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    Unlocking a path to better female health: Why raising knowledge is key

    Imagine having never heard about menstruation before your first period. Now imagine having limited access to information, products, or facilities to allow you to manage your menstrual health. In the face of this inequity, how would you navigate your cycles, fertility, and sexual health?

    4 min read
    Reviewed by Liudmila Zhaunova, PhD, Flo director of science, UK

    Around the world, the menstrual health needs of millions remain unmet.  

    This leads to stark consequences, including pervasive social stigma, mental health and reproductive health issues, and exclusion from social, educational, and professional opportunities.  

    Menstrual health knowledge is a crucial aspect of our ability to take care of our menstrual health needs. Yet low levels of knowledge are pervasive, particularly in low- and middle-income countries. 

    At Flo, we are dedicated to providing expert-reviewed health content to our members. It’s part of our mission to build a better future for female health. 

    But does using the Flo app actually improve knowledge levels, particularly in areas where access to evidence-based health information is limited? 

    In short, it does.

    Our science team has published our latest research in the journal BMJ Public Health, showing that access to Flo for at least three months leads to higher levels of menstrual health knowledge as well as significant improvements in other aspects of health. 

    Read on to find out how much menstrual health knowledge improved during the study and how this impacted other factors including stigma, awareness of sexually transmitted infections (STIs), and quality of life.

    Low knowledge levels at the start

    This research was part of Flo’s Pass It On Project, which provides free access to Flo Premium in countries where there’s little access to safe and trustworthy health information. 

    In total, 6,165 adult Flo app members from 52 countries took part in our study. 

    Our main goal was to assess whether using the Flo Premium app, with its extensive library of medically reviewed health information, could improve levels of menstrual health knowledge.

    “What’s really exciting about our study is that we could measure the real-life impact that using the Flo app has on women’s lives,” explained Liudmila Zhaunova, PhD, director of science at Flo.  

    New app members who installed Flo Premium as part of the Pass It On Project were invited to join the study. Study participants answered questions to test their menstrual health knowledge as well as other aspects of female health after installing the app. 

    “One thing that was really striking was how low levels of menstrual health knowledge were at app installation among this adult population. In a quiz with 10 questions, the average number of correct answers was 3.4. This shows the huge scope to improve menstrual health knowledge,” said lead study author Frederick Goddard, PhD. 

    For example, while more than 8 out of 10 survey participants correctly identified the length of a normal period, only 6 out of 10 knew when during the cycle unprotected sex would most likely result in pregnancy, and fewer than 4 out of 10 knew the typical length of a normal fertile window. 

    More knowledge, better health outcomes

    After using the app for at least three months, our study participants answered the same questions so we could see what had changed since they started using Flo Premium.

    Menstrual health knowledge was nearly 19% higher.

    Importantly, in addition to higher levels of menstrual health knowledge, we also saw improvements in other aspects of female health and well-being, including:

    • Menstrual health awareness increased by 9%.
    • Communication confidence was up by 5%.
    • STI awareness was nearly 2% higher.
    • Menstrual stigma was 8% lower. 

    “These are meaningful changes,” said April M. Ballard, PhD, assistant professor at Georgia State University and a member of Flo's scientific advisory board. “When people have access to accurate, relevant information about their health, they’re more equipped to take care of themselves. In our study, greater menstrual knowledge translated into real improvements in well-being.” 

    Knowledge as a pathway to better health

    Using a type of analysis called mediation analysis, our scientists were able to show that higher menstrual health knowledge contributed to improvements in health and well-being. This suggests that women and people who menstruate benefit from access to information that helps them build their foundational menstrual health knowledge. 

    Mobile phone use continues to climb, including in remote communities. Where learning resources are hard to come by, digital health apps like Flo can fill crucial gaps. 

    Adults living in countries where access to menstrual health knowledge is particularly low are often overlooked in studies. Many focus on high-income countries or on adolescents. 

    That’s why our research is so impactful; it provides evidence of a solution to improve menstrual health knowledge and the health and well-being of those often excluded and neglected. 

    “It’s important that we continue to conduct research to test to what extent Flo can improve health knowledge and outcomes. We want to ensure that our app is evidence-based,” says Liudmila. “Our study clearly shows the benefits of using Flo, particularly in areas of the world where menstrual health education is under-resourced.” 

    History of updates

    Current version (18 August 2025)

    Reviewed by Liudmila Zhaunova, PhD, Flo director of science, UK

    Published (19 August 2025)

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