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How Women Can Deal With Periods In Space

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By Varsha Jain

- PHOTO TAKEN 05AUG05 - Astronaut Eileen Collins, STS-114 commander, floats in the Zvezda Service Module of the International Space Station while Space Shuttle Discovery was docked to the Station, August 5, 2005. Astronaut John Phillips, Expedition 11 NASA Space Station science officer and flight engineer, is visible at bottom right. Picture taken August 5, 2005.  ? EDITORIAL USE ONLY - RTXNORM
Astronaut Eileen Collins. Source: Reuters 

Who was the first woman to have her period in space? What is it like changing sanitary products while being weightless? And why doesn’t menstrual flow just float up into the body when gravity isn’t around?

These were some of the questions I had when I started researching female astronaut health. The human body goes through a lot of changes when in space. Not having gravity to constantly work against, it loses bone density and muscle mass. The cardiovascular system gets lazy and the body’s balance control mechanisms have to completely readapt themselves to find a new norm.

Therefore, I was surprised to learn that one system that doesn’t change at all is the female menstrual cycle. Studies have shown that women can have periods as normally in space as they do on Earth. What’s more, menstrual blood flow isn’t actually affected by the weightlessness we experience in space, so it doesn’t float back in – the body knows it needs to get rid of it.

The fact that women can get periods in space was once used as an argument that women shouldn’t be astronauts. However, we now know that periods don’t impair an astronaut’s ability. Nevertheless, it may be something that female astronauts simply don’t want to deal with.

A Personal Choice

Luckily, there are ways to stop women from having periods these days. But research studies have shown that there are certain groups of women who identify with their periods, feeling it is natural to have a monthly cycle, while others would be happy to never have a period again. Experts haven’t reached a consensus on whether to routinely recommend complete menstrual suppression, but the majority do suggest there are no long-term side effects to not bleeding.

International Space Station, NASA

There are no rules or regulations surrounding what a female astronaut should do about her period – it is a completely personal choice. Some female astronauts have felt menstrual suppression is not suitable for them and therefore have chosen to menstruate in space. However, when making the decision a female astronaut may want to consider some of the challenges of getting periods in space. These tend to be related to the practicalities of hygiene – wash water is limited and changing sanitary products while floating in space would also be quite a task.

If a woman decides against having her periods in space – as many of the long-duration fliers do – their current best available option is to use the oral contraceptive pill. On Earth, the so-called “combined” oestrogen-based contraceptive pill, which prevents ovulation, is taken for three weeks in a row, with a fourth pill-free week to allow for a periodic bleed. However, astronauts who do not want to menstruate can take these pills back-to-back and forgo that week of bleeding. For fit and healthy women, doing this is not linked to any harmful side effects.

But an issue is that, for a three-year mission (say, to Mars and back), you’d need about 1,100 pills to keep periods away – and the flight needs to cope with carrying and disposing of all the packaging, including the cost of launching any extra payload into space. The same problem applies to sanitary products.

We are, however, discovering a number of different options. My recent research suggests long-acting reversible contraceptive (LARC) agents, implants that are typically put under the skin or within the uterus to slowly release menstruation-suppressing hormones, may be more convenient. After all, it may be difficult to remember to take a pill at a certain time each day when managing training schedules and multiple long-haul flights with the added difficulty of changing time zones.

But are they safe? My study didn’t find any evidence that the huge acceleration forces on the body, during launch or landing, could actually damage these devices. But we still don’t know exactly how the implant would fare under specialist diving or spacewalk clothing which lies close to the skin.

NASA astronaut Cady Coleman, Expedition 26 flight engineer. NASA

Despite the advances in space-based research, there’s a lot we still don’t know. One issue is what effect different contraceptives have on bone mineral density. A lack of minerals in our bones increases the risk of conditions such as osteoporosis and fractures. Astronauts lose bone at a much higher rate than on Earth, and there is some evidence that certain contraceptives, such as injections with synthetic progestogen, may make this worse. However, more research is needed for us to fully understand the risks.

Reproductive Health

There’s a lot more we don’t know about female astronaut health. One is the impact on fertility as a result of spaceflight. A study from the 1990s suggested that spaceflight did not have a significant impact on female fertility. A woman’s fertility does, however, decrease with age. So if female astronauts are trying to have their first baby after the age of 41 years – and struggling – it is difficult to tease out whether spaceflight has had an impact, or just age.

Having babies in space is a far-fetched idea, as the radiation impact in space would be severely detrimental to the unborn child – leaving this as a completely unethical area of research. Only once advances in radiation research have progressed to a point where we can safely protect humans from space radiation on long duration missions could we properly ask whether women can carry a pregnancy in space.

However, when it comes to the impact of suppressing menstruation in space, it is possible to do more research. This will be crucial if we want to send astronauts on increasingly long missions such as to Mars and beyond. Luckily, we are already making progress. Our systematic work means there is, for the first time, a “go to guide” for female astronauts looking to make the right choices for them.

Varsha Jain, Space Gynaecologist and Visiting Researcher at the Centre of Human and Aerospace Physiological Sciences , King’s College London

This article was originally published on The Conversation.

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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