Facts about Female Veterans Health in Afghanistan

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Facts about Female Veterans Health in Afghanistan
 

– Reported, 18 January 2013

 

In July 2011, the Society for Women’s Health Research(SWHR) convened a 1-day, interdisciplinary scientific conference on female veterans’ health entitled, ‘‘What a Difference an X Makes: The State of Women’s Health Research. A Focus on Female Veterans.’’ Researchers and medical professionals from academia and the military presented new research findings and shared future perspectives related to the female veteran population. This report focuses on research highlights related to mental health (posttraumatic stress disorder [PTSD] and depression), urogenital health, musculoskeletal health, and traumatic brain injury (TBI).

Women and PTSD:
PTSD is defined by symptoms that last > 1 month and include reexperiencing of a traumatic event, persistent avoidance of stimuli associated with a traumatic event, and numbing of general responsiveness and persistent symptoms of increased arousal, both absent before the traumatic event.

If men have more traumatic experiences, why do women have more PTSD? Dr. Magruder suggested three reasons for this paradox:
(1)women experience traumas that are higher risk for PTSD, specifically sexual assault/abuse,
(2) women have longer duration of PTSD symptoms, and
(3) women have stronger reactions to traumatic events.

Levels of reproductive steroids fluctuate at hormonal transitions across the female life span, which are critical time points for susceptibility to mood disorders, such as perimenopausal depression and premenstrual dysphoric disorder (PMDD). The menopause transition is associated with increased risks of both first-onset and recurrent depression, with episodes clustering during the late menopause transition and early postmenopause. The prevalence of depression in these groups is 20%–30%.

Changes in levels of sex steroids also play a role in PMDD (prevalence 3%–8%), with symptoms occurring in the luteal phase of the menstrual cycle when progesterone and estrogen levels increase. Interestingly, women who suffer from PMDD do not exhibit abnormal levels of gonadal hormones, again indicating differential susceptibility to gonadal influences on depression among women. Treatments for PMDD may involve SSRIs or therapies that suppress hormonal fluctuations and ovulation. A study using Lupron, a gonadotropin-releasing hormone agonist that suppresses ovarian hormone production, demonstrated reduction in PMDD symptoms and provided evidence for gonadal hormone effects on brain function.

Although women are technically barred from serving in combat, since Operation Desert Storm, women have been deployed to forward positions in greater numbers. This increased involvement in combat zones and the associated risk from exposure to trauma, injury, and environmental hazards present new health consequences for woman that must be addressed for both actively serving women and female veterans. Considering that the female segment of the military continues to increase, female veterans’ health must be situated at the forefront of the biomedical research and health policy agendas. Biomedical research in veterans that incorporates the study of sex and gender differences will translate to better health outcomes for female veterans and will help the Department of Veterans Affairs to better serve the needs of female veterans. Access to gender-appropriate care and an advanced understanding of the unique health needs of the female veteran are essential. Improved outreach should continue to raise further awareness among the female veterans seeking healthcare and also interest researchers to pursue areas within their work that include studies relevant to female veterans.

CREDITS:
Eileen M. Resnick, Ph.D., Monica Mallampalli, Ph.D., and Christine L. Carter, Ph.D., M.P.H.
http://www.womenshealthresearch.org/