Women Veterans Health Care
This month’s campaign seeks to increase awareness about pelvic health with information about defining the pelvic floor, examining common pelvic floor disorders, symptoms and treatment options.
The pelvic floor refers to the group of muscles that support the opening of the pelvic bone structure. The pelvic floor is involved in many basic life functions as varied as digestion, elimination, reproduction, breathing, and balance. A healthy functioning pelvic floor promotes greater health in all of these areas of the body.
Pelvic floor disorders (PFDs) occur when women have weakened pelvic muscles or tears in these connective tissues. PFDs can cause problems in the organs located in the female pelvis region such as the bladder, parts of the bowel or intestine, all reproductive organs (uterus, ovaries, and vagina), and the muscles, ligaments and other tissues that hold everything together. PFDs symptoms can vary, with bowel and bladder symptoms being common. Examples include difficulty urinating, incontinence, or difficulty having a bowel movement. PFD is a common problem, especially for women.
One particularly common pelvic floor problem that is increasing in prevalence is incontinence. Incontinence affects all generations and genders. For example, it affects women Veterans, athletes as well as those less active, mothers, and women who've never given birth, younger and older woman as well. For postmenopausal women, one study reports that one out of five suffer with incontinence, although it may be even higher because incontinence is often a secret, undiscussed issue. Problems stemming from pelvic floor difficulties affect women Veterans and active duty women.
- Across the Nation, more than 28 million (1) women suffer with pelvic floor disorders.
- Urinary conditions including incontinence were among the top five reproductive conditions for women Veterans using VA in fiscal year (FY) 2010 in all age groups and the second most common condition among women ≥65 years old. (2) In FY 2010 more than 12,000 were treated for urinary incontinence (UI). (3)
- Women Veterans may have unique risk factors for pelvic floor concerns and urinary conditions related to their military service (3)
- Active duty women are often exposed to conditions that may increase their risk of urinary tract infection (UTI), such as poor hygiene, decreased access to care and bathrooms, postponed urination, and fluid restriction. Data from a study of 841 deployed women reported that 18.4% experienced UTI during deployment. (4) Findings also demonstrate that the population-based prevalence of UI was 45%, and increased with age to 55% for 80- to 90-year-old women. Eighteen percent of respondents reported severe urinary incontinence (5).
Pelvic Floor Disorder Symptoms Can Include:
- Incontinence is any involuntary loss of urine or feces
- Feeling a lump in the vagina or vaginal pressure or pain
- "Fullness" in the vagina, rectum, or both
- Frequent, irritating bowel and bladder symptoms (difficulty urinating, incontinence, or difficulty having a bowel movement)
- Difficulty starting urination
- An "insides are falling out sensation"
- Inability to keep a tampon in
- Pain with sexual intercourse
- Lack of sexual sensation
Pelvic Health is Treatable
- Pelvic floor disorders are common and treatable, yet women often avoid the topic and treatment. Often, individuals are hesitant to seek treatment because these disorders can be embarrassing or they do not know what to do.
- Nearly 40 percent of women in the United States manage a pelvic floor disorder (PFD) with over-the-counter supplies, such as pads, or wait until they are very uncomfortable to seek treatment.
- Minimally invasive procedures are available to correct PFDs, yet only one in five women reports she would undergo a surgical procedure to correct a PFD.
Treatment Options for Pelvic Health Disorders
VA provides a variety of comprehensive diagnostic tests to determine the causes of pelvic health problems. Once a diagnosis is made, a variety of treatment options can be tailored for each woman’s pelvic health needs. Some Treatment options may include:
- Lifestyle and behavioral changes; it is important to maintain a healthy weight and eat a diet with enough fiber. Being overweight can affect the normal function of nerves and muscles in the pelvis by putting excess strain on them, which can cause PFDs to worsen.
- Other treatment options may include pelvic floor muscle exercises (Kegels), bladder training, Pessary devices, medications, fiber supplements, laxatives, nerve stimulation, injections and surgery.
Women Veterans are encouraged to talk to their doctor or health care provider about any pelvic health concerns. Women Veterans may also call the Women Veterans Call Center at (855) 829-6636 to learn more about treatment options for pelvic floor disorders. The following links offer additional materials and resources for local outreach to women Veterans.
- Women with PFDs in the US: J Womens Health (Larchmt).
- 2014 State of WVs Reproductive Health, page 22: www.womenshealth.va.gov/WOMENSHEALTH/docs/SRH_FINAL.pdf
- Katon, J. G., et al. (2015). "Reproductive Health Diagnoses of Women Veterans Using Department of Veterans Affairs Health Care." Med Care 53 Suppl 4 Suppl 1: S63-S67
- 2012 Sep; 21(9): 895–900.doi: 10.1089/jwh.2012.3644 WVs with UI: www.ncbi.nlm.nih.gov/pmc/articles/PMC3430482
- Melville JL, Katon W, et al. Urinary incontinence in US women: a population-based study. Arch Intern Med 2005;165(5): 537-542
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