Abstract
Background:
According to the World Health Organization, approximately 18 million women are affected by heavy menstrual bleeding (HMB), which can be a key early clinical indicator of an underlying rare bleeding disorder, yet often remains under-recognized. The spectrum of symptoms ranges from asymptomatic or mild manifestations to severe complications, such as anemia and dysmenorrhea. These symptoms can significantly impair mobility and quality of life, leading to changes in daily routines and lifestyle. Despite increasing awareness among healthcare professionals and patient advocacy groups, only a minority have been adequately supported. Therefore, the mobile application (app) ‘‘Red Lilly“has been developed.
The app aims supporting women in general, but especially for abnormal menstruation and in addition by making indication in case of altered values recommending further medical investigation.
Objective:
To address this gap, we developed Red-Lilly, a mobile app designed to systematically track menstrual bleeding and identify patterns suggestive of bleeding disorders. The app aims to empower women through accessible, user-friendly digital self-monitoring and guide them toward timely medical evaluation. In addition, valuable data concerning frequency, severity and treatment of HMB/ dysmenorrhea will be generated.
Methods and Features:
Red-Lilly is available in English and German and can be downloaded free of charge from Android and iOS platforms. Upon registration, users provide core personal data including age, and blood group.
During each cycle, users can document the relevant aspects of their menstruation using a standardized input interface, including:
Type of menstrual hygiene product (e.g., tampons, pads, menstrual cups, period underwear)
Absorbency level
Product condition (e.g., saturation)
Bleeding intensity
Presence of tissue clots
The app enables through these inputs an automatically calculation of the Pictorial Blood Assessment Chart (PBAC) score. When the PBAC score exceeds a defined threshold, the user is prompted to consult a physician or a specialized bleeding disorder center.
Quality of Life Monitoring:
Red-Lilly also includes a brief questionnaire addressing the impact of menstruation on daily activities and the need for analgesic medication. These insights allow for a broader evaluation of the burden associated with menstrual bleeding and its potential connection to bleeding disorders.
Data privacy and ethics: All the data are anonymized and stored in compliance with the General Data Protection Regulation (GDPR) and exclusively located on servers within Germany.
The data are collected in accordance with the WMA Declaration of Helsinki – Ethical Principles for Medical Research Involving Human Subjects.
Conclusion:
Red-Lilly is an innovativ, accessible, and evidence-informed digital tool for the systematic evaluation of menstrual bleeding. In a prospective study, unsolved questions concerning HMB/Dysmenorrhea will be analyzed. By identifying abnormal bleeding patterns and encouraging further medical assessment, the app aims to support earlier diagnosis of bleeding disorders in women and contribute to improve health outcomes and quality of life.
