Frequently Asked Questions on Diving Medicine

When we pressurise the middle ear space using the Valsalva manoeuvre or another equalisation technique, the tympanic membrane (ear drum) bulges outward slightly. If the ear canal is uncovered and can transmit that pressure, the water in the ear canal moves easily in response. A hood that fits snugly against the outer ear can greatly restrict the movement of this water, hampering the diver’s ability to equalise. An easy remedy to this is to insert a finger under the hood near the ear, which will allow the water to move more easily. Another solution some divers choose to implement is to cut a hole from the inside of the hood, near the ear canal, through the inner lining and the neoprene but leaving the outer fabric or covering intact. This hole allows the water to move with little restriction.

Premenstrual Syndrome, or PMS, is a group of poorly understood and poorly defined psychophysiological symptoms experienced by many women (25-50 percent of women) at the end of the menstrual cycle, just prior to the menstrual flow. PMS symptoms include mood swings, irritability, decreased mental alertness, tension, fatigue, depression, headaches, bloating, swelling, breast tenderness, joint pain and food cravings. Severe premenstrual syndrome has been found to exacerbate underlying emotional disorders. Although progesterone is used in some cases, no consistent, simple treatments are available.

FITNESS AND DIVING ISSUES

Research has shown that accidents in general are more common among women during PMS. If women suffer from premenstrual syndrome, it may be wise to dive conservatively during this time. There is no scientific evidence, however, that they are more susceptible to decompression illness or dive injuries/accidents. Also, individuals with evidence of depression or antisocial tendencies should be evaluated for their fitness to participate in diving: they may pose a risk to themselves or a dive buddy.

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Women and Diving: Health Considerations

At present, there are no medical indications that favor one contraceptive method over another with regard to being exposed to decompression stress. There are no clinical trials or data on the IUD, however I do not see any particular contraindications with regard to its use while diving. As a rule, if no side effects or a documented greater individual risk of thrombotic events are present (but this would also affect the prescription of the contraceptive), also the use of oral contraceptives does not have any contraindications connected to diving. This said, the practice of choosing more conservative dive profiles is strongly advised (dives without decompression stops, no more than two dives a day, maximum depth within 30 meters, bottom time within 70-75% of the maximum limit, possible use of Nitrox with dive times calculated for air).

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Women and Diving: Health Considerations

There is no accumulation of nitrogen in breast milk, and even if this were the case, drinking this milk would not cause any risk of decompression in the baby. In general, it is recommended to wait at least 3 weeks to recover from the “trauma” of childbirth and hormonal changesIn the first few months, we recommend to stay within the limits of “no-deco dives”, i.e. dives which don’t have mandatory decompression stops – after all, the bodily changes induced by these 9 months of pregnancy should not be underestimated. Only one disadvantage may occur when breastfeeding: the pressure exerted by the dive suit on the chest and on the breasts could (in some cases) reduce milk production (it is a known technique for woman who want to stop breastfeeding, to wear tight clothes or bandages around the chest).

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Women and Diving: Health Considerations

Yes, it is safe. A mother’s breast milk is not adversely affected by diving, and there is no risk of decompression sickness for the infant. Although nitrogen accumulates in all of the tissues and fluids of the mother’s body, washout of inert gas occurs quickly after a safe dive. Insignificant amounts of nitrogen may be present in the mother’s breast milk, but it is inert and poses no risk to the infant. However, because of the possible risk of bacterial growth on the skin under a suit, careful cleansing of the breast after diving and before feeding may help prevent systemic illness.

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Women and Diving: Health Considerations