DIVING AND MENSTRUATION
By Kristy Allison
Having a menstrual period is a normal and regular event in many women's lives. However, many women who dive do not feel they have someone with whom they feel comfortable discussing this issue. Many times they don't have all the facts they need.
When I began diving in 1972, few women were diving as compared to today. It has only been over the course of the last 20 years that larger numbers of women have become active in the sport. Therefore, research and information on women's issues has been fairly scarce and changes as new research is conducted. Once I became an instructor I had female students asking questions that I had no answers to, as these issues were not part of my open water or instructor training. Through years of searching for answers many questions remain, however the diving industry is beginning to come up with more information to help you make informed decisions on diving.
The issues of diving during menses can be put into two categories: physiological and convenience.
Physiological Issues:
Emotional upset, exhaustion and traveling through different time zones can all contribute to an upset in the menstrual pattern. Irregular menstruation is a very common problem affecting women travelers, excessive exercise and the stress of travel may also cause infrequent periods.
Are women at greater risk of experiencing decompression illness (DCI) while menstruating?
According to DAN and the British Hyperbaric Association, a review of women divers (956 divers) with DCI found 38 percent were menstruating at the time of their injury. Additionally, 85 percent of those taking oral contraceptives were menstruating at the time of the accident. This suggests, but does not prove, that women taking oral contraceptives are at increased risk of decompression illness during menstruation. Based upon available data, it may be prudent for women taking oral contraceptives, particularly if they are menstruating, to reduce their dive exposure and stay well within their limits. This could involve making fewer dives, shorter and shallower dives and making longer safety stops.
Until a series of questions pertaining to the menstrual cycle becomes standard at all chamber admissions, there can be little hope of assessing this area adequately.
Are Tampons safe to use while diving? There is no evidence that tampons or any other intravaginal objects are in any way dangerous from the effects of increased pressure. Not being a closed space, it does not suffer the effects of Boyle's Law.
PMS (Premenstrual Syndrome) occurs to some degree in 25 - 50% of all women. There are secondary concerns for PMS where the physical symptoms can include irritability, emotional liability, depression, drowsiness, decreased mental alertness, slowed reaction time, bloating, headaches and other symptoms, which may compromise the diver's safety in the water and interaction with their dive buddy or others on the dive.
A study of diving women done in 1997 by UHMS Mexico determined that 93% of women dive while menstruating, 71% have symptoms of PMS, and 34-48% perceive some decrement in performance due to menstruation.
Can you take MidolTM while diving?
MIDOLTM helps many women relieve their various menstrual and premenstrual symptoms. The ingredients in MidolTM vary according to which strength you use. In general ingredients can include a diuretic ingredient to help reduce bloating, an antihistamine, which helps to relieve cramp pain, and caffeine to help fight tiredness.
Please be aware that it is important to avoid additional caffeine from other substances such as coffee or soda. You should be aware that caffeine acts as a diuretic and may contribute to overall dehydration. It is not recommended for divers to drink beverages containing caffeine prior to, during or after diving. If you choose to take MidolTM with the diuretic component, insure an adequate intake of water is also added.
Are women at an increased risk of shark attacks during menstruation?
Sharks are not an issue. There are few reported shark attacks on women, and there is no data to support the belief that menstruating females are at an increased risk for shark attacks. The average blood lost during menstruation is small and occurs over several days. Also, it is known that many shark species are not attracted to the blood and other debris found in menstrual flow.
Hygiene, privacy and convenience:
Tampons are a good choice for active women. They can be worn while swimming and don't interfere with physical exercise.
If you choose to dive, check out the facilities on the boat or beach area in advance. You can usually find a female instructor or employee at the dive center to take aside and ask for advice. I have seen facilities range from a private head below deck to a large plastic bucket or no access to private facilities at all. Disposal can pose a few problems, since tampons cannot be flushed on a boat. Do the best you can to dispose of them in a responsible manner in the trashcan.
One of the greatest inventions for women divers to utilize should they decide to dive during menstruation is a full darlex, 3 ml or greater suit a lycra is not sufficient. If, during your dive, you are unable to find the proper time or facility to take care of things, wearing one of these suits will help keep you from having an embarrassing situation until you are able to get to a shower.
If you are traveling keep in mind that tampons may be very difficult or virtually impossible to find in many places. Therefore it is advisable to take a sufficient amount to cover you for your entire trip.
Traveling women should be sensitive to the cultural and religious attitudes towards menstruation. In some countries there are cultures will not allow women to touch or even walk near food during this time. To avoid such situations discreet use of and disposal of sanitary towels and tampons would be advisable.
Check with your Doctor if you are taking the pill. For short trips, several packets of pills can be run in together to prevent menstruation, but this is not a good idea for longer travels.
Final Thoughts:
In general, diving while menstruating does not seem to be a problem as long as normal, vigorous exercise does not increase the menstrual symptoms. As long as the menstrual cycle poses no other symptoms or discomforts that affect your health, there is no reason that a menstruating female should not dive. Remember your basic training? Dive only if you feel well. If you don't feel up to it or don't want to deal with the issue of taking care of logistics while on the dive boat, plan a day of laying by the pool and working on your tan or getting caught up with a good book in a hammock. Most women will feel better if they take it easy during the heaviest day or two and are able to dive the rest of the time.
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