As a VA priority, suicide prevention research seeks to understand the predictors of suicide risk and develop interventions to reduce or prevent suicidal thoughts and actions.

Women Veterans offer suggestions for improving the Veterans Crisis Line

• The Veterans Crisis Line (VCL), founded in 2007, is a key component of VA’s suicide prevention strategy. To better understand the experiences and needs of Women Veterans using the VCL, researchers conducted interviews with 26 Women Veterans who had contacted the VCL. Participants noted barriers to VCL service use, including concerns about potential unwanted intervention, uncertainty about the types of services VCL provides, and desires to be able to speak with a female VCL responder. Participants recommended providing opportunities for Women Veterans to choose to speak with a female VCL responder and providing more information about what to expect from a VCL call, including what might happen as a result of the call and the degree of confidentiality. These recommendations can be used to strengthen VCL services for Women Veterans.
  Publication: “Something has to be done to make women feel safe”: Women Veterans’ recommendations for strengthening the Veterans Crisis Line for women Veterans (Dichter et al., 2024, Women’s Health Issues).

A need for suicide prevention strategies geared toward Women Veterans

• This study was the first longitudinal, national survey of Veterans with a non-fatal suicide attempt, conducted to better understand the differences between male and female Veterans in their psychosocial symptoms and suicidal thoughts and behaviors. There were 1,000 Veterans (570 women, 430 men) who completed the initial survey. Psychological distress was a core contributor to suicide risk for both groups, however, Women Veterans identified a possible need for additional support to improve their sense of self-compassion and reduce feelings of institutional betrayal. This work highlights a need for tailored suicide prevention strategies for Women Veterans.
  Publication: Gender differences in risk and resilience for suicidal thoughts and behaviors: A national longitudinal survey study of United States veterans with a recent suicide attempt (Denneson et al., 2024, Journal of Affective Disorders).

Research on mental health disorders includes work on anxiety, depression, posttraumatic stress disorder (PTSD), and eating disorders, among others. As major depressive and anxiety disorders are the top two conditions in Women Veterans aged 18-44 who use the VA for their care,^[2] research in this area is key.

Postpartum alcohol problems are linked with prenatal stress and PTSD in new mothers

• This study looked at the relationship between maternal alcohol problems, stress, and posttraumatic stress disorder (PTSD) in 450 Women Veterans who had recently given birth. New mothers were asked about whether they had experienced stressful events in the one year before giving birth. Women who had a history of PTSD or recent major life stressors were more likely to exhibit hazardous drinking behaviors postpartum, compared to those without PTSD or significant stress. These results identify stress as a risk factor for developing alcohol problems postpartum and offer ways for maternity care coordinators and other VA providers to promote mother and infant health.
  Publication: Prenatal stress exposure and post-traumatic stress disorder associated with risk of postpartum alcohol misuse among women Veterans (Holzhauer et al., 2021, Women’s Health Issues).

Women Veterans experience greater mental health issues but similar alcohol use

• This study looked at the relationship between alcohol use disorder and comorbid mental health conditions in 94 male and 32 female Veterans who were receiving inpatient treatment for alcohol use disorder. Women reported experiencing greater early life stress and more symptoms associated with anxiety, depression, and posttraumatic stress disorder (PTSD) than men reported. However, there were no differences in alcohol use or relapses between the groups. Women also exhibited higher co-occurring mental health problems with their alcohol use, which could be an area for future interventions, especially as the number of Women Veterans continues to grow.
  Publication: Rethinking gender differences: An investigation of comorbid psychopathology and alcohol use disorder in Veterans (Craft & Padula, 2025, Alcohol, Clinical and Experimental Research).

Access to high-quality care is a priority at the VA. Research on this topic includes how and where Veterans receive their care -- for example, care provided directly by the VA, care provided in the community, or a combination of the two -- as well as the quality of that health care.

Coordinating access to mammograms for VA patients

• VA patients are often referred outside of VA medical facilities (known as Community Care) for mammograms. In this study, 44 VA staff members across 10 VA facilities were interviewed about the process of coordinating Community Care mammograms. Staff noted that there was variability in community provider processes and that not all community providers were familiar with VA processes. Although technology could help address some of these challenges, some barriers remained, such as the time-consuming process of keeping referral spreadsheets up to date. In some cases, coordination challenges affected Veterans’ ability to get timely access to care. Results from this study suggest that defining clear roles and responsibilities for VA staff and promoting communication could improve referral and coordination processes for Community Care mammograms.
  Publication: “We Are Working Harder, Not Smarter”: A Qualitative Inquiry into Care Coordination for Department of Veterans Affairs Mammograms Referred to the Community (Monty et al., 2023, Women’s Health Research).
  

Access to gynecology care for Women Veterans

• Women Veterans who receive their care at the VA must have access to specialty gynecology care; however, access to this care either at the VA or in the community may be limited for certain individuals. Among all women primary care patients at the VA, 9% (~37,000 Veterans) lived in a “gynecology supply desert,” meaning that there was no local VA gynecologist and only a short supply of community-based gynecologists in their county. There were some subgroups of women who were more likely than others to be far away from a gynecologist – one of these groups included women who lived in rural areas. Moving forward, virtual programs and expanded transportation options may help all Women Veterans to receive access to VA-provided gynecological care.
  Publication: Gynecologist Supply Deserts Across the VA and in the Community (Friedman et al., 2022, Journal of General Internal Medicine).

Studies in this area focus on rehabilitation and prosthetic and sensory aids to improve daily life for Veterans. This research focuses on the unique needs of Women Veterans with amputations.

A new prosthetic device for shoes with different heel heights

• Historically, prosthetic feet have not worked well with shoes of different heel heights, such as flats, boots, stilettos, and sneakers. Researchers recently developed a prosthetic ankle-feet system that allows people with amputations to wear nearly any pair of shoes. As part of the initial testing, three women with leg amputations who were regular prosthesis users tested out the new system by walking around in three pairs of shoes with varying heel heights that they wanted to wear. Motion tracking indicated that participants’ prostheses remained aligned with the different foot-shoe sets, without the need for realignment by the participant or prosthetist. This new ankle-feet system provides more footwear options for individuals with lower limb amputations and may be especially relevant for Women Veterans interested in wearing shoes with different heel heights.
  Publication: Functional dynamic prosthesis alignment maintained across varying footwear using a modular prosthetic ankle-feet system (Walker et al., 2025, PLOS One).

Women Veterans with lower limb amputations have unique needs

• Thirty Women Veterans were asked about their experiences living with lower extremity amputations. These women emphasized that they want 1) prosthetic devices that meet their biological and social needs; 2) peer interaction with other Women Veterans with lower extremity amputations; and 3) prosthetists who understand and assess the needs of women seeking prosthetic devices and tailor their prescribed devices to meet these needs. This qualitative study identifies a need to expand and tailor prosthetic services and products to Women Veterans.
  Publication: Voices of Women Veterans with Lower Limb Prostheses: A Qualitative Study (Lehavot et al., 2022, Journal of General Internal Medicine).

Chronic medical conditions that impact Women Veterans include autoimmune diseases, cardiovascular disease, chronic kidney disease, chronic pain, hypertension, diabetes, osteoporosis, and sleep disorders.

Two virtual treatment options for urinary incontinence

• Women Veterans have an increased risk for urinary incontinence, in part due to the physical and psychological stressors of military service. In this project, 286 Women Veterans across three sites participated in one of two virtual behavioral treatments for urinary incontinence. Both behavioral interventions included bladder education, pelvic floor muscle exercises, and self-monitoring. The main goal is to understand if symptoms improved after 12 weeks. While study results are still pending, results may help determine which virtual treatment is best for improving symptoms and increasing access to care for Women Veterans experiencing urinary incontinence. 
  Publication: Optimizing remote access to urinary incontinence treatments for women veterans (PRACTICAL): Study protocol for a pragmatic clinical trial comparing two virtual care options (Markland et al., 2023, Contemporary Clinical Trials).

Possible links between mental and cardiovascular health in Black Women Veterans

• Posttraumatic stress disorder (PTSD) – highly prevalent in Veterans – is associated with an increased risk of developing hypertension and cardiovascular disease. Women and Black adults are at increased risk for PTSD and cardiovascular disease associated with stress. In this study, bodily measures, including blood pressure, heart rate, and markers of inflammation, were measured in 42 Black Veterans, about half of whom were women. Women had higher heart rates, but similar resting blood pressure compared to men. Women also had some signs of higher inflammation, which can be an early sign that cardiovascular disease is developing. This study provides biological evidence that Black Women Veterans with PTSD may be at an especially increased risk for cardiovascular events, paving the way for future targeted and quality interventions.
  Publication: Sex differences in Black Veterans with PTSD: Women versus men have higher sympathetic activity, inflammation, and blunted cardiovagal baroreflex sensitivity (Fonkoue et al., 2023, Clinical Autonomic Research).

Research in violence prevention examines intimate partner violence, military sexual trauma, and harassment, with an emphasis on trauma-informed care.

Impact of military sexual trauma, depression on mother-infant bonding

• Women Veterans who experienced sexual harassment and/or assault in the military have been shown to­­ be at an increased risk for health problems during and after pregnancy. In this study, 697 pregnant Veterans who were using VA maternity care benefits completed surveys about depression, posttraumatic stress disorder (PTSD) history, and postpartum bonding with their infant. Women who had experienced military sexual trauma (MST) had higher rates of maternal depression, and higher maternal depression was also associated with poorer mother-infant bonding. The results from this study can hopefully pave the way for high quality, trauma-informed mental health treatment for new mothers.
  Publication: The impact of military sexual trauma on parent-infant bonding in a sample of perinatal women Veterans (Creech et al., 2021, Depression and Anxiety).

Military sexual trauma is common and may be linked with menopause symptoms

• This study explored the relationship between military sexual trauma and menopause in 232 women Veterans between the ages of 45-64. Military sexual trauma was reported in 73% of the study participants and was associated with symptoms like hot flashes and night sweats, vaginal symptoms like irritation and dryness, and clinically significant symptoms of depression. Because military sexual trauma may have long-term effects on Women Veterans’ reproductive and mental health, trauma-informed care approaches should be incorporated into the health care of women across their lifespan.
  Publication: Military Sexual Trauma and Menopause Symptoms Among Midlife Women Veterans (Travis et al., 2024, Journal of General Internal Medicine).
  

Pain research at the VA characterizes different types of pain conditions and who they impact, explores novel therapies to treat pain (for example, drug discovery and complementary and integrative treatments), investigates opioid use, and describes how pain impacts Veterans’ daily lives.

Migraines are more common in Women Veterans

• A large study of more than 491,000 Veterans (450,625 men and 40,979 women) looked at the relationship between migraines, other health conditions, and environmental exposures during military service. Women Veterans reported a significantly higher rate of migraines: 30.1% vs. 8.2%. Veterans with a history of migraines also reported worse overall health, higher likelihood of psychiatric conditions, higher levels of pain, and greater lifetime opioid use. Migraine prevalence was associated with environmental exposures during military service, including Agent Orange and chemical and biological warfare. Migraine history was also more common in Women Veterans who were deployed in OEF/OIF, served in the U.S. Navy, and served post September 2001. The results of this study highlighted how migraines in Veterans, particularly women, are common and that tailored interventions are needed to address the unique health care needs of this population, especially as it relates to service-related environmental exposures.
  Publication: Migraine prevalence, environmental risk, and comorbidities in men and women Veterans (Gasperi et al., 2024, JAMA Network Open).

How stress can trigger symptoms of irritable bowel syndrome

• Irritable bowel syndrome (IBS), predominant in females, is a disorder that impacts communication between the brain and digestive system. Chronic stress can contribute significantly to IBS. In this study, female rats were exposed to a water avoidance stress test, and several molecular, epigenetic changes occurred in brain regions important for pain and stress processing. The results provided new insights into the mechanisms underlying how stress can trigger symptoms of irritable bowel syndrome. In the future, these results could lead to treatments for abdominal pain in IBS patients.
  Publication: Stress-induced visceral pain in female rats is associated with epigenetic remodeling in the central nucleus of the amygdala (Louwies et al., 2021, Neurobiology of Stress).