Eating from pouches, sleeping in a bag tied to the wall, using a vacuum-powered toilet: Basic processes of human life require scientifically tested solutions in space. It's the same for menstruation, a process female astronauts must plan for before flying to space, especially for longer missions in the future.
"We are developing so many systems, making humans survive in a place we're not supposed to be," said astrobiologist Lígia Coelho, 51 Pegasi b Postdoctoral Fellow in astronomy in the College of Arts and Sciences (A&S) and fellow at the Carl Sagan Institute. "The farther we go, to the moon and Mars, that's becoming harder and harder."
To equip astronauts with health choices for future missions, Coelho is leading research with AstroCup, a group that recently tested two menstrual cups in spaceflight as payload on an uncrewed rocket flight. Their container, designed by aerospace engineers on the team, measured temperature, acceleration and humidity. They analyze the results in "One Giant Leap for Womankind: First Menstrual cup Tested in Spaceflight Conditions" published Dec. 2 in npj Women's Health.
Co-authors with Coelho are Catarina Miranda, Miguel Morgado and Diogo Nunes of the University of Lisbon and João Canas of aerospace company SpinWorks. Contributing authors are André F. Henriques, University of Lisbon, and Adam B. Langeveld, visiting scholar in astronomy (A&S) and CSI.
The menstrual cups performed well, said Coelho, who uses her expertise in biology toward understanding life processes related to space. Through pre- and post-flight testing, the team found that the silicon menstrual cups, made by Finland-based company Lunette, retained their structural integrity and functionality through 9.3 minutes of flight and some extreme acceleration, especially during liftoff and just before the parachute deployed for landing. In fact, they sustained forces higher than they would on a crewed flight, Coelho said, assuring performance on a flight with astronauts on board.
A water test after the flight confirmed the cups retained their structural integrity. A test with glycerol, a blood analogue, confirmed they retained functionality.
"The first time something is done on a rocket payload, the paper is used as methodology precedent," Coelho said. "We wanted to have a bulletproof methodology that can be replicated by other people. We put a lot of thought into how we could do this consistently with a good control setting that could be replicated."
With these results, Coelho and her team show that a silicon menstrual cup made by a standard brand here on Earth will work in space flight conditions. They are also setting the stage for a larger discussion within the space industry, Coelho said.
"I get passionate about the reasons why menstrual devices are still not in space," she said. "We need to have a serious conversation about what it means to have autonomy for health in space."
Most astronauts who menstruate suppress menstruation hormonally on missions that last up to six months. There is currently an option to pack pads or tampons, but dealing with these single-use materials on a yearslong mission to the moon or Mars would be unsustainable, Coelho said.
At those long-term timelines, hormonal suppression becomes more difficult, too, requiring packing years of medicine. NASA is also looking into connections between hormonal suppression and blood clots, Coelho said. Under these conditions, choices around menstrual health will not just be convenient but essential.
Without workable options, women going into missions lasting five, 10 or even more years might be required to put their reproductive health on long-term hold. Plus, using a preferred method of menstruation care could improve astronauts' productivity and happiness on long missions.
Cleaning and reusability must be studied, but portable sterilization kits used on Earth for camping or hiking trips could be repurposed for space, she said. Menstrual underwear is another simple solution closely related to current practice - all astronauts on the International Space Station wear single-use underwear.
In February, the AstroCup team (made of professionals in science and space fields who volunteer their time for the project) sent menstrual cups with crew members on the simulated Hypatia II Mission on the Mars Desert Research Station in Utah, collecting data about usability and astronauts' reactions.
Their next step is to send more rocket payloads into space, with a goal of placing menstrual devices of various kinds on the International Space Station.
"It's validated, it works," Coelho said. "Now we can start implementing and redefine health autonomy in space."
Kate Blackwood is a writer for the College of Arts and Sciences.
