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VA Research Spotlight

Highlights of VA research on women's health

June 19, 2019

VA Research Spotlight is a monthly roundup of research news on topics affecting Veterans' health. This month, in honor of Women's Health, our focus is on research that examines the unique health needs of women.

Find out about the health services that VA provides to women Veterans.

Women's Health

Women's Health Fact Sheet Currently, there are 1.9 million living women Veterans, who make up 9.4 percent of the total Veteran population. VA researchers are looking at a broad range of health issues related to women Veterans—from gender differences in health care to mental and behavioral health to the impacts of military service. Recent research is also addressing issues related to intimate partner violence and homelessness among women Veterans.


Journal supplement on sex/gender differences in VA

A 2019 supplement to the journal Women's Health Issues, sponsored by the VA Cooperative Studies Program, examines sex and gender differences in U.S. Veterans' health conditions and responses to treatments. Women veterans make up a growing share of the population receiving VA care, but too few clinical trials report results by sex or gender. This collection of articles highlights some of the innovative research VA is doing to promote evidence-based care for women Veterans.



VA Research in Action

Prolonged exposure therapy to treat PTSD Validation of screening tool for intimate partner violence
VA researchers tested and validated a screening tool, or brief questionnaire, to elicit reports of intimate partner violence experienced by women Veterans. VA now uses the tool nationwide. Read more



Infograph

Military Sexual Trauma and Chronic Pain

Military Sexual Trauma and Chronic Pain

VA Research Quarterly Update

How intimate partner violence affects women Veterans How intimate partner violence affects women Veterans
Dr. Katherine Iverson is a clinical psychologist and researcher in the Women's Health Division of the National Center for PTSD, located at the VA Boston Healthcare System. Her research focuses on women's health and trauma—in particular, intimate partner violence in women Veterans.



VA Research Currents

When it comes to using birth control, intention and attitude matter When it comes to using birth control, intention and attitude matter
A new VA study adds to the evidence that women's intentions around becoming pregnant don't fully explain whether and how they use contraception. Rather, their attitudes toward becoming pregnant also play a role.... (11/28/2018)



Study shows how binge drinking and stress affects male, female mice differently Study shows how binge drinking and stress affects male, female mice differently
A VA and Oregon Health & Sciences University team found that a history of binge drinking made male and female mice react differently to traumatic stress. The research may help scientists understand why men and women seem to handle both alcohol and stress differently.... (10/04/2018)



Study: Demanding, fast-paced military lifestyle may cause women to adopt poor eating habits Study: Demanding, fast-paced military lifestyle may cause women to adopt poor eating habits
VA researchers sought to learn how the unique demands of the military lifestyle had affected the eating habits of 20 female Veterans who had reported changing their eating habits in response to stress while in the service.... (06/27/2018)



Female Veterans comprise fastest-growing segment of homeless Veteran population  Homelessness and women Veterans
Researchers are helping VA design and deliver services for homeless women Veterans, or those at risk for becoming homeless—and seeking to understand the factors that drive homelessness in this population... (03/21/2018)



Study to focus on women with limb loss  Study to focus on women with limb loss
A VA researcher in New York has Department of Defense funding to study the unique physical and psychosocial needs of women living with amputation.... (02/08/2018)



Relationship impairment due to PTSD and depression has opposite effect on treatment-seeking in men and women  Relationship impairment due to PTSD and depression has opposite effect on treatment-seeking in men and women
Relationship problems stemming from PTSD and depression could have opposite effects on men and women in terms of their seeking mental health treatment, found a VA Boston Healthcare System.... (01/23/2019)

VA Research News Briefs

Osteoporosis drug treatment studies show both effectiveness and risk

Osteoporosis drug treatment studies show both effectiveness and risk - Photo for illustrative purposes only. ©iStock/Steve DebenportPhoto for illustrative purposes only. ©iStock/Steve Debenport

Minneapolis VA Health Care System researchers reviewed the existing evidence on long-term drug therapy to prevent fractures in patients with osteoporosis. They surveyed 35 trials and 13 observational studies of various osteoporosis drugs. The literature shows that long-term treatment with alendronate acid or zoledronic acid, two drugs known as bisphosphonates, reduces fracture risk in women with osteoporosis. Long-term bisphosphonate treatment may increase risk for rare adverse events, but continuing this treatment beyond three to five years may reduce the risk of vertebral fractures. Another osteoporosis treatment, long-term hormone therapy, reduces hip fracture risks but has serious side effects, according to the literature. One limitation of the review is that the researchers did not find any studies involving male patients. (Annals of Internal Medicine, April 23, 2019)



Mixed reports from women Veterans on their family-planning experiences

Mixed reports from women Veterans on their family-planning experiences - Photo for illustrative purposes only. ©iStock/PeopleImagesPhoto for illustrative purposes only. ©iStock/PeopleImages

Women Veterans had both negative and positive experiences with family planning in the military and VA, in a study by VA Puget Sound and Pittsburgh health care system researchers. Researchers interviewed 32 women Veterans about their family planning care. Nearly all described negative experiences in military or VA health care. These included perceived gender-based discrimination and pressure to choose certain contraceptive methods, judgment of reproductive choices, and lack of continuity with providers. Some women also reported positive family planning experiences in VA. These included feeling respected, receiving comprehensive information about options, and having their perspectives and concerns considered. Women preferred counseling that included providers initiating and validating family planning discussions. Establishing trust and avoiding judgment, asking women’s individual preferences, and engaging them as equal decision-making partners were also important. The results provide key insights that could improve family planning care in VA, say the researchers. (Women's Health Issues, April 10, 2019)



Higher rates of insomnia drug overprescribing in women Veterans

Higher rates of insomnia drug overprescribing in women Veterans - Photo: ©iStock/Martin DimitrovPhoto: ©iStock/Martin Dimitrov

Women are more likely than men to be inappropriately prescribed the insomnia drug zolpidem (sold as Ambien) within VA, found a Bedford VA Medical Center study. Researchers looked at prescribing data for more than 500,000 Veterans taking zolpidem. They found that 30 percent of female Veterans taking the drug received an inappropriately high dose of zolpidem, compared with only 0.1 percent of male Veterans. Nearly 19 percent of those women had a prescription to both zolpidem and benzodiazepine, while 14 percent of men did. Benzodiazepine is another insomnia drug that is also used to treat other conditions such as anxiety and seizures. Drug interactions between zolpidem and benzodiazepine are linked with increased hospitalizations. Younger women and those with substance use disorders were more likely to receive too-high doses of zolpidem. Women with anxiety or schizophrenia and men with cancer, anxiety, or schizophrenia were more likely to have overlapping prescriptions. Guidelines recommend lower doses of zolpidem for women than men because of metabolism differences, but many women may still be prescribed similar doses to men. The results show that more attention is needed to gender-specific dosing, say the researchers. (American Journal of Managed Care, March 1, 2019)



Study finds low adherence to hormone therapy guidelines

Study finds low adherence to hormone therapy guidelines  -  Photo for illustrative purposes only.©iStock/Highwaystarz-Photography Photo for illustrative purposes only.©iStock/Highwaystarz-Photography

Adherence to prescribing guidelines for systemic hormone therapy for menopausal symptoms was low among VA providers, in a VA Greater Los Angeles Healthcare System study. Systemic hormone therapy with estrogen is effective in treating menopausal symptoms such as hot flashes and insomnia. Researchers looked at prescribing in four VA facilities across three states to see how well dosage guidelines were followed. Average guideline adherence was 58 percent. Adherence was highest with new prescriptions, at 74 percent. An inappropriately high dose was used in new prescriptions more than half the time. Most renewals were at a high dose, and only 16 percent had a documented rationale for the dosing. Among 116 prescriptions for systemic estrogen, progesterone was not prescribed in eight cases. Failure to co-prescribe progesterone puts women at increased risk for endometrial cancer. Intervention is urgently needed to improve guideline adherence, say the researchers. They also suggest similar studies should be done in community settings to see how widespread the problem is. (Journal of Healthcare Quality, March/April 2019)



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