A new report mulls options on how female astronauts can manage menstrual bleeding while on a space mission.

Researchers from King's College London and Baylor College of Medicine are exploring the idea of suppressing menstruation during space missions with the use of contraceptive devices, which are presently being used by aviation staff and military personnel.

Discontinuing menstruation during space missions is a popular choice for astronauts because of the challenges faced during spaceflight. Some astronauts time short duration missions with their menstrual cycles. But this is not possible during long-haul spaceflights.

For longer missions, astronauts suppress their menstrual period by using combined oral contraceptive (COC) pills.

Past studies have shown that microgravity in space cause the bone to lose minerals making astronauts prone to osteoporosis later in life. The paper suggests that extensive studies should be done to identify whether continued use of COCs factor in bone demineralization.

Menstruation in space has much impracticality. Packaging of pills and tampons contributes to the mass and disposal issues aboard the International Space Station (ISS). Menstrual blood disposal is also challenging as ISS's waste disposal system only allows for reclamation of water from urine.

The paper suggests the use of long acting reversible contraceptives (LARCs) like subdermal implants and IUDs. LARCs would omit the packaging and disposal issue and management in-flight. The report stated that LARCs are not seen to hinder tasks. Moreover, no notable information suggests that G-loading during space launch or landing displaces the IUD or subdermal implant.

Varsha Jain, a researcher at the Centre of Human and Aerospace Physiological Sciences (CHAPS), said that early studies of women in the military revealed that there is a high preference to suppress menstruation during deployment. Jain said that since more and more women are joining space missions, it is important that they have the proper information about menstrual suppression and the options available for them, if any.

Due to the challenges faced in studying female astronauts, the report recommends that pharmacological data during spaceflights should be compared with and complemented by ground-based studies.

Assistant Professor at the Centre for Space Medicine Virginia Wotring said that women should be given options catered to her lifestyle and needs. She acknowledges that spaceflight environment during menstruation can be particularly challenging and recommendations on how to suppress it should not be given haphazardly.

"[W]e need more data regarding health effects, including bone health, with long-term use of hormone treatments, not just for contraception (as most women use them), but also for the less-common use to suppress menses," Wotring said.

The report was published in npj Microgravity.

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