Consortium for Health and Military Performance, Department of Military and Emergency Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814.
Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., 67020A Rockledge Dr, Suite 100, Bethesda, MD 20817.
Mil Med. 2021 Jan 25;186(Suppl 1):775-783. doi: 10.1093/milmed/usaa339.
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.
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.
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.
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.
女性军人面临着特殊的挑战,这些挑战会带来生理和后勤方面的负担,可能会影响其战备状态。训练的压力会改变月经模式和症状,而有限的卫生、私人设施可能会妨碍月经管理。因此,通过持续的激素避孕来抑制月经可能是有意义的。
对参加为期 6 个月的二级培训课程的女性军官在入职(基线)和毕业(入职后)时进行了 9 项“女性军人对月经抑制的态度”问卷。被调查者对月经和训练压力、对月经抑制的渴望以及月经期间的后勤负担的态度进行了 1(非常同意)到 5(非常不同意)的评分。Wilcoxon 符号秩检验确定了从基线到入职后反应分布的变化。
108 名女性军官(年龄 25.2±0.3 岁)完成了基线和入职后问卷。在基线时,大多数人不同意/强烈不同意训练的压力“使经期比平时更糟糕”(77 人,71%),“增加经期症状和出血”(77 人,71%),或“放大经前综合征(PMS)”(69 人,64%)。尽管 50%(54 人)同意/强烈同意“女性在训练期间停止月经是个好主意”,但 37%(40 人)不同意/强烈不同意。大多数人同意/强烈同意,月经抑制将防止“担心月经用品”(75 人,70%)和“训练期间经期不便”(69 人,64%)。许多人同意/强烈认为,由于“没有隐私”(52 人,48%)、“无法找到足够的设施”(70 人,65%)和“缺乏使用足够设施的机会”(52 人,48%),在训练期间处理月经非常困难。从基线到入职后的意见基本保持一致。
在训练期间,女性军人对月经抑制的需求很高。军队医疗保健提供者应该准备好为女性军人提供有关管理月经的策略的咨询,包括持续激素避孕对月经抑制的疗效。未来研究应告知临床建议,调查持续激素避孕对女性军人月经抑制的益处或风险。