Genitourinary health in female military personnel: An exploration of prevalence and impacts on occupational performance

PURPOSEGenitourinary health issues, such as incontinence, pelvic organ prolapse and urinary tract infections, more commonly affect women. Whilst anatomical differences, parity, and menopause represent non-modifiable risk factors, high impact physical activity, load carriage, and sanitary conditions have been implicated. This presentation will explore what is currently known about the genitourinary health of women working in military contexts, examine the specific risk factors, and consider the relationships with occupational health and performance.METHODPublished studies of relevance to the aim were identified through searches of journal databases and consultation with experts in the field. Findings of relevance were extracted and synthesised to provide an overview of current knowledge on the topic.RESULTSGenitourinary symptoms such as urinary tract infections are quite common, with 30.4% of women in the US Armed Forces experiencing them compared with 3.5% of men. Similarly, in a US military survey, 26% of female soldiers reported experiencing urinary incontinence during physical activity. One third reporting incontinence also needed to modify or stop the aggravating activity, demonstrating that occupational performance was affected. Of concern is that common strategies to manage urinary incontinence – restricting fluid intake or postponing voiding – may lead to more serious health issues such as heat illness.Differences in genitourinary anatomy, poor sanitation conditions and more challenging toileting practices, particularly during field exercises or when deployed, are likely to increase the risk of urinary symptoms and infections in servicewomen. Female military personnel have also been reported to be less likely to seek medical attention for genitourinary symptoms because of limited women-specific health services and female medical staff, embarrassment and poor confidentiality.These findings provided background for the development of a survey on female pelvic health in the Australian Defence Force. Preliminary findings from this survey will be discussed, if available, alongside the findings from published studies.CONCLUSIONSFurther research is required to more broadly investigate female genitourinary health in military contexts, including the types, severity, prevalence and their coexistence in this population, the strategies used to manage these conditions in military contexts, and the impacts of female genitourinary conditions on occupational performance.OPERATIONAL RELEVANCEWomen are increasingly assuming non-traditional, more physically-demanding roles within military forces. The unique operational demands of many military roles may place servicewomen at a higher risk of genitourinary health issues, which in turn may impact on their occupational health, safety and performance.