Hormonal health
Acceptable data use vs exploitation when women receive ‘free’ digital health tools
By Wolfgang Hackl, CEO, OncoGenomX Inc., Allschwil, Switzerland
In women’s health, “free” digital tools occupy an especially sensitive space. Period trackers, fertility apps, pregnancy platforms, menopause programs, pelvic-floor wearables, contraception reminders, mental-health chatbots and symptom diaries have become essential resources for millions worldwide. For many, these tools fill longstanding gaps in clinical care, offering information, monitoring and community.
Yet women’s health data are uniquely intimate, politically vulnerable and commercially valuable. The same apps that help a woman identify a fertility window or track post-partum mood changes may also collect sexual history, location, device IDs, hormonal patterns, and behavioral clues that can be monetized or repurposed – sometimes without meaningful transparency.
The core ethical question is urgent: When does the data exchange that underpins “free” women’s health tools empower individuals, and when does it exploit them?
Across research and policy commentary, the fault lines remain the same – transparency, proportionality, control, fair value sharing, and protection from harm – but their stakes are heightened in women’s health.
The high-risk profile of women’s health data
The sensitivity of women’s health data is not abstract. It becomes dangerous in real-world contexts:
- Reproductive rights volatility – In jurisdictions with restrictive reproductive laws, menstrual cycle data, geolocation patterns around clinics, search histories and communication logs can be weaponized.
- Stigma and discrimination – Data related to miscarriage, abortion, infertility, menopause symptoms, mental health, sexual function or domestic violence can lead to insurance denial, unfair pricing, employment impacts or social vulnerability.
- Relationship and safety risk – Some apps collect or expose data that partners or third parties could misuse, from mood logs to location traces.
- Commercial targeting – Women are historically targeted with exploitative advertising around fertility supplements, weight loss, anti-aging and alternative therapies, often amplified by intimate behavioral data.
These risks transform the ethics of “free.” When a tool’s business model depends on collecting sensitive reproductive or behavioral attributes at scale, the user is no longer the beneficiary – the user is the product.
What women expect when sharing health data
Studies consistently show broad support among women for sharing data when it drives tangible health benefits—research, better care pathways, early diagnosis, or community insights. Trust collapses when data are:
- shared with advertisers, data brokers or insurers
- used for profiling, risk scoring or targeted pricing
- stored indefinitely or without clarity
- accessible to third parties unknown to the user
Women expect three things above all:
- Radical transparency
Not euphemisms, not hidden trackers, not 30-page terms. Women want to know who sees what, why and how it will be protected.
- Meaningful agency
Granular control – “yes” to sharing anonymized cycle data for research, “no” to targeted ads; “yes” to contributing to public-good datasets, “no” to third-party data inference.
- Safety guarantees
Technical and legal safeguards that explicitly prohibit uses exposing women to legal, financial, physical or psychological risk.
Women’s health is not a sandbox for broad, open-ended data collection. When platforms request permissions unrelated to their core health function – photos, contacts, continuous location, device fingerprinting – alarm bells ring.
Exploitation patterns in “free” women’s health tools
Technical audits of menstrual and fertility apps show that many collect extraordinarily detailed data: cycle length, symptoms, sexual activity, pregnancy intentions, test results, mood logs, sleep, stress, location, device IDs, email metadata, and “other information.” Some share with dozens of third parties.
The exploitation signals are increasingly well understood:
- Opaque data pipelines to marketers, analytics firms and profiling engines
- Unbounded storage of sensitive reproductive histories
- Engagement-driven design that nudges users toward disclosing more
- Commercial re-use of intimate behavioral patterns unrelated to health
- Minimal or performative governance despite high-risk categories
When a woman logs cramps or sexual activity, the ethical baseline is higher than in general wellness apps. The potential harms – legal, social, relational – are uniquely gendered and often irreversible.
Value capture and the “women pay twice” problem
Women’s health technologies have become a multi-billion-dollar market. But the value chain often flows upward, not back to the users:
- Women supply intimate, high-granularity data – Immense value for R&D, precision marketing, and investor storytelling.
- Companies monetize the insights – Through partnerships, advertising, risk scoring or AI model development.
- Women then purchase the resulting products – Including paid upgrades, supplements, or premium diagnostics whose innovation was subsidized by their data.
Without mechanisms that guarantee affordability, open reporting or reinvestment into women’s health services, the model becomes extractive. Women contribute the raw material, then buy back the finished product at retail price.
Pathways to acceptable – and truly empowering – data use
Responsible data practice in women’s health requires stricter standards than generic “digital health ethics.” The following markers – derived from current scholarship—are especially critical in women’s health contexts:
- Purpose-bound data practices
Tools should collect only what is strictly necessary for the health purpose. Fertility predictions do not require contact lists or persistent location tracking.
- Prohibitions on harmful secondary uses
Contracts and code must explicitly block:
- insurance scoring
- law enforcement access without due process
- targeted advertising linked to reproductive data
- cross-platform tracking
- sale to data brokers
- High-security architecture
Women’s health data should be treated like genomic or mental health data:
- encryption at rest and in transit
- zero-trust design
- independent security audits
- strict third-party access regimes
- Governance designed for vulnerable contexts
Oversight bodies should include women’s health experts, legal scholars, and patient advocates, reviewing not just privacy compliance but real-world harm potential.
- Fair value and reciprocity
If population-level reproductive or maternal health data fuel AI models, companies should commit to:
- affordability of products derived from those models
- investment in community health infrastructure
- transparency in data-driven improvements
This is not charity. It is ethical reciprocity.
The way forward: trust as a differentiator
Women’s health is evolving from niche to mainstream. With this visibility comes responsibility. Investors and innovators who treat data stewardship as a strategic asset – not a compliance hurdle—will define the next era of digital women’s health.
The future belongs to tools that:
- put safety ahead of scale
- align business models with women’s interests
- eliminate dark patterns
- prove that “free” does not mean “exploitative”
- create value with, not from, women
Ultimately, the line between acceptable data use and exploitation is shaped by one question:
Does this tool treat women as partners—or as data sources?
The companies that choose the former will earn the trust that defines the next generation of global women’s health innovation.
Simultaneous exposure to toxic chemicals and climate-related heat may be worsening fertility harms across humans and wildlife, research suggests.
The review of scientific literature looks at how endocrine-disrupting chemicals, often found in plastic, together with climate-related effects such as heat stress, are each linked to lower fertility and fecundity, meaning the ability to reproduce, across species including humans, wildlife and invertebrates.
Though the reproductive harms of each issue in isolation are well studied, there is little research on what happens when living organisms are exposed to both.
“Together, the two issues are likely to pose a greater threat to fertility, and the additive effect is “alarming”, said Susanne Brander, a study lead author and courtesy faculty at Oregon State University.
“You’re not just getting exposed to one, but two, stressors at the same time that both may affect your fertility, and in turn the overall impact is going to be a bit worse,” Brander said.
The paper looked at 177 studies.
Shanna Swan, a co-author on the new paper, co-produced a 2017 study that found sperm levels among men in western countries had fallen by more than 50 per cent over four decades. Other research has suggested human fertility has been declining at a similar rate.
The University of Washington’s Institute for Health Metrics and Evaluation has previously said the world was approaching a “low-fertility future”, with more than three quarters of countries below replacement rate by 2050.
The new paper’s authors focused on the effects of endocrine-disrupting chemicals and substances, including microplastics, bisphenol, phthalates and PFAS.
These are thought to cause a range of serious reproductive problems, disrupt hormones and be a potential driver of falling fertility.
Brander said the harms linked to these chemicals are often similar across organisms, from invertebrates to humans.
Phthalates, for example, have been linked to altered sperm shape in invertebrates, spermatogenesis in rodents, meaning sperm production, and reduced sperm counts in humans.
PFAS are also thought to affect sperm quality, and both have been linked to hormone disruption.
The chemicals are widespread in consumer goods, so people are often regularly exposed.
Meanwhile, previous research has shown how rising temperatures, lower oxygen levels and heat stress, among other effects linked to climate change, may also worsen infertility.
Heat stress has been found to affect human hormones, and is linked to spermatogenesis in rodents and bulls.
Research shows temperature also plays a role in sex determination in fish, reptiles and amphibians.
The species has evolved to choose which sex it produces in part based on temperature, and the heating planet can “push it too far in one direction or the other, which overrides that evolutionary benefit”, Brander said.
Similarly, many endocrine disruptors may alter environmental sex determination.
The study set out some of the overlapping effects of chemical exposure and climate change across taxonomic groups, from invertebrates to humans.
In birds, for example, exposure to increased temperature, PFAS, organochlorines and pyrethroids may each individually cause abnormal sperm, increased fledgling mortality, abnormal testes and population decline.
“What happens if they’re exposed to more than one of those stressors at the same time? There has been little exploration of that question.
“Even if there have not been a lot of studies looking at these simultaneously, if you have two different factors that both cause the same adverse effect, then there’s a likelihood that they are going to be additive,” Brander said.
Katie Pelch, a senior scientist with the Natural Resources Defense Council nonprofit, who was not part of the study, said the authors had reviewed high-quality science.
She said she wanted to see more examples of the overlap in impacts, but agreed with the overall premise.
“It is likely [multiple stressors] would have an additive effect, at very least, even if they have different mechanisms of harm,” Pelch added.
The solution to the systemic problems would involve tackling climate change and reducing the use of toxic chemicals.
The study cites the global reduction in the use of DDT and PCBs achieved under the Stockholm Convention as an example of an effective measure, but Brander said much more is needed.
“There is enough evidence in both areas to act to reduce our impact on the planet,” she said.
Weight loss jabs are being studied to see if they could help women with polycystic ovary syndrome (PCOS)
The condition, which affects up to one in ten women, changes how the ovaries work and is linked to infertility and weight gain.
Dr Shagaf Bakour has won a £60,000 NHS research grant through Sandwell and West Birmingham NHS Trust to look at whether drugs such as Mounjaro and Ozempic might help.
“The research could lead to earlier support, better long-term health, and more joined-up care for a condition that affects many women but is still often overlooked,” she said.
Women with PCOS have higher levels of male hormones and can suffer from irregular periods and symptoms such as excess body or facial hair, the NHS said.
Associated weight gain can also lead to an increased risk of diabetes and heart problems.
Bakour, a gynaecologist and director of medical education at Aston Medical School, will work with a team to evaluate the effect of the weight loss medicines on metabolic and reproductive outcomes.
The drugs mimic a hormone called GLP-1, which suppresses appetite.
Bakour, alongside Dr Hoda Harb, a consultant obstetrician and gynaecologist at the NHS trust, will review existing evidence on their use and assess how they help patients with PCOS.
“The aim is to give women with PCOS evidence-informed, clearer treatment options and more consistent care,” she said.
“The project hopes to show whether these medicines can improve both general health and fertility health, while also helping local services develop clearer care pathways.
Prof Elizabeth Hughes, director of research and development at the NHS trust, said the effects of PCOS, including infertility, were “very emotive subjects”.
“We should be doing all we can within research and development to advance healthcare for women and to better help future generations with this condition,” she added.
Health secretary Wes Streeting has relaunched England’s women’s health strategy, vowing to stop women being “gaslit” by doctors.
Speaking before publication of the renewed strategy, the health secretary said the NHS was “failing women” and set out measures to help them access the healthcare they need.
The government said the strategy would include a new standard of care to ensure women were offered pain relief for invasive procedures, such as fitting a contraceptive coil and hysteroscopies.
Feedback would be directly linked to provider funding through a new trial, giving women more power to affect change if they have a poor experience.
Action would also be taken to ensure women no longer face long waits for diagnoses for conditions such as endometriosis, which can take a decade to diagnose.
Streeting said: “[Women] have for so long been let down by a healthcare system that too often gaslights women, treating their pain as an inconvenience and their symptoms as an overreaction.
“Whether it’s being passed from one appointment to another for conditions like endometriosis and fibroids, or a lack of proper pain relief during invasive procedures, through to having to navigate symptoms for years before receiving a diagnosis, it’s clear the system is failing women.
“Women’s voices must be central to delivering effective, respectful and empathetic care. We need to hit medical misogyny where it hurts – the wallet.
“Today’s renewed strategy will tackle the issues women face every day and ensure no woman is left fighting to be heard.”
A report last month by the women and equalities committee found that gynaecological and menstrual health had not been “sufficiently prioritised” by the government.
MPs said parts of the 10-year women’s health strategy, launched in 2022 by the Conservatives, were at risk of being scaled back or discontinued under wider changes to the NHS.
These included initiatives that had reduced waiting lists and improved women’s access to healthcare, such as women’s health hubs.
Sarah Owen, chair of the committee and a Labour MP, said: “This would be a disaster for girls’ and women’s menstrual healthcare, when it is in dire need of more support.
“It is a national scandal that nearly half a million women are on hospital gynaecology waiting lists when there are effective treatments that could be administered in primary and community care, if only they could access them.”
The report said women faced “medical misogyny” and were left to “suck it up” and suffer in pain for years because of a lack of awareness of women’s health conditions.
A redesign of clinical pathways for some women’s health issues will aim to speed up diagnosis and treatment, and there will be a review of support for families who experience repeated baby loss.
The government also promised a “single referral point” to ensure women were directed to the right place the first time they sought help.
Dr Sue Mann, NHS England’s women’s health director, said too many women were dismissed for “serious symptoms” that affected every part of their lives.
“The renewed women’s health strategy will build significantly on the work the NHS has been doing to ensure women are heard and get the specialist care they need,” she said.
Women’s health groups cautiously welcomed the renewed strategy. Emma Cox, chief executive of Endometriosis UK, said decisive action would be vital to improve women’s healthcare in England.
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