Feminine Hygiene in the Field

Addressing Critical Health Issues for Military Women

Understanding the Problem

The Air Force faces a significant challenge in managing feminine health among its female service members. According to statistics from the National Institute of Health (NIH) and the Air Force’s 14th Medical Group Aerospace Medicine Group, military women experience yeast infections, urinary tract infections (UTIs), and other related conditions at rates 30 times higher than their civilian counterparts and military male counterparts. Factors such as vigorous exercise, extreme temperatures, and prolonged periods in uniforms that are not designed to manage a woman's unique physiological needs exacerbate these health challenges. These issues lead to decreased readiness, diminished effectiveness, increased sick days, higher antibiotic usage, and elevated healthcare costs.

Challenges in the Field

In field settings, female service members often lack adequate access to bathrooms, showers, laundry facilities, and sanitary products necessary to maintain proper feminine hygiene. This scarcity places them at a higher risk for vaginal yeast infections during deployments. Over a six-year surveillance period, nearly 3,000 U.S. military women were diagnosed with at least one clinically significant yeast infection while supporting combat operations in Southwest/Central Asia. The overall incidence rate was 35.1 per 1,000 person-years (p-yrs), with higher rates among black, non-Hispanic service women, and those in the Army and Air Force, in enlisted grades, and in communications/intelligence and motor transport occupations.

Addressing Yeast Infections

The yearly rate of yeast infections was relatively stable from 2008 through 2010, followed by a decrease from 2011 through 2013. To mitigate the risk of yeast infections in austere operational settings, it is crucial to provide female service members with practical information, realistic training, and material support before deployment. These measures can help reduce the risk of acquiring and improve the treatment of clinically and operationally significant yeast infections.

Urinary Tract Infections (UTIs)

Austere living conditions during deployment also increase the risk of urinary tract infections (UTIs). Over the same six-year surveillance period, 6.5 percent of females (n=7,214) and 0.3 percent of males (n=2,412) who were deployed had at least one UTI diagnosed while in Southwest Asia and the Middle East. The incidence rate of first-time UTIs during deployment was 86.7 per 1,000 p-yrs in females and 3.3 per 1,000 p-yrs in males. Of those with at least one UTI during deployment, 13.6 percent of females and 3.6 percent of males experienced a recurrent UTI during the same or a follow-up deployment period.

Demographic Insights

The highest rates of UTIs were observed among the youngest service members, those in armor/motor transport occupations, and individuals with "other" marital status (e.g., separated, divorced). Throughout the surveillance period, annual overall rates of UTIs were 26-55 percent higher among non-deployed than deployed females and 130-250 percent higher among non-deployed than deployed males. Notably, 53.6 percent of females and 13.9 percent of males diagnosed with UTIs during deployment had at least one prior UTI diagnosed during a medical encounter in a fixed medical treatment facility before deployment.

Conclusion

Addressing feminine health issues in the field is critical for maintaining the readiness and effectiveness of female service members. By providing the necessary resources, training, and support, the military can help mitigate the risks of yeast infections and UTIs, ensuring that female service members can perform their duties without compromising their health. This proactive approach is essential for enhancing overall mission success and safeguarding the well-being of women in the armed forces.