{
  "abstract": "Menstrual-cycle–related conditions and, later, menopausal symptoms are highly prevalent across the female life course and impose a large, under-recognized burden on quality of life and work, yet digital tools to support self-management are fragmented, hard to sustain, and unevenly reached. We propose HERA (Health Engagement and Reflective Agent architecture), a conceptual, hypothesis-generating framework for supporting engagement, behavior change, and equitable self-management in menstrual and menopausal health across the life course. Under human governance, HERA combines two adaptive agents (interpretation and orchestration) with three rule-based modules (self-monitoring and data integration, guidance and content governance, and equity and engagement monitoring) that integrate self-monitoring, deliver personalized feedback, surface governed guidance, monitor equity, and coordinate hand-offs to clinicians and occupational-health services. Distinct from clinician-facing diagnostic agents, HERA is patient-facing and treats equity and engagement as first-class. We distinguish technically feasible from aspirational elements and set out a staged, threshold-gated evaluation plan. HERA is a design reference, not a validated system.",
  "abstract_shown": true,
  "affiliations": [
    "Project Division of International Healthcare Innovation Research, The Institute of Medical Science, the University of Tokyo, Tokyo, Japan",
    "Department of Research, Kitasato Institute Hospital, Tokyo, Japan",
    "Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan",
    "Department of Obstetrics and Gynecology, Nippon Medical School Hospital, Tokyo, Japan"
  ],
  "article_type": "Opinion",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Koichiro Yuji"
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    {
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        1
      ],
      "name": "Wakako Yuji"
    },
    {
      "affs": [
        2
      ],
      "name": "Maika Nariai"
    },
    {
      "affs": [
        3
      ],
      "name": "Yuki Enomoto"
    },
    {
      "name": "Osamu Wada-Hiraike"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8tgan6j3tdmaq.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pdig.0001821",
  "fulltext_url": "https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001821",
  "id": "8tgan6j3tdmaq",
  "issns": [
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  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
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  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
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  "native_subjects": [
    [
      "plos",
      "/Biology and life sciences/Physiology/Endocrine physiology/Menopause"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Endocrine physiology/Menstrual cycle"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Reproductive physiology/Menstrual cycle"
    ],
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      "/Biology and life sciences/Population biology/Population dynamics"
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      "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Hemorrhage"
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    [
      "plos",
      "/Medicine and health sciences/Critical care and emergency medicine/Triage"
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    [
      "plos",
      "/Medicine and health sciences/Endocrinology/Endocrine physiology/Menopause"
    ],
    [
      "plos",
      "/Medicine and health sciences/Endocrinology/Endocrine physiology/Menstrual cycle"
    ],
    [
      "plos",
      "/Medicine and health sciences/Epidemiology/Medical risk factors"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Quality of life"
    ],
    [
      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine"
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      "plos",
      "/Medicine and health sciences/Vascular medicine/Hemorrhage"
    ]
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  "pdf_url": "https://journals.plos.org/digitalhealth/article/file?id=10.1371/journal.pdig.0001821&type=printable",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-05",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/8tgan6j3tdmaq.ris",
  "sources": [
    {
      "first_seen": "2026-11-06T12:20:42Z",
      "native_id": "10.1371/journal.pdig.0001821",
      "source": "plos",
      "url": "https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001821"
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  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "plos:endocrinology",
      "subfield": "endocrinology-metabolism"
    },
    {
      "field": "medicine",
      "origin": "plos:physiology",
      "subfield": "physiology"
    }
  ],
  "title": "Supporting engagement, behavior change, and equitable self-management in menstrual and menopausal health: A multi-agent digital-health framework",
  "title_text": "Supporting engagement, behavior change, and equitable self-management in menstrual and menopausal health: A multi-agent digital-health framework",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:20:24Z",
  "url": "https://research.draconitic.com/paper/8tgan6j3tdmaq",
  "venue": "PLOS Digital Health",
  "versions": []
}