title: Menstrual and premenstrual issues in female military cadets: a unique population with significant concerns.
abstract: BACKGROUND
  There is a strong need to determine what effect, if any, menstruation has on the performance of duty as a Cadet at the United States Military Academy (USMA) at West Point, and to determine what impact, if any, the USMA environment has on the menstrual cycle.
  
  
  OBJECTIVE
  To study menstrual function and premenstrual symptoms in a structured, rigorous military environment; determine the perceived impact of menstrual and premenstrual symptoms on academic, physical, and military activities; and evaluate the difficulties inherent to menstruation in a military setting.
  
  
  METHODS
  A survey about high school menstrual and premenstrual function, and the Premenstrual Assessment Form (PAF), were completed by all 158 freshman female Cadets in July 1991. In May 1992, 83 participants completed a survey assessing menstrual and premenstrual symptoms, including interference with activities during the year.
  
  
  METHODS
  Menstrual regularity, premenstrual symptoms, interference with activities.
  
  
  RESULTS
  Participants reported menstrual patterns and premenstrual symptoms in high school similar to other females their age. Most (62%) predicted a change in menstruation at the USMA, half were worried that physical symptoms would interfere with activities, one-fourth were worried that premenstrual symptoms would interfere with activities, and one-fourth were worried that obtaining and changing menstrual materials would interfere with activities. Almost all respondents (91%) reported changes in menstruation during the year, most commonly less regular, less frequent, shorter, lighter, and less crampy periods. Menstrual and premenstrual symptoms interfered with physical activities (66.2%, 61.4% respectively) more so than academic (50.6%, 45.7% respectively) or military activities (39.8%, 47.0% respectively). Female Cadets described significant difficulties with changing (62.6%), obtaining (51.8%), and disposing of (38.5%) menstrual materials.
  
  
  CONCLUSIONS
  The data demonstrate major changes in menstrual function in over 90% of female Cadets; a significant perceived impact of menstrual and premenstrual symptoms on academic, physical, and military activities; and difficulties in obtaining, changing, and disposing of menstrual materials in a military setting. These findings have implications for females in the military, as well as for young women generally.
authors.affiliation: Adolescent Program, Greenwich Hospital, Connecticut 06830, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Schneider
authors.forename: M
authors.initials: M
authors.lastname: Fisher
authors.forename: S B
authors.initials: SB
authors.lastname: Friedman
authors.forename: P E
authors.initials: PE
authors.lastname: Bijur
authors.forename: A P
authors.initials: AP
authors.lastname: Toffler
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008597:Menstrual Cycle / Q000523:psychology*; D008599:Menstruation Disturbances / Q000503:physiopathology / Q000523:psychology*; D008889:Military Personnel / Q000523:psychology; D009518:New York; D013334:Students / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D016387:Women's Health