Sexual and Reproductive Health Issues among Recreational Female Hikers at High Altitude: A Scoping Review

Hiking offers well-documented cardiovascular, psychological and sleep benefits and is increasingly popular among women. However, strenuous conditions at high altitude introduce unique challenges to female physiology, particularly their sexual and reproductive health (SRH). This scoping review explores the SRH issues experienced by recreational female hikers especially at high altitude. It was conducted according to Joanna Briggs Institute methodology for scoping reviews and was reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). A systematic search was performed across PubMed, Scopus and Web of Science, using keywords and synonyms related to females, reproductive health, hiking and high altitude. Inclusion criteria encompassed studies addressing SRH issues faced by female hikers. Fifteen studies met these criteria. Reported issues clustered into six topics: menstrual disturbances and hormonal dysregulation; nutrition–menstrual interactions; pregnancy at high altitude; contraceptive considerations; the association between menstruation and acute mountain sickness; and other challenges, including sexual harassment and menstruation-related participation barriers. Most studies were small and observational, with more than half published before 2005, limiting the certainty of the evidence. Despite the growing participation of women in hiking and mountaineering, substantial gaps remain in understanding the short-term effects of high-altitude exposure on female SRH. This review highlights the necessity for targeted research to address these knowledge gaps and to develop evidence-based guidelines for female hikers. Ensuring safe participation in high-altitude activities will allow women to realise these benefits without compromising reproductive health