Decompression sickness in women: a possible relationship with the menstrual cycle

Women are increasingly participating in recreational scuba diving and the professional roles of women are expanding in the fields of aviation, space, and diving. Evidence exists that there may be a relationship between altitude decompression sickness (DCS) and the menstrual cycle, although diving studies to support such findings are limited. The aim of the present study was to investigate the presence of any relationship between the development of DCS in female sports divers, the phase of the menstrual cycle, and the use of the oral contraceptive pill (OCP).

Personal, dive, symptom, and menstrual history details were collected by questionnaire from women treated with hyperbaric therapy for DCS in 23 treatment centers worldwide.

There were 150 records suitable for analysis. The phase in the menstrual cycle of the DCS incident was estimated. The DCS incidents were unevenly distributed throughout the cycle (p = 0.001) with the greatest percentage of incidents occurring in the first week of the menstrual cycle. The variation in incidence across the cycle appeared to be greatest for the non-OCP users (p = 0.01), and when age was taken into account there was a significant difference between the OCP and non-OCP users with respect to risk of DCS across the menstrual cycle (p = 0.03).

These data suggest that the risk of DCS may be dependent on the phase of the menstrual cycle and that the distribution of risk differs between OCP and non-OCP users.