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Gardner L, Keyes LE, Phillips C, Small E, Adhikari T, Barott N, Zafren K, Maharjan R, Marvel J. Women at Altitude: Menstrual-Cycle Phase, Menopause, and Exogenous Progesterone Are Not Associated with Acute Mountain Sickness. High Alt Med Biol 2024. [PMID: 38516987 DOI: 10.1089/ham.2023.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
Gardner, Laurel, Linda E. Keyes, Caleb Phillips, Elan Small, Tejaswi Adhikari, Nathan Barott, Ken Zafren, Rony Maharjan, and James Marvel. Women at altitude: Menstrual-cycle phase, menopause, and exogenous progesterone are not associated with acute mountain sickness. High Alt Med Biol. 00:000-000, 2024. Background: Elevated progesterone levels in women may protect against acute mountain sickness (AMS). The impact of hormonal contraception (HC) on AMS is unknown. We examined the effect of natural and exogenous progesterone on the occurrence of AMS. Methods: We conducted a prospective observational convenience study of female trekkers in Lobuche (4,940 m) and Manang (3,519 m). We collected data on last menstrual period, use of exogenous hormones, and development of AMS. Results: There were 1,161 trekkers who met inclusion criteria, of whom 307 (26%) had AMS. There was no significant difference in occurrence of AMS between women in the follicular (28%) and the luteal (25%) phases of menstruation (p = 0.48). The proportion of premenopausal (25%) versus postmenopausal women (30%) with AMS did not differ (p = 0.33). The use of HC did not influence the occurrence of AMS (HC 23% vs. no HC 26%, p = 0.47), nor did hormonal replacement therapy (HRT) (HRT 11% vs. no HRT 31%, p = 0.13). Conclusion: We found no relationship between menstrual-cycle phase, menopausal status, or use of exogenous progesterone and the occurrence of AMS in trekkers and conclude that hormonal status is not a risk factor for AMS. Furthermore, women should not be excluded from future AMS studies based on hormonal status.
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Affiliation(s)
- Laurel Gardner
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Linda E Keyes
- Department of Emergency Medicine, Section of Wilderness Medicine, University of Colorado-Anschutz Campus, Aurora, Colorado, USA
| | - Caleb Phillips
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Elan Small
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Tejaswi Adhikari
- Department of General Practice and Emergency Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Nathan Barott
- SUNY Upstate Medical University, Syracuse, New York, USA
| | - Ken Zafren
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Rony Maharjan
- Department of General Practice and Emergency Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - James Marvel
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, California, USA
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