PELVIC HEALTH

PELVIC HEALTH AND FEMALE MILITARY PERSONNEL

Why study this group?

The female workforce is growing rapidly

The number of women serving in the Australian Defence Force is increasing, with women now representing 17.9% of the workforce (Navy 21.5%, Army 14.3%, Air Force 22.1%) (ADF, 2018).  In addtion, women are increasingly assuming non-traditional, more physically-demanding and diverse roles. Concerns regarding the ability of women to cope with the physical & psychological demands of military roles have traditionally restricted the range and types of roles open to them. However in recent years, these restrictions have been lifted as the value of having women serving in wide ranging roles has been increasingly recognized (ADF, 2016).  A larger female workforce necessitates comprehensive consideration of the requirements of female personnel in areas such as health care, deployment, physical training, load carriage, and equipment and apparel procurement. Understanding relevant issues allows for the provision of appropriate support, training, equipment, and health care, and contributes to the ongoing success of women in wide-ranging military roles (Epstein et al., 2015; Nindl, 2015).

Pelvic health is different for men & women

Pelvic health is a key area where the care and support needs between genders varies because of differences in genitourinary anatomy and function, as well as their respective roles in reproduction and parenthood. Genitourinary health issues, such as pelvic floor dysfunction (i.e. incontinence, pelvic organ prolapse), are more common in women (Hawthorne 2006).   The unique physical work requirements of many military roles mean that personnel undertake high levels of physical training and load carriage. For servicewomen this may place them at an even higher risk of pelvic floor dysfunction than women in non-military contexts, particularly during childbearing years and beyond.

Pelvic health issues are more common in women

Whilst there is currently no Australian data on pelvic floor dysfunction in women in the ADF, there is evidence from studies of US servicewomen that suggests it is a significant issue and can impact on job performance (Criner, 2001). Strategies used by female military personnel to manage genitourinary health issues may also pose serious health risks.  For example, servicewomen experiencing urinary incontinence have reported restricting their fluid intake or altering their bladder habits, significantly increasing the risk of heat illness (Steele et al., 2013). 

Other genitourinary conditions, such as urinary tract infections, are also more common in women than men because of anatomical differences. Recent US military data indicate that urinary tract infections are a significant issue for female military personnel, and can impact on their occupational health and performance (AFHSC, 2014).  Poor sanitation conditions, more challenging toileting practices, particularly during field exercises or deployment, increase the risk of urinary tract infections in female service women (Steele et al., 2013). In addition, pelvic floor dysfunction, alterations in fluid intake and bladder habits may further increase the risks.

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Better understanding allows the ADF to support women to be "Fit for Life, Fit to Fight"

The genitourinary health of female military personnel have not previously been explored in detail within the Australian Defence Force context. Better understanding of how women manage and maintain their pelvic health is required to optimise the support required and ensure the health and fitness of women in the ADF and support Force readiness.