Women's Health Issues and Travel
Hygiene Practices
- Sanitary pads and tampons may not be available or may not be up to the same standard you are used to, consider bringing your own.
- Toilet facilities are different in some locations and toilet paper isn’t used in many countries. Stick rolls of toilet paper in your bag or bring some moistened cleansing wipes such as Kleenex Cottonelle® brand. These are available in resealable travel packs or tubs.
Constipation
- Bowel habits may change with travel. Consider bringing fiber supplements (like Metamucil® or Cetrucil® – they both come in individual packets), or a mild laxative. Hemorrhoid medications like Preparation H® or Tucks® may be helpful.
Urinary Tract Infections
- If you are prone to bladder infections, speak with your provider about taking some medication with you. Often Ciprofloxacin® used for Traveler’s Diarrhea can be used for treatment of a bladder infection.
- You may also want to bring some Pyridium®, which can help the symptoms but you will still need antibiotics to treat the infection. Bladder infections should be treated as soon as possible to avoid a more serious infection of the kidneys.
Vaginitis
- If you are prone to yeast infections it might be advisable to bring some treatment (like Monistat® or Diflucan®) with you. Antibiotics for traveler’s diarrhea and Doxycycline®, an antibiotic sometimes given for prevention of malaria, may also cause yeast infections.
- You can help prevent vaginitis by avoiding wet clothing, tight clothing, underwear at night, douching and unwashed sex toys.
Women and High Altitude
- Oral contraceptives and Nuvaring® use at high altitude (>8000 ft) is a theoretical concern but data is inconclusive. Women may be at increased risk for blood clots, migraines, and high blood pressure.
- Pregnant women are usually advised to avoid trips above 8,0000 feet especially in the 3rd trimester.
Sexual Assault
- Traveling in unfamiliar areas can increase your risk of sexual assault so take precautions; travel with companions, make sure someone knows your whereabouts, and use only reputable public or private transportation.
- Avoid excessive alcohol and never drink from a glass that has been unattended. Do not use illegal drugs.
Contraception
- Talk to your clinician about using your method in a continuous fashion (oral contraceptives or Nuvaring®) to avoid having menses while traveling.
- If you will be abroad for an extended period of time, talk to your clinician about using one of the convenient newer methods such as a Mirena IUD® (good for at least 5 years) or the Implanon implant (good for 3 years).
- If you are on birth control pills and you are traveling across time zones make sure you are taking 1 pill every 24 hours.
- Consider changing your method practices to avoid having a period while on your trip if it will be inconvenient. Discuss this option with your clinician.
- Consider bringing a course of Plan B® (or other form of emergency contraception) in case you need one while away, these may not be readily available.
- Always use condoms with any new partner regardless of other methods used, to help prevent sexually transmitted infections.
Some circumstances present with travel (certain medications, illness, changing time zones, etc.) may lead to decreased effectiveness of oral contraceptives and Nuvaring, so you may want to use a backup method. Current research reveals that antibiotics do not decrease the effectiveness of contraceptives, except for those used to treat tuberculosis. St John’s Wort, however, a commonly used over the counter medicine for depression, does decrease the effectiveness.
Pregnancy
- If you are pregnant or planning to become pregnant and planning a trip, it is best to contact your clinician to discuss any potential risks a trip might pose to you or your developing fetus.
- Immunizations:
- Inactivated vaccines such as Tetanus/diphtheria, polio and Hepatitis B vaccines are considered safe in pregnancy. Hepatitis A, typhoid (injectable), meningococcal, rabies (tissue culture derived), Japanese encephalitis, pneumococcal, viral influenza, and cholera vaccines are probably OK in pregnancy. The risks and benefits of vaccinating in pregnancy are considered on an individual basis.
- Live vaccines like measles, mumps, rubella and varicella vaccines are not given in pregnancy. It is recommended that a woman wait 3 months to become pregnant after getting one of the above vaccines. Yellow fever and oral polio vaccines are usually not given in pregnancy but may be given under certain circumstances. Oral typhoid is usually not given due to theoretical risks.
- Malaria Prevention: Chloroquine is considered safe in pregnancy. Larium is considered safe in the 2nd and 3rd trimesters. Doxycycline and Malarone are contraindicated in pregnancy.
- Traveler’s Diarrhea: Ciprofloxacin is not given in pregnancy. Zithromax® is currently the recommended drug in these cases.
- Altitude: trips above 8,000 feet are not recommended for the pregnant travelers especially in the 3rd trimester.
- Flying: most commercial airlines restrict travel after 35-36 weeks. They may require a letter from your provider, which lists your expected date of delivery.
- Activities: scuba diving and water skiing or other sports, which may result in serious trauma, are contraindicated in pregnancy.