It is common for women to have concerns about scuba diving especially during menstruation. After all, what if it increases the risk of a shark attack or the risk of decompression illness? Overall, there is no evidence of an increased risk for female divers who dive during menstruation, although some symptoms of menstruation may make diving uncomfortable. However, another concern for women divers is the issue of contraceptives. Contraceptives are taken by millions of women in developed countries in order to prevent pregnancy. Taken orally or via an injection, contraceptives prevent ovulation in women and it also chemically alters the cervical mucus, thus making it more difficult for sperm to enter the uterus. There are a number of possible side effects to taking oral contraceptives, including nausea, vomiting, fluid retention, dizziness, and headaches. These side effects usually disappear after the initial period of taking the medication, but during this time it might be wise to avoid diving if you experience any of these side effects.
The question remains, can a woman dive when taking contraceptives? When taking oral contraceptives, the general feeling is that women can dive safely without any adverse effects. Theoretically, women could be at a higher risk for decompression sickness due to the fluid retention and change in venous tone that comes with the hormonal changes. However, there has not been any hard evidence that this is actually the case. In general, women who take oral contraceptives are at a greater risk of non-fatal thrombic events by three to four times. This applies to oral contraceptives sold in the United States. Those sold in Europe carry an even greater risk, with women being six to eight times more likely to experience a non-fatal thrombic event.
What does this mean for female divers who are taking these drugs? It means that theoretically there is a chance of increased risk of thromboembolism. In other words, there may be an increased risk of decompression sickness or another related thrombic event. However, a test was conducted on pigs, in which half of them were subjected to oral contraceptives while placed under increased pressures. There was no difference in the injuries sustained by the pigs that were given the contraceptives and those were not. Similar studies on humans have not been done yet. However, in looking at the statistics, it looks as though women who are taking oral contraceptives may be at a higher risk of decompression illness while they are menstruating. It was found that out of 956 female divers who had decompression illness, 38% were menstruating at the time, but 85% of those taking oral contraceptives were menstruating at the time of their accident.
For women who take oral contraceptives this means that some caution may be required. While there needs to be further studies done on this issue, it certainly doesn't hurt for women taking oral contraceptives to take precautions. If you choose to dive, you should dive at shallower depths, for less time, and with a longer decompression and or safety stops on the way back to the surface. Fewer dives in a day may also be a wise choice. These precautions may help to lower any risk that may be present. It may also be beneficial for women to dive more conservatively while they are experiencing pre-menstrual syndrome (PMS) as during this time a female diver is more prone to accidents due to the irritability and other symptoms that tend to accompany PMS.
Scuba diving can be a dangerous sport and as such, it is important that you ensure your safety while diving. Women are more likely to have a safe and happy dive if they take extra precautions while menstruating and taking oral contraceptives. While the jury is still out on the safety of diving while taking oral contraceptives, there is certainly no harm in playing it safe and making sure that you are well protected. After all, the last thing you want is to have an unexpected trip to a hyperbaric chamber during your dive vacation. By planning ahead, being prepared, and playing it safe, you can dive safely and enjoy the incredible beauty that awaits you under the sea.