Women’s Health in Spaceflight

Authors: Drudi, Laura; Grenon, S. Marlene
Source: Aviation, Space, and Environmental Medicine, Volume 85, Number 6, June 2014, pp. 645-652(8)
Publisher: Aerospace Medical Association

Objective: To review the current state of knowledge with regards to clinical challenges related to women’s health during spaceflight. Methods: Articles were reviewed relevant to “women”, “sex,” and “gender” in “microgravity,” “weightlessness,” and “spaceflight” in the English and Russian languages.Results: There were 50 papers identified. Studies have shown that crewmembers suffer from space motion sickness, but gender discrepancies have not been explored. Nearly all women experience orthostatic intolerance in space, which may be due to differences in female cardiovascular response. Immunosuppression in spaceflight results in susceptibility to opportunistic infections, but no studies have investigated gender differences. Finally, radiation exposure and germ cell viability influence the reproductive health of astronauts. Conclusions: With changes in space access offered by commercial space activities, research areas devoted to women’s health in microgravity should become one of the

THE HUMAN SPACEFLIGHT program is at the point of major changes. The National Aeronautics and Space Administration (NASA) Space Shuttle program has left many significant scientific and medical legacies. Since the dawn of human spaceflight, it was imperative to be aware of issues pertinent to health and well-being in space.
The first woman to fly in space was Valentina Tereshkova, a Russian cosmonaut, in 1963. Only when NASA designed and built the Space Shuttle did they begin recruiting female astronaut candidates. In 1977, NASA received 8000 applicants and selected the top 35, which included 6 U.S. female astronaut candidates. The integration of women in the Astronaut Corps prompted the beginning of a medical program which was aimed at evaluating the health of women as potential spaceflight crewmembers (23). Large gaps of knowledge still exist with gender-based issues during spaceflight.

As of October 2013, there are in total 57 female astronauts of 530 total space travelers and 15 female astronaut candidates. Historically, physiological responses in spaceflight have not been aimed at studying sex- or gender-based differences. Most studies have been performed with male astronauts, which result in difficulty extrapolating data from women in these studies. Given the small number of female astronauts in the Astronaut Corps, data derived from female astronauts has often been pooled together with data derived from male astronauts. It is no surprise that the understanding of sex-based differences in spaceflight remains a challenge.
The 30-yr Space Shuttle program ended in July 2011, bringing with it important ramifications in human spaceflight. Simultaneous efforts have been growing in the commercial spaceflight industry with the development of private industries, spaceports, and space tourism enterprises. Therefore, the number of women flying in space may increase. Furthermore, the increasing commercial activities may translate into less stringent selection criteria for space travel, which has potential implications for occupational space medicine. More studies and investigations will be required as the endeavors of space exploration continue beyond lower Earth orbit to exploratory class missions with national astronauts as well as commercial spaceflight participants, which may include an augmenting female population.

The Institute of Medicine is committed to understanding the sex and gender differences between men and women. They define sex differences as the biological and physiological aspects of individuals, whereas gender differences are defined as the psychosocial construct of individuals, including values, opinions, and beliefs (24). Using the Institute of Medicine definition and recommendations, a comprehensive evaluation of women’s health in spaceflight was undertaken, including sex and gender differences. The goals of this paper are threefold: a) to review the literature to highlight the status of the study of women’s health during space missions; b) to identify areas where research is needed; and c) to provide a platform of discussion for international research efforts to advance the field of sex and gender-based research in the contextual framework of space exploration.