Women Veterans are among the fastest growing groups of new VA health care users of the VA healthcare system, and currently reflect approximately eight percent of all U.S. Veterans. With Operation Enduring Freedom and Iraqi Freedom (OEF/OIF), women comprise a larger percentage of the military (11.3 percent) than of prior military operations. As of fiscal year 2010, 51.3 percent of female OEF/OIF Veterans had enrolled in VA health care, in sharp contrast to women from previous eras (an estimated 11 percent). Of this group, 88 percent have used VA health care more than once. To better understand the needs of this rapidly growing group, women Veterans' health research has expanded as well. Two previous systematic reviews examined the literature on women Veterans' health and health care up to 2008. In this review, we specifically explored women Veterans' post-deployment health, with two main areas of concentration: 1) post-deployment effects on reproductive health for women Veterans, and 2) post-trauma sequelae among women Veterans from the OEF/OIF cohort. The published literature on deployment and post-deployment health was included in the two previous systematic literature reviews. Most of the extant literature focused on the population of Veterans from OEF/OIF. The previous review also examined the reproductive health literature among military women and women Veterans. However, the previous reviews assessed the literature up through 2008, while the current review further updates these topics by examining them in more detail and extending the literature search through 2010.

Women Veterans are among the fastest growing groups of new VA health care users of the VA healthcare system, and currently reflect approximately eight percent of all U.S. Veterans. With Operation Enduring Freedom and Iraqi Freedom (OEF/OIF), women comprise a larger percentage of the military (11.3 percent) than of prior military operations. As of fiscal year 2010, 51.3 percent of female OEF/OIF Veterans had enrolled in VA health care, in sharp contrast to women from previous eras (an estimated 11 percent). Of this group, 88 percent have used VA health care more than once. To better understand the needs of this rapidly growing group, women Veterans' health research has expanded as well. Two previous systematic reviews examined the literature on women Veterans' health and health care up to 2008. In this review, we specifically explored women Veterans' post-deployment health, with two main areas of concentration: 1) post-deployment effects on reproductive health for women Veterans, and 2) post-trauma sequelae among women Veterans from the OEF/OIF cohort. In response to a growing need to understand the effects of military service on health status, this report supplements our prior review by focusing directly on the reproductive and trauma effects on women in the military or Veterans who have been deployed. The goal is to broaden the knowledge of VA policy leaders and clinicians about post-deployment health issues for women. The Key Questions were: Key Question #1: What research has been published on the effects of deployment on postdeployment reproductive outcomes? We operationalized “reproductive effects” to encompass the following: fertility issues, birth defects, menstrual effects (e.g., change in cycles, loss of cycles), urinary tract infections, sexually transmitted infections, and reproductive cancers (e.g., cervical, ovarian, etc). Key Question #2: What research has been published on post-trauma sequelae in OEF/OIF women Veterans, including: mental health problems, suicide, cardiovascular disease, risky health behaviors (including: tobacco use, hazardous alcohol use, substance abuse, suicide, homicide, assaultive behavior, and eating disorders), and other post-trauma sequelae?

Approximately 4 million U.S. service members took part in the wars in Afghanistan and Iraq. Shortly after troops started returning from their deployments, some active-duty service members and veterans began experiencing mental health problems. Given the stressors associated with war, it is not surprising that some service members developed such mental health conditions as posttraumatic stress disorder, depression, and substance use disorder. Subsequent epidemiologic studies conducted on military and veteran populations that served in the operations in Afghanistan and Iraq provided scientific evidence that those who fought were in fact being diagnosed with mental illnesses and experiencing mental healthâ€"related outcomesâ€"in particular, suicideâ€"at a higher rate than the general population. This report provides a comprehensive assessment of the quality, capacity, and access to mental health care services for veterans who served in the Armed Forces in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn. It includes an analysis of not only the quality and capacity of mental health care services within the Department of Veterans Affairs, but also barriers faced by patients in utilizing those services.

In the very first text of its kind, Women at War brings together all available information and experience on women's physical and mental health in one resource to enlighten the practitioners caring for them. Our U.S Department of Defense is approximately 15% women with over 300,000 women having deployed since September 11th, 2001. This book reviews the epidemiology, changes in policy and demographics of women in the services, the factors affecting their health and health care while serving in austere environments, issues related to reproductive and urogenital health and how health care providers can help prepare and prevent illness. The book also looks at mental health issues to include PTSD and other psychological effects of war, intimate partner violence, sexual assault and suicide, as well as the veteran experience. The book brings together researchers, clinicians, and service member experience and presents the information in a practical, actionable format. It also highlights areas where data is lacking and more study is demanded.

Using data compiled from longitudinal studies of World War II, Korean War, and Vietnam War veterans, contributors to this groundbreaking book examine the effects of military service across the lifespan. The US spends over 100 billion dollars annually on healthcare for more than 30 million active military and veterans. The prevalence of negative trauma and post-traumatic stress disorder (PTSD) among military veterans is well-known. But other more subtle effects of military service--particularly on health and well-being in later life--are less well-understood, among researchers as well as medical and mental health professionals who care for veterans. Chapters in this book give us crucial insights into the impact of military service, including the surprising finding that service can serve as a protective factor in some contexts, throughout the aging process. Topic areas include the effects of combat and stress on longevity and brain functioning; the use of memory, cognition, and ego development at various points in life; the relationship between experiences of discrimination and the later development of PTSD; marriage longevity; employment; and the way notions of patriotism and nationalism among service personnel and their families may change over time.

Department of Veterans Affairs Office of Inspector General conducted a review to assess the Department's capacity to address combat stress in women veterans. It assessed women veterans use of VA health care for traumatic brain injury (TBI), posttraumatic stress disorder (PTSD), and other mental health conditions, and whether the Veterans Benefits Administration (VBA) properly adjudicated women veterans' disability claims for these conditions. It also assessed whether VBA developed and disseminated military sexual trauma (MST) training and reference materials and policies to claims processors and the feasibility of requiring MST training and testing as part of VBA's claims processor certification. The results show that, with variations in degree, female veterans generally were more likely to use VA health care. They were also more likely to continue using VA health care services, even years after separating from active military service, and to use it more frequently. VA generally diagnosed higher proportions of female veterans with mental health conditions after separation, but lower proportions were diagnosed with the specific mental health condition of PTSD and with TBI. These patterns corroborated our findings from data analyses and from review of claims files that higher proportions of female veterans generally were awarded disability for mental health conditions other than PTSD, and a higher proportion of men were generally awarded disability for PTSD and TBI. Data analyses of the study population indicated that VBA denied females more often for PTSD, and denied male veterans more often for a mental health condition other than PTSD, although the denial rates for male and female veterans for all mental health conditions were almost the same. The study did not find any evidence that claims processors applied VBA's current policies and procedures differently when evaluating male and female veterans' disability claims.