Is Menopause a Cause of the Bends?

Undercurrent subscriber Hollie Lindauer (Portland, OR) wrote to us, "Skin bends are not something I've heard much about, until I got them. At that point, I was on Google right away to figure it out. I contacted Divers Alert Network with questions about, 'Why me?' I dove within my limits for deco and, as always, did my three-minute safety stop. Then I find skin bends are yet another thing women get to discover about menopause - we're prone to skin bends. Who knew? The bruising went away by the next morning, although I was deep-muscle sore for about a week. I had no other symptoms. Is there anything I should know about the damage done?"

We couldn't find any direct evidence to support menopause increasing the risk of DCS. We did find a 2015 Alert Diver article by dive medical technicians Brittany Trout and Lana Sorrell that stated, "With aging comes special considerations for female divers. The symptoms of menopause can include anxiety, decreased energy, hot flushes, sleep-disruption and mood changes. Nonetheless, menopause is not a contraindication to diving, assuming symptoms do not compromise dive safety, nor is it the greatest risk for aging female divers."

So we asked Doug Ebersole, a Florida cardiologist based in Florida who consults for DAN for his take. "Decompression sickness is a 'sports injury'," he says. "It is not a sign that Hollie did anything wrong. It just happens sometimes, despite diving within the no-decompression limits and doing safety stops. I agree with the recommendations for 'conservative' diving to decrease the risk of recurrent skin bends (or other forms of DCS) in the future. This would be sensible hydration, limiting depths, diving nitrox with the diving computer set to air (but not exceeding the maximum operating depth of the nitrox), and doing long safety stops.

Ebersole's advice to Hollie and other older female divers: "Limiting yourself to only a couple of dives per day and considering taking one day off from diving if on a week-long dive trip can also be helpful. There should not have been any damage done [to Hollie] as a result of this event."