Menstrual Irregularities in Military Members

Funding opportunity

Researchers are invited to apply for a new funding opportunity sponsored by Canadian Forces Health Services (CFHS), Women and Diversity Health (WDH), to conduct a scoping review regarding menstrual irregularities associated with the military environment.

This scoping review is required to:

1. Determine the occurrence of menstrual irregularities in Canadian Armed Forces (CAF) members, or in other militaries;
2. Describe risk factors for menstrual irregularities in military populations;
3. Identify possible outcomes or impacts that may be associated with menstrual irregularities in CAF members; and
4. Propose areas for further research and/or solutions or interventions appropriate to a military environment, where possible.

Anticipated timeline and budget

Background

Women and diverse populations have historically been under-researched in medicine. This has limited our knowledge of their unique health needs, including health risks, prevention, and treatment options. For these reasons, CFHS established the WDH program. WDH aims to optimize prevention and care for women and members with diverse identity factors, using an intersectional lens, to improve their physical, mental, and psychosocial well-being. This is aligned with governmental priorities and current shifts in research.

Since its inception in 2022, the WDH program has focused on establishing relationships with stakeholders and partners to identify collaborative opportunities and minimize duplication of effort, as well as to identify opportunities for high priority research. This Funding Opportunity represents a collaboration between WDH and the Defence Research Development Canada Women and Diversity Health Program Activity Area and is building upon the research funding already awarded to address the gaps in knowledge related to the health of military women and members with diverse identity factors.

Recently, several studies (Givens et al., 2023; O’Leary et al., 2022; Popp et al., 2025) have indicated that female military members may be more likely than the general female population to experience menstrual irregularities, in particular during sustained training periods. In this context, menstrual irregularities are broadly defined as an impairment of the normal ovulatory menstrual cycle (e.g., amenorrhea). Other terms that sometimes can be used interchangeably include menstrual disturbances or abnormalities.

Physiological and psychological factors sometimes present in the military environment (e.g., intense physical activity, sleep disruption, heat exposure and psychological stress) have been associated with menstrual irregularities in other populations. Any associations between short or long-term menstrual irregularities, including, but not limited to, infertility, bone loss, musculoskeletal injury, and impact on performance or readiness, should be included in the scoping review. Areas requiring future research and/or strategies to mitigate menstrual irregularities in a military environment should be proposed.

Scope and Research objectives

This funding opportunity is seeking submissions from researchers to conduct a scoping review of the literature describing:

• The incidence and/or prevalence of menstrual irregularities in military members, as compared to incidence/prevalence in the general population or other populations for comparison.
• The causes that may be associated with menstrual irregularities in military members and populations with similar operational or occupational environments (e.g., athletes, first-responders, shift-workers, etc.).
• The potential health outcomes associated with menstrual irregularities and effects on performance or readiness.
• The effect of hormone-based contraception on the occurrence and health outcomes associated with menstrual irregularities.
• Possible interventions or mitigating strategies that can be incorporated into a military environment.
• All known demographic or diversity factors that could affect risk factors for menstrual irregularities or associated health issues.

Desired outputs:

• A report that includes a scoping review, including an Executive Summary, Abstract, Introduction, Methods, Data analysis, Results, Discussion and a full set of References used to produce the final report, and the other specifications described here. The research team is encouraged to publish their findings in one or more peer-reviewed publications. Any funds needed for publication should be accounted for in the budget.

The scoping review should:

• follow appropriate guidelines and checklists (e.g. PRISMA-ScR);
• use a broad search strategy with respect to research methodology, and to include qualitative, quantitative, and mixed methods research, grey literature, and clinical guidelines; and
• focus on work applicable, transferable, or generalizable to the CAF population but should draw broadly to include international literature, general populations, and grey literature.

The report should address the following objectives:

• identify gaps and trends in the current evidence to direct future research;
• provide recommendations to inform CAF and CFHS policy or practice; and
• provide recommendations to addressing strategies to mitigate menstrual irregularities in a military context.

The report must also:

• Follow SAGER guidelines, including a detailed description of the GBA+ considerations.
• Include a knowledge translation or knowledge transfer component.
• Be presented virtually to the project sponsor and stakeholders and include key findings relevant to the CAF (may take place after the project end date).

Applicant qualifications and requirements for selection:

• Principal investigator (PI) must have a PhD or MD in a relevant field, with experience conducting literature reviews in a related research area.
• All appropriate academic research guidelines must be followed, including a research ethics board approval from an accredited academic institution in Canada prior to funding being issued if applicable to the method(s) selected.
• Additional internal DND/CFHS approval will be required for research involving CAF members. A CFHS point of contact will be provided to facilitate this process once the research proposals are selected.
• All reports, publications, and presentations from this funding opportunity are required to acknowledge that the research was conducted in response to a Funding Opportunity developed and funded by the CFHS WDH.

Application form

Please download and submit the Research Funding Application form.

Applicants are advised to include eight weeks of administrative lead-time in their timelines. This will allow for ethics board submission and approval (if required), and the drafting and signing of the funding agreement.

Enquiries

Questions about this funding opportunity can be sent to the VAC Research office.

References:

Givens, Andrea C., Jake R. Bernards, and Karen R. Kelly. "Characterization of female US marine recruits: workload, caloric expenditure, fitness, injury rates, and menstrual cycle disruption during bootcamp." Nutrients 15.7 (2023): 1639.

O'Leary, Thomas J., et al. "Menstrual disturbances in British servicewomen: a cross-sectional observational study of prevalence and risk factors." Frontiers in Nutrition 9 (2022): 984541.

Popp, Kristin L., et al. "Hypothalamic-pituitary-ovarian axis suppression is common among women during US Army Basic Combat Training." British Journal of Sports Medicine 58.18 (2024): 1052-1060.