title: Menstrual suppression for combat operations: advantages of oral contraceptive pills.
abstract: BACKGROUND
  increasing numbers of women are deployed to austere settings in which menstruation may impose logistical challenges. Minimal data exists about the use of oral contraceptive pills (OCPs) for menstrual suppression in this population. Post-deployment survey was undertaken to establish prevalence of continuous OCP use, perceived barriers, and associations with menstrual burden in a military population within the austere environment.
  
  
  METHODS
  voluntary and anonymous 44-item questionnaire.
  
  
  RESULTS
  of 500 women, 78% (n = 390) had personal experience using OCPs and 66% (n = 330) desired menstrual suppression. However, only 40% (n = 192) reported any OCP use and only 21% (n = 99) reported continuous use during deployment. Sixty-seven percent of women reported some difficulty in daily pill compliance and nearly half (45%) missed ≥ 1 pill per week in the austere setting. Continuous users were nearly twice as compliant as conventional users (p = .019) and compliant OCP users reported significantly less menstrual burden than noncompliant users (p = .017). Almost all women (85%) desired mandatory education about menstrual suppression through OCPs.
  
  
  CONCLUSIONS
  despite OCP experience and desire for amenorrhea, prevalence of extended cycle OCP use in this population is low. Extended OCPs users in the austere setting report improved compliance and reduced menstrual burden compared with conventional users. Education about OCPs is highly desirable for most military women and may benefit those in austere settings.
authors.affiliation: Uniformed Services University of the Health Sciences-Department of Military & Emergency Medicine, Bethesda, Maryland, USA. Dunford.powell@us.army.mil
authors.forename: Nicole C
authors.initials: NC
authors.lastname: Powell-Dunford
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Cuda
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Moore
authors.forename: Mark S
authors.initials: MS
authors.lastname: Crago
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Kelly
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Deuster
mesh_terms: D000328:Adult; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D003625:Data Collection; D004334:Drug Administration Schedule; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008598:Menstruation / Q000187:drug effects*; D008875:Middle Aged; D008889:Military Personnel; D011293:Premenstrual Syndrome / Q000453:epidemiology / Q000517:prevention & control; D015995:Prevalence; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014481:United States; D014857:Warfare; D055815:Young Adult; D016903:Drug Monitoring
chemical_list: D003278:Contraceptives, Oral, Hormonal