Menstrual Health in Servicewomen - The Menstrual Cycle, Menstrual Disturbances, and Occupational Consequences

Sep 29, 2026

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Menstrual health in servicewomen is shaped by military service during reproductive years, often starting at a young gynecological age. This review outlines the menstrual cycle and synthesizes evidence on menstrual cycle disturbances in military settings, focusing on how these disturbances affect health and operational performance. It describes impacts across nutrition and energy availability, micronutrients and microbiome, physical activity and recovery, and psychological stress.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages19

Reading Time48 min

AccessFree to download

Background

Servicewomen, reproductive life, and early service entry

Menstrual health in the military context

Managing menstruation and symptoms in austere settings

Nutrition, physical activity, recovery, and stressors

Conclusions and calls to action

Representation, research gaps, and policy implications

Mikkonen etal. Sports Medicine-Open (2026) 12:2 Sports Medicine-Open [https://doi.org/10.1186/s40798-025-00963-1](https://doi.org/10.1186/s40798-025-00963-1) REVIEW ARTICLE Open Access Menstrual Health in Servicewomen: The Menstrual Cycle, Menstrual Disturbances, and Occupational Consequences Ritva S. Mikkonen 1, Holly McClung2, Gabrielle Giersch3, Jeroen Van Cutsem4, Helen Wright5, Thomas J. O’Leary6*† and Julie P. Greeves6† Abstract Background Most women serving in the military do so during their reproductive life and enter service at a young gynecological age. This review provides an overview of the menstrual cycle and summarizes the evidence for menstrual cycle disturbances in the military and how these disturbances to the menstrual cycle impact health and performance in the military. Main Text Servicewomen often manage the practical challenges of menstruation and symptoms of the menstrual cycle or menstrual disturbances/dysfunction in an austere environment with no formalized support and/or education, and with unknown stigma and risks. Menstrual health in the military context implies that those who experience a menstrual cycle can access timely information, diagnosis, and support/treatment to achieve “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, in relation to the menstrual cycle.”Herein we describe how menstrual health is impacted in a multistressor environment, including nutrition (energy balance and energy availability, micronutrients, and microbiome), physical activity, and recovery (occupational tasks, sleep, psychological stress, environment), and how menstrual disturbances can affect occupational performance and the lived experience of the female workforce. Conclusions We call for action of militaries worldwide to protect the health of Servicewomen to maximize their potential. Low representation, relatively recent full integration of women into the military workforce, and the exclusion of women from military research have led to policies developed from evidence on men, with the potential to impact the health and performance of Servicewomen. Key Points 1. Servicewomen face unique physiological challenges. Often, they must meet sex-neutral physical employment—or fitness—standards to be employed, and manage menstrual health. †Thomas J O’Leary and Julie P. Greeves have contributed equally as senior authors *Correspondence: Thomas J. O’Leary [thomas.oleary100@mod.gov.uk](thomas.oleary100@mod.gov.uk) Full list of author information is available at the end of the article © Crown 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/.)[.](http://creativecommons.org/licenses/by/4.0/.) Mikkonen et al. Sports Medicine-Open (2026) 12:2 Page 2 of 19 2.A bidirectional relationship exists between multistressor military environments and menstrual health, whereby multistressors can influence endocrine function and menstrual health can be an additional stressor. 3. More high-quality research investigating the many aspects of menstrual health on the overall health and performance of Servicewomen is ess

FAQs

Why does the review focus on menstrual cycle disturbances in military environments?

Most women serving do so during their reproductive life, and many enter service at a young gynecological age. The review summarizes how disturbances occur in military contexts and how they can affect health and performance.

What factors in military service are described as affecting menstrual health?

The review discusses a multistressor environment, including nutrition and energy balance/availability, micronutrients and microbiome, physical activity, recovery factors, sleep, psychological stress, and the environment.

What are the review’s main conclusions for militaries worldwide?

The review calls for action to protect servicewomen’s health and maximize their potential. It highlights low representation, recent integration, and exclusion of women from research that has led to policies based largely on evidence from men.

Sep 29, 2026

Upload by Levi