Hormonal Contraception and Menstrual Cycle Control at High Altitude: A Scoping Review-UIAA Medical Commission...

Area of Science:

• High-altitude medicine
• Women's health
• Reproductive health

Background:

• Women using hormonal contraception (HC) may have concerns regarding its use at high altitudes.
• Understanding the efficacy and safety of HC for menstrual cycle control in this environment is crucial.

Purpose of the Study:

• To conduct a scoping review of current evidence on the efficacy and safety of hormonal contraception (HC) and menstrual cycle control during high-altitude travel.
• To inform recommendations for the International Climbing and Mountaineering Federation (UIAA) Medical Commission on Women's Health in the Mountains.

Main Methods:

• A scoping review of literature from PubMed and Cochrane databases was performed.
• Keyword searches included "contraception" and related terms, supplemented by hand searches.
• Seventeen studies were identified from over 7,000 potentially eligible articles.

Main Results:

• No studies assessed contraceptive efficacy during short-term high-altitude exposure.
• Hormonal contraception (HC) neither benefits nor harms acclimatization or acute mountain sickness (AMS) risk.
• HC is commonly used and safe for menses suppression at high altitude; estrogen-containing HC carries a theoretical increased thrombotic risk in hypobaric hypoxia.

Conclusions:

• Evidence is limited regarding HC interactions with high altitude concerning performance, thrombosis, and contraceptive efficacy.
• Hormonal contraception (HC) does not influence the risk of acute mountain sickness (AMS).
• The most effective and safe contraceptive method at high altitude is typically the one the woman is most familiar with and already using.