula Moorthy, Melissa Suter, Ankit Patel, Peter Nordlander and Naomi Halas
https://doi.org/10.1073/pnas.2422537122
Access associated media files:
https://rice.box.com/s/xo2c07vnwa6ns34b0omf0w5iu7k2em6e
CAPTION: Peter Nordlander (from left), Oara Neumann, Melissa Suter, Bhagavatula Moorthy, Ankit Patel and Naomi Halas (Photo by Jeff Fitlow/Rice University)
About Rice:
Located on a 300-acre forested campus in Houston, Texas, Rice University is consistently ranked among the nation’s top 20 universities by U.S. News & World Report. Rice has highly respected schools of architecture, business, continuing studies, engineering and computing, humanities, music, natural sciences and social sciences and is home to the Baker Institute for Public Policy. Internationally, the university maintains the Rice Global Paris Center, a hub for innovative collaboration, research and inspired teaching located in the heart of Paris. With 4,776 undergraduates and 4,104 graduate students, Rice’s undergraduate student-to-faculty ratio is just under 6-to-1. Its residential college system builds close-knit communities and lifelong friendships, just one reason why Rice is ranked No. 1 for lots of race/class interaction and No. 7 for best-run colleges by the Princeton Review. Rice is also rated as a best value among private universities by the Wall Street Journal and is included on Forbes’ exclusive list of “New Ivies.”
Journal
Proceedings of the National Academy of Sciences
Method of Research
Experimental study
Subject of Research
People
Article Title
Machine Learning-enhanced Surface-Enhanced Spectroscopic Detection of Polycyclic Aromatic Hydrocarbons in Human Placenta
Article Publication Date
10-Feb-2025
Position menstrual cups carefully to avoid possible kidney problems, doctors urge
Warning comes after lopsided placement blocked urine flow into the bladder
A poorly positioned menstrual cup to capture monthly blood flow may lead to more serious complications than leakage alone, warn doctors in the journal BMJ Case Reports, after treating a young woman with uterohydronephrosis—a swollen kidney caused by blocked urine flow into the bladder.
The use of menstrual cups as a sustainable alternative to other methods of controlling period blood flow is rising, note the report authors. While reported complications are rare, the evidence suggests that pain, vaginal wounds, allergic reactions, leakage, urinary incontinence, dislodgement of intrauterine devices (‘coils’), and infections, are all possible, they add.
The doctors treated a young woman in her early 30s who had noticed blood in her urine and was experiencing intermittent right-sided flank and pelvic pain that had lasted for around 6 months.
Three years earlier, she had had a 9 mm kidney stone removed. And she was using a copper coil for contraception. One or 2 days a month, during the heaviest period blood flow, she used a menstrual cup which she emptied every 2–3 hours.
A scan revealed no signs of kidney stones, but it did show a swollen right kidney and ureter—the tube that carries urine away from the kidneys. It also showed a menstrual cup positioned right next to the opening of the ureter into the bladder (ureteral ostium).
The woman was asked not to use the menstrual cup during her next period and to return for a follow up scan a month later. The scan showed that the swelling had gone down and that urine was draining normally from both kidneys.
The woman’s symptoms had cleared up completely, prompting the report authors to conclude that the cup had obstructed the flow of urine from the right ureter.
When the woman attended for a further check-up six months later, she said that she had only used the menstrual cup occasionally for 3–4 hours at a time during visits to a swimming pool. She hadn’t wanted to use the cup regularly again, for fear of possible complications.
“To our knowledge only a few similar cases have previously been reported. [These] cases were similar to our case,” note the report authors.
“In all cases except one, a follow-up [computed tomography scan] or ultrasound was performed which showed regression of the ureterohydronephrosis. In three cases, the women resumed use of the menstrual cup, and none of them experienced resumption of symptoms (unknown follow-up periods). One of them chose a smaller sized cup,” they write.
Women (and clinicians) need to be better informed about the correct use (and potential complications) of menstrual cups, suggest the report authors.
“When the terminal part of the ureters passes into the bladder, they are in close proximity to the vagina, which can affect urinary drainage from the ureter. Correct positioning, along with choosing the correct cup shape and size, is important to prevent negative effects on the upper urinary tract,” they explain.
“Presently, menstrual cups can be bought and used without clinical advice from a health professional, which emphasises the importance of detailed and clear patient information material,” they add.
Journal
BMJ Case Reports
Method of Research
Case study
Subject of Research
People
Article Title
Ureterohydronephrosis due to a menstrual cup
Article Publication Date
10-Feb-2025
Impact of intermediate-term oral contraceptive use on oxidative stress, lipid profile, and liver function in Iraqi women
Xia & He Publishing Inc.
Background and objectives
Oral contraceptive pills (OCPs) are commonly used for contraception, but their long-term effects on oxidative stress, lipid profiles, and liver function remain unclear. This study aimed to evaluate the impact of intermediate-term OCP use (Yasmin) on oxidative stress, lipid profile, and liver function, with particular emphasis on antioxidant markers, lipid metabolism, and hepatic enzyme activity, to better understand the potential metabolic and hepatic effects.
Methods
A case-control study was conducted in Maysan Governorate, Iraq, involving 150 women (100 OCP users and 50 non-users). Blood samples were collected from Al-Sadr Teaching Hospital and a specialized clinic between February and April 2023. Serum levels of antioxidants, lipids, and liver enzymes were measured using biochemical assays.
Results
OCP users had significantly lower levels of glutathione peroxidase vitamin E and uric acid (p < 0.001) compared to non-users. Lipid profiles showed that OCP users had higher levels of triglyceride and low-density lipoprotein (p < 0.05), whereas total cholesterol was significantly higher in non-users (p < 0.05). Liver enzyme activity, including alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, and total serum bilirubin, did not show statistically significant differences (p > 0.05). Longer duration of OCP use was significantly negatively correlated with vitamin E levels (r = −0.67), glutathione peroxidase activity (r = −0.56), uric acid levels (r = −0.45) and high-density lipoprotein (r = −0.54). Positive correlations were found between the duration of OCP use and total cholesterol (r = 0.62), triglyceride (r = 0.58), low-density lipoprotein (r = 0.60), and liver enzymes alanine aminotransferase (r = 0.66) and aspartate aminotransferase (r = 0.64).
Conclusions
Intermediate-term OCP use was associated with changes in oxidative stress and lipid metabolism, potentially increasing cardiovascular and metabolic risks. Regular monitoring of these parameters is recommended for OCP users.
Full text:
https://www.xiahepublishing.com/2472-0712/ERHM-2024-00035
The study was recently published in the Exploratory Research and Hypothesis in Medicine.
Exploratory Research and Hypothesis in Medicine (ERHM) publishes original exploratory research articles and state-of-the-art reviews that focus on novel findings and the most recent scientific advances that support new hypotheses in medicine. The journal accepts a wide range of topics, including innovative diagnostic and therapeutic modalities as well as insightful theories related to the practice of medicine. The exploratory research published in ERHM does not necessarily need to be comprehensive and conclusive, but the study design must be solid, the methodologies must be reliable, the results must be true, and the hypothesis must be rational and justifiable with evidence.
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Journal
Exploratory Research and Hypothesis in Medicine
Article Title
Impact of Intermediate-term Oral Contraceptive Use on Oxidative Stress, Lipid Profile, and Liver Function in Iraqi Women: A Comprehensive Biochemical Assessment
