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A preliminary study of the effect of menstruation on the incidence of acute mountain sickness
  1. Megan Elizabeth Paul1,
  2. Thomas D Wagner2,
  3. Connor A Tukel1,
  4. Dana R Levin3,4
  1. 1 Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  2. 2 Medical Education, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA
  3. 3 Aerospace Medicine, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
  4. 4 Emergency Medicine, University of Colorado—Anschutz Medical Campus, Aurora, Colorado, USA
  1. Correspondence to Megan Elizabeth Paul, Icahn School of Medicine at Mount Sinai, New York, New York, USA; megan.paul{at}

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Over 50% of those engaging in high altitude activities are women.1 Nonetheless, women have historically been neglected in scientific literature regarding backcountry environments. Acute mountain sickness (AMS), a condition triggered by hypoxia, is common at altitudes >2500 m above sea level, and prior studies suggest that women are particularly vulnerable to it due to hormonal changes associated with menstruation.2–4 Therefore, this study assessed the association of menstruation and AMS incidence during a high-altitude expedition to Mount Kilimanjaro.

This retrospective study involved a review of records from the Equal Playing Field expedition, in which 48 female athletes trekked to the summit of Mount Kilimanjaro via the Shira route (5895 m) to set a world record for the highest altitude soccer match. One emergency medicine physician with altitude experience served as Chief Medical Officer along with two wilderness emergency medical technicians. The medical team conducted ‘rounds’ in the mountain camp …

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  • Handling editor Ellen J Weber

  • Contributors Study concept and design: MEP, DRL; data acquisition: MEP, DRL; data analysis: MEP, DRL; drafting and critical revision of the manuscript: MEP, TDW, CAT, DRL and approval of final manuscript: all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.