Female Military Officers Report a Desire for Menstrual Suppression During Military Training.

ABSTRACT

INTRODUCTION: Service women face female-specific challenges that present physiological and logistical burdens and may impact readiness. The stress of training can change menstrual patterns and symptoms, and limited access to hygienic, private facilities can hinder menstrual management. Therefore, suppressing menses with continuous hormonal contraception may be of interest. MATERIALS AND METHODS: The 9-item "Military Women's Attitudes Toward Menstrual Suppression." questionnaire was administered to female officers upon entry (baseline) and graduation (post) from a 6-month secondary training course. Respondents rated their attitudes about menstruation and the stress of training, the desire for menstrual suppression, and the logistical burden of menstruation on a 1 (strongly agree) through 5 (strongly disagree) scale. Wilcoxon Signed Rank Tests determined changes in the distribution of responses from baseline to post. RESULTS: Female officers (n = 108) completed baseline and post questionnaires (age 25.2 ± 0.3 years). At baseline, the majority disagreed/strongly disagreed that the stress of training "makes periods worse than usual" (n = 77, 71%), "increases menstrual symptoms and bleeding" (n = 77, 71%), or "magnifies premenstrual syndrome" (PMS; n = 69, 64%). Although 50% (n = 54) agreed/strongly agreed that "stopping periods while women are training is a good idea," 37% (n = 40) disagreed/strongly disagreed. The majority agreed/strongly agreed that menstrual suppression would prevent "the worry about menstrual supplies" (n = 75, 70%) and "the inconvenience of having a period during training" (n = 69, 64%). Many agreed/strongly agreed that it is difficult to deal with periods during training because "there is no privacy" (n = 52, 48%), "the inability to find adequate facilities" (n = 70, 65%), and "the lack of opportunity to use adequate facilities" (n = 52, 48%). Opinions remained largely consistent from baseline to post. CONCLUSIONS: The desire for menstrual suppression among service women during training is high. Military health care providers should be prepared to counsel service women about strategies to manage menstruation, including the efficacy of continuous hormonal contraception for menstrual suppression. Future studies investigating benefits or risks of continuous hormonal contraception for menstrual suppression in service women should inform the clinical recommendations.