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Background: Women veterans are a growing but understudied population believed to be at increased risk for pain problems. Because of risk factors and clinical observations, we hypothesized that women veterans might have a high prevalence of pain and, thus, sought to determine the prevalence of (and age-related variations in) pain and to characterize several key pain dimensions in a sample of women veterans. Methods: Women with routine appointments at the VA Connecticut Women's Health Center were recruited for study. Participants completed a 59-item questionnaire that provided information about their demographic, clinical, and pain status, as well as use of health services. Results: Of 236 women approached, 213 (89%) completed the questionnaire. The mean age was 52 years, and most (78%) reported an ongoing pain problem. For those reporting pain, the mean duration of pain was 6 years, average pain intensity was 6.3 (range 1–10), and commonly endorsed pain sites included lower extremity (68%), low back (63%), and shoulder (48%). The most frequently endorsed treatment (by 80%) was analgesic medication use. Across the four age categories (20–35, 36–50, 51–65, and ≥66 years), pain prevalences were 64%, 89%, 83%, and 69%, respectively. Although pain intensity levels did not vary across age groups, older women (≥66) reported using fewer pain treatments, including analgesic medications. Finally, those with (vs. those without) pain reported a greater number of medical and mental health visits in the preceding year. Conclusions: This study documented a significantly high prevalence of pain among a sample of women veterans receiving primary care in a VA women's health clinic. [ABSTRACT FROM AUTHOR]

Purpose: The current wars in Iraq and Afghanistan have led to an increasing number of female veterans seeking medical and mental healthcare in the Department of Veterans Affairs (VA) healthcare system. To better understand gender differences in healthcare needs among recently returned veterans, we examined the prevalence of positive screenings for depression, posttraumatic stress disorder (PTSD), military sexual trauma (MST), obesity, and chronic pain among female and male veterans of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) receiving care at the VA Connecticut Healthcare System., Methods: We performed a retrospective, cross-sectional data analysis of OEF/OIF veterans at VA Connecticut who received services in either Primary Care or the Women's Health Clinic between 2001 and 2006., Results: In this study, 1129 electronic medical records (1032 men, 197 women) were examined. Female veterans were more likely to screen positive for MST (14% vs. 1%, p < 0.001) and depression (48% vs. 39%, p = 0.01) and less likely to screen positive for PTSD (21% vs. 33%, p = 0.002). There was no significant gender difference in clinically significant pain scores. Men were more likely than women to have body mass index (BMI) >30 kg/m(2) (21% vs. 13%, p = 0.008)., Conclusions: These results suggest that important gender differences exist in the prevalence of positive screenings for MST, depression, obesity, and PTSD. As the VA continues to review and improve its services for women veterans, clinicians, researchers, and senior leaders should consider innovative ways to ensure that female veterans receive the health services they need within the VA system.

A recent requirement from the Accreditation Council for Graduate Medical Education that internal medicine residents must provide care for a minimum of 25% of female patients in their longitudinal clinics has posed difficulties for Internal Medicine programs that utilize Department of Veterans Affairs (VA) hospitals for outpatient training. The authors report an innovative program developed at a Connecticut VA hospital for internal medicine residents at the Yale University School of Medicine. Residents participate in the clinic at the VA Women's Health Center every fourth week instead of attending their usual VA primary care clinic. To increase the numbers of patients being seen by residents, the "Sharing Program" was initiated in 2001 so that wives of veterans could be seen in the VA women's clinic. Sharing Program patients are billed for their care by the Yale University Medical Group and the VA is reimbursed by the University Medical Group for the cost of providing care to these patients. As a result of the Sharing Program, the mean proportion of female patients assigned to residents has reached 25%. Surveys showed high levels of patient and resident satisfaction, and that residents perceived an improvement in their education in the outpatient care of women.