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Effect of Menstrual Health Apps on Menstrual Symptom Monitoring among Female University Students in Nigeria

Abstract

Menstrual health is an important component of women's reproductive health, and effective monitoring of menstrual symptoms may help young women recognize patterns in their menstrual experiences and identify symptoms that may require professional healthcare attention. Female university students in Nigeria may experience menstrual symptoms such as abdominal pain, headaches, fatigue, mood changes, breast tenderness, heavy menstrual bleeding, irregular cycles, and other physical or emotional symptoms that may interfere with academic activities and daily life. However, limited awareness, inconsistent record-keeping, forgetfulness, stigma, and lack of convenient monitoring tools may make it difficult for students to track menstrual symptoms systematically. Menstrual health applications provide digital tools that may enable users to record menstrual dates, symptoms, bleeding patterns, medication use, and other menstrual-health information. Against this background, this study investigates the effect of menstrual health apps on menstrual symptom monitoring among female university students in Nigeria. The study will be anchored on the Health Belief Model, Health Literacy Theory, and Technology Acceptance Model. The Health Belief Model explains how students' perceptions of menstrual-health problems, perceived benefits of monitoring, perceived barriers, self-efficacy, and cues to action may influence their use of menstrual-health monitoring tools. Health Literacy Theory emphasizes students' ability to obtain, understand, evaluate, and use menstrual-health information generated or presented through digital platforms. The Technology Acceptance Model explains how perceived usefulness and perceived ease of use may influence students' acceptance and utilization of menstrual-health applications. Collectively, these theoretical perspectives provide a suitable framework for explaining how menstrual health apps may influence menstrual symptom monitoring among female university students in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise female undergraduate and postgraduate students aged 18 years and above enrolled in selected public and private universities across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, universities, faculties or departments, academic levels, and eligible students. Menstrual health app use will be assessed using indicators such as access to a menstrual health application, frequency of app use, duration of use, frequency of symptom entry, recording of menstrual dates, recording of bleeding patterns, tracking of abdominal pain, headaches, fatigue, mood changes, breast tenderness, bloating, medication use, and other relevant symptoms, use of reminders, review of symptom trends, access to educational information, and use of symptom-monitoring features. Menstrual symptom monitoring will be assessed using indicators such as regularity of symptom recording, completeness of symptom records, accuracy of menstrual dates, documentation of symptom severity, identification of recurring symptom patterns, monitoring of changes in symptoms, recognition of unusually severe or persistent symptoms, maintenance of menstrual-health records, and appropriate healthcare-seeking when concerning patterns are identified. Data will be collected using structured questionnaires, menstrual symptom-monitoring assessment tools, app-use records or screenshots where appropriate and voluntarily provided, menstrual diaries, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize students' demographic and academic characteristics, menstrual experiences, smartphone and internet access, previous symptom-monitoring practices, sources of menstrual-health information, and patterns of menstrual health app use. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of menstrual health apps on menstrual symptom monitoring. Where a quasi-experimental design is adopted, symptom-monitoring scores before and after introduction of the menstrual health application may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that menstrual health apps have a significant positive effect on menstrual symptom monitoring among female university students in Nigeria. Students who regularly use menstrual health applications are expected to demonstrate more consistent and comprehensive monitoring of menstrual symptoms than students without comparable access to digital monitoring tools. Menstrual health apps may improve students' ability to record symptoms systematically, identify recurring patterns, monitor changes in symptom severity, and maintain accessible menstrual-health records. Reminders and automated tracking features may also reduce forgetfulness and encourage regular monitoring. Educational information provided through appropriate applications may improve students' awareness of menstrual-health concerns and encourage professional healthcare consultation when persistent, severe, or unusual symptoms are identified. However, limited smartphone or internet access, data costs, concerns about privacy and personal-health information, inaccurate or misleading app-generated information, inconsistent app use, digital literacy differences, and limited access to appropriate healthcare services may reduce the effectiveness of menstrual health apps. The study therefore expects user-friendly, privacy-conscious, evidence-based, and accessible menstrual health applications to contribute significantly to improved menstrual symptom monitoring among female university students in Nigeria. The study is expected to contribute to the literature on menstrual health, digital health, menstrual symptom monitoring, women's health, reproductive health, mobile health applications, university student health, health technology, digital health literacy, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, universities, university health centres, digital-health developers, healthcare professionals, gynaecologists, nurses, women's health organizations, technology innovators, development partners, and policymakers regarding strategies for strengthening digital menstrual-health services. The study will also provide evidence-based recommendations for promoting appropriate menstrual-health applications, improving digital menstrual-health literacy, strengthening privacy and data-protection awareness, integrating reliable menstrual-health information into digital platforms, encouraging appropriate healthcare-seeking for concerning symptoms, and developing sustainable digital-health interventions that support menstrual symptom monitoring among female university students across Nigeria.

Keywords: Menstrual health apps, menstrual symptom monitoring, female university students, menstrual health, digital health, mobile health applications, women's health, reproductive health, digital health literacy, menstrual symptoms, Nigeria, public health.