Changes in Reproductive and Sexual Health Diagnoses of Women Veterans Using Department of Veterans Affairs Health Care Between FY2010 and FY2018

Jessica K Friedman; Amanda M Johnson; Erica V Tartaglione; Jacob R Eleazer; Susan M Frayne; Kristin O Haeger; Alexandra K R Schule; Claudine Offer; Ciaran S Phibbs; Danielle Rose; Fay Saechao; Megha Shankar; Jonathan G Shaw; Elizabeth M Yano; Alicia Y Christy; Jodie G Katon

doi:10.1016/j.whi.2025.07.004

Changes in Reproductive and Sexual Health Diagnoses of Women Veterans Using Department of Veterans Affairs Health Care Between FY2010 and FY2018

Womens Health Issues. 2025 Sep-Oct;35(5):398-404. doi: 10.1016/j.whi.2025.07.004. Epub 2025 Aug 23.

Authors

Jessica K Friedman¹, Amanda M Johnson², Erica V Tartaglione³, Jacob R Eleazer⁴, Susan M Frayne⁵, Kristin O Haeger², Alexandra K R Schule², Claudine Offer⁶, Ciaran S Phibbs⁷, Danielle Rose⁸, Fay Saechao⁶, Megha Shankar⁹, Jonathan G Shaw⁵, Elizabeth M Yano¹⁰, Alicia Y Christy¹¹, Jodie G Katon⁸

Affiliations

¹ VA HSR Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles, VA Healthcare System, Los Angeles, California. Electronic address: jessica.friedman@va.gov.
² Office of Women's Health, Office of the Under Secretary for Health, Veterans Health Administration, Washington, District of Columbia.
³ Denver-Seattle Center for Innovation for Veteran-Centered Value-Driven Care, VA Puget Sound Health Care System, Seattle, Washington.
⁴ Transgender and Intersex Specialty Care Clinic, Mayo Clinic Florida, Jacksonville, Florida; Department of Psychiatry and Psychology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota.
⁵ VA HSR Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California; Division of Primary Care and Population Health, School of Medicine, Stanford University, Stanford, California.
⁶ VA HSR Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California.
⁷ VA HSR Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Palo Alto, California; Department of Pediatrics, School of Medicine, Stanford University, Stanford, California; Department of Health Policy, School of Medicine, Stanford University, Stanford, California.
⁸ VA HSR Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles, VA Healthcare System, Los Angeles, California.
⁹ Division of General Internal Medicine, Department of Medicine, University of California San Diego, San Diego, California.
¹⁰ VA HSR Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles, VA Healthcare System, Los Angeles, California; Division of General Internal Medicine and Health Services Research, Department of Medicine, Geffen School of Medicine, University of California Los Angeles, Los Angeles, California; Department of Health Policy and Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, California.
¹¹ Office of Women's Health, Office of the Under Secretary for Health, Veterans Health Administration, Washington, District of Columbia; School of Medicine, Howard University, Washington, District of Columbia; Uniformed Services University, Bethesda, Maryland.

PMID: 40849197
DOI: 10.1016/j.whi.2025.07.004

Abstract

Background: Women veterans are the fastest growing group of new Veterans Health Administration (VA) users, with more than half a million women veterans using VA care in 2018. VA has implemented policies and programs to meet the reproductive and sexual health (RSH) needs of women veterans who increasingly rely on VA to provide comprehensive care.

Objective: We aimed to describe changes in the prevalence of RSH diagnosis categories among women veterans using VA care in fiscal year (FY) 2010 and FY2018.

Methods: Repeated cross-sectional VA administrative data were used to identify women veterans using VA care in FY2010 and FY2018. RSH diagnosis categories were identified from International Classification of Diseases (ICD), Ninth (FY2010) and 10th (FY2018) revision codes for all VA-covered health care encounters. Standardized incidence ratios (SIRs) were used to adjust for age and compare the rates of 15 reproductive health diagnoses in FY2010 and FY2018.

Results: Women veterans using VA for RSH care increased by 61% between FY2010 (n = 317,122) and FY2018 (n = 520,179). Prevalence of common RSH diagnoses remained consistent across fiscal years, including urinary conditions (SIR = 1.02; 95% CI [1.02, 1.03]) and reproductive organ conditions (SIR = .96; 95% CI [.95, .97]). Conversely, there were larger than expected increases in diagnoses of female infertility (SIR = 1.71; 95% CI [1.70, 1.76]) and sexual dysfunction (SIR = 1.51; 95% CI [1.47, 1.54]).

Conclusion: As VA continues to build capacity to provide RSH care to women veterans, understanding changing needs is important for evaluating the impact of programs and policies designed to improve access to care.

Published by Elsevier Inc.

MeSH terms

Adult
Aged
Cross-Sectional Studies
Female
Humans
Middle Aged
Prevalence
Reproductive Health* / statistics & numerical data
Sexual Health* / statistics & numerical data
United States / epidemiology
United States Department of Veterans Affairs / statistics & numerical data
Veterans Health
Veterans Health Services*
Veterans* / statistics & numerical data
Women's Health