Despite the numerous changes that the body undergoes in space, studies have found that the female menstrual cycle is unaffected. Women can have their periods as they normally would on Earth. Interestingly, menstrual blood flow is not impacted by the absence of gravity, as the body recognizes the need to expel it.
The ability to menstruate in space was once used as an argument against sending women into space.
However, we now know that periods do not impair an astronauts' ability to perform their duties. Nonetheless, it may be a personal preference for some female astronauts to not have to manage their periods while in space.
Thankfully, modern medicine provides options for women who wish to stop having periods. However, research shows that some women feel a natural connection to their monthly cycle while others would prefer to never have a period again. While there is no consensus among experts regarding the routine recommendation of complete menstrual suppression, many agree that there are no long-term side effects to forgoing bleeding.
For female astronauts, the decision of what to do about their period is a personal one. Some choose to suppress their periods while others opt to menstruate in space. However, practical challenges exist for those who choose to have their period in space, particularly with regards to hygiene and limited wash water. The current best option for those who wish to suppress their periods is taking the oral contraceptive pill continuously, without the fourth pill-free week. This is safe for fit and healthy women.
However, for longer missions such as a trip to Mars and back, the cost of carrying and disposing of the packaging for 1,100 pills, as well as sanitary products, becomes a challenge. Long-acting reversible contraceptive (LARC) agents may be a more convenient option as they slowly release menstruation-suppressing hormones, eliminating the need for daily pill-taking.
There is still much to learn about the effects of spaceflight on female astronaut health, including its impact on fertility. Although a study from the 1990s suggested that spaceflight did not significantly affect female fertility, age-related fertility decline makes it difficult to determine the effects of spaceflight on women attempting to conceive after age 41.
While the idea of having babies in space is currently unrealistic due to the harmful effects of radiation, further research can be conducted on the impact of menstrual suppression in space. This research will be especially important as missions to Mars and beyond become increasingly common. Progress is already being made, as systematic research has resulted in a guide that female astronauts can use to make informed decisions about their menstrual cycles in space.
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