Menstrual management considerations in the space environment

Steller, Jonathan; Blue, Rebecca S.; Zahner, Christopher; Frisch, Emily; Bayuse, Tina; Auñón-Chancellor, Serena M.; Jennings, Richard T.

doi:10.1016/j.reach.2021.100044

Cited by 5 publications

(3 citation statements)

References 155 publications

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“…Indeed, whilst there are some physiological differences that should be considered 21 , females may also present operational physiological advantages for extended spaceflight due to decreased (on average) body size and energy consumption 22 compared to their male counterparts 23 . Sex-based risks include the optional but frequent use of hormonal contraception in female astronauts to suppress menstruation 17,18,24,25 . The elevated risk is highest during the first months but remains significantly increased compared to non-users, depending on the type of hormonal contraceptive prescribed (ie.…”

Section: Venous Thrombus In Space: What Do We Know? Vt Pathophysiolog...mentioning

confidence: 99%

Pathophysiology, risk, diagnosis, and management of venous thrombosis in space: where are we now?

Harris

Arya

Elias³

et al. 2023

npj Microgravity

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The recent incidental discovery of an asymptomatic venous thrombosis (VT) in the internal jugular vein of an astronaut on the International Space Station prompted a necessary, immediate response from the space medicine community. The European Space Agency formed a topical team to review the pathophysiology, risk and clinical presentation of venous thrombosis and the evaluation of its prevention, diagnosis, mitigation, and management strategies in spaceflight. In this article, we discuss the findings of the ESA VT Topical Team over its 2-year term, report the key gaps as we see them in the above areas which are hindering understanding VT in space. We provide research recommendations in a stepwise manner that build upon existing resources, and highlight the initial steps required to enable further evaluation of this newly identified pertinent medical risk.

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Section: Venous Thrombus In Space: What Do We Know? Vt Pathophysiolog...mentioning

confidence: 99%

Pathophysiology, risk, diagnosis, and management of venous thrombosis in space: where are we now?

Harris

Arya

Elias³

et al. 2023

npj Microgravity

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“…Final determination of medical certification currently rests with NASA and the Multilateral Space Medicine Board of the ISS International Partners (MSMBIP). For the postflight female astronaut population, more conservative recommendations including annual mammography with adjunctive ultrasound for dense breast tissue, or alternating mammography with biennial breast magnetic resonance imaging (MRI), earlier and more frequent colon cancer screening (starting at 40 y and every 5 y thereafter), and an annual skin exam by dermatologist [154,158] have been recommended [161].…”

Section: Gynecologic Medical Standards For Career and Private Astronautsmentioning

confidence: 99%

Extraterrestrial Gynecology: Could Spaceflight Increase the Risk of Developing Cancer in Female Astronauts? An Updated Review

Drago-Ferrante

Fiore

Karouia

et al. 2022

IJMS

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Outer space is an extremely hostile environment for human life, with ionizing radiation from galactic cosmic rays and microgravity posing the most significant hazards to the health of astronauts. Spaceflight has also been shown to have an impact on established cancer hallmarks, possibly increasing carcinogenic risk. Terrestrially, women have a higher incidence of radiation-induced cancers, largely driven by lung, thyroid, breast, and ovarian cancers, and therefore, historically, they have been permitted to spend significantly less time in space than men. In the present review, we focus on the effects of microgravity and radiation on the female reproductive system, particularly gynecological cancer. The aim is to provide a summary of the research that has been carried out related to the risk of gynecological cancer, highlighting what further studies are needed to pave the way for safer exploration class missions, as well as postflight screening and management of women astronauts following long-duration spaceflight.

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“…Sometimes women use oral contraceptives during space flight 4 to facilitate comfort in a confined environment, which hinders the evaluation of follicle and endometrial growth, as well as hormonal levels. Concurrently, a documented case of jugular vein thrombosis in a female astronaut 5 has provided a rationale for considering alternative approaches or potentially abandoning cycle suppression during spaceflight missions 6 .…”

Section: Introductionmentioning

confidence: 99%

Weightlessness leads to an increase granulosa cells in the growing follicle

Kikina,

Matrosova,

Gorbacheva

et al. 2024

npj Microgravity

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The participation of women in space programs of increasing flight duration requires research of their reproductive system from the perspective of subsequent childbearing and healthy aging. For the first time, we present hormonal and structural data on the dynamics of recovery after a 157-day space flight in a woman of reproductive age. There were no clinically significant changes in the reproductive system, but detailed analysis shows that weightlessness leads to an increase in the proportion of early antral follicles and granulosa cells in large antral follicles. Returning to Earth’s gravity reduces the number and diameter of early antral follicles.

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Menstrual management considerations in the space environment

Cited by 5 publications

References 155 publications

Pathophysiology, risk, diagnosis, and management of venous thrombosis in space: where are we now?

Pathophysiology, risk, diagnosis, and management of venous thrombosis in space: where are we now?

Extraterrestrial Gynecology: Could Spaceflight Increase the Risk of Developing Cancer in Female Astronauts? An Updated Review

Weightlessness leads to an increase granulosa cells in the growing follicle

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