United States Department of Veterans Affairs
 Health Care
Female Veterans of Today Facing Vastly Different Health Issues Than Their Predecessors
Physician at desk speaks with woman, sitting.
Service With a Smile — Dr. Manuel Morales, speaks with a staff member in his office. He says that the women he sees today, many in their teens and 20s, are coming to VA “with a whole different set of health issues than our older female Veterans.”

“Thirteen years ago, I was mainly seeing female Veterans from World War II, Vietnam and the first Gulf War. Their average age back then was about 55. We were treating them for things like uterine cancer, ovarian cancer and issues related to menopause.

“Today, the average age of my patients is 35. These women are Veterans of the wars in Iraq and Afghanistan. Many of them are in their teens or 20s, and so they’re coming to VA with a whole different set of health issues than our older female Veterans.”

Dr. Manuel Morales retired on the last day of June after spending more than a decade as a gynecologist with the Department of Veterans Affairs Central Texas Health Care System. During that time he’s seen some big changes at VA.

Morales, who continues to work at VA two days each week, said the female patients he cares for today are a different breed from those he was seeing back in 1997, when he first started with the Department.

“These are young women,” Morales continued, “and so they are going to have the gynecological issues that afflict young, sexually active women. For example, they’re more prone to cervical cancer, as opposed to uterine cancer, because cervical cancer is caused by the HPV virus — a sexually transmitted virus.”

Morales noted that cervical cancer and certain other gynecological issues affecting younger female Vets are often easily preventable. “I asked one of my young patients if she used protection during intercourse,” Morales said. “She said ‘no.’ So right away we gave her a talk on how important it is to use protection.”

“These women served our country,” said Dr. Laurie Zephyrin, VA’s National Director for Reproductive Health. “We have an obligation to make sure they’re receiving the best health care we can possibly give them.”

This is the first generation of women to be in actual combat alongside men. They’re coming back with psychological scars, just like the men.
—Dr. Manuel Morales, Central Texas VA Health Care System, Temple

Zephyrin and her team at VA are currently working hard at making sure women Vets are receiving the care they need in several fundamental areas, such as making sure women with abnormal mammograms receive prompt follow-up, providing women with the latest birth control information, and closely monitoring cervical cancer trends in women enrolled in the VA health care system.

Morales said military sexual trauma, also known as MST, appears to be another significant health issue faced by today’s younger female Veterans returning from Iraq and Afghanistan. He said about one in five women are sexually traumatized while serving in the military, according to the latest estimates. He also noted that women who experience MST are not only at higher risk for gynecological issues, they also have a 60 percent greater risk of developing mental health issues.

“Fortunately, we have an excellent Women’s Trauma Recovery Center and an MST Outpatient Clinic here VA Temple,” Morales said.

“This is the first generation of women to be in actual combat alongside men,” he added. “They’re coming back with psychological scars, just like the men. We’re seeing a lot more MST. We’re seeing a lot more post traumatic stress disorder, and other anxiety disorders. Obviously, when you have men and women serving on the front lines together, there’s going to be a lot more interaction between the sexes. Most of it will be good, healthy interaction. Some of it, unfortunately, will not.”

Morales said he’s noticed another big change since starting his career with VA 13 years ago.

“My first two or three years, I didn’t have that many patients,” he admitted. “These days, that’s all changed. We have a lot of female patients now. That’s because VA is a different place today. The organization has transformed itself...we’ve really stepped up our game as far as the quality of care we’re providing to our female Veterans.”

Morales said he remembers one female Vet who drove 200 miles to receive her care at VA’s Central Texas Health Care System. “She told us she had cancer, and that she didn’t want to be treated anywhere but here,” Morales explained. “She said she’d heard, through a friend, that VA Temple had a reputation for providing excellent health care for women.

“As it turns out, she had uterine cancer,” he said. “That was back in September of 2000. We operated on her successfully, and today she still drives all the way here to receive her care. When she comes to see us, she always brings us fish and shrimp.”

By Tom Cramer, VA Staff Writer

Related links:
  Women Veterans Health Programs
  Women Veterans Now Have Strong Advocate
  VA’s Central Texas Health Services for Women