aiMH Lab

applied informatics for Mental Health

Sex and menstrual cycle differences in the mood-activity association should inform cycle-aware digital phenotyping


Journal article


K. Delray, J. Zeitler, J. Hayes, A. Kandola, N. Keay, R. Evans
medRxiv, 2026

Semantic Scholar DOI
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APA   Click to copy
Delray, K., Zeitler, J., Hayes, J., Kandola, A., Keay, N., & Evans, R. (2026). Sex and menstrual cycle differences in the mood-activity association should inform cycle-aware digital phenotyping. MedRxiv.


Chicago/Turabian   Click to copy
Delray, K., J. Zeitler, J. Hayes, A. Kandola, N. Keay, and R. Evans. “Sex and Menstrual Cycle Differences in the Mood-Activity Association Should Inform Cycle-Aware Digital Phenotyping.” medRxiv (2026).


MLA   Click to copy
Delray, K., et al. “Sex and Menstrual Cycle Differences in the Mood-Activity Association Should Inform Cycle-Aware Digital Phenotyping.” MedRxiv, 2026.


BibTeX   Click to copy

@article{k2026a,
  title = {Sex and menstrual cycle differences in the mood-activity association should inform cycle-aware digital phenotyping},
  year = {2026},
  journal = {medRxiv},
  author = {Delray, K. and Zeitler, J. and Hayes, J. and Kandola, A. and Keay, N. and Evans, R.}
}

Abstract

Passive physical activity is increasingly used as a digital-phenotyping proxy for mood, assuming a stable relationship across people and time. We tested this assumption using daily mood and activity data from 1,072 individuals (121 women, 951 men; 13,909 person-days) in the Juli app. The within-person activity-mood association was stronger in women than men (slope difference -0.194, p = 0.019). Within women, it varied across the menstrual cycle (p = 0.022): absent in the early luteal phase, significant in all other phases, and largest in the late luteal phase (+0.46). A male pseudo-cycle control showed no such modulation (p = 0.974), confirming the effect is cycle-specific rather than a general temporal pattern. Accounting for cycle phase improved out-of-sample mood prediction in women in 75% of cross-validation splits. Digital phenotyping should account for sex and menstrual cycle phase to avoid biased predictions and enable personalized recommendations for women.