Every VA offers Pap Tests and Care for Gynecologic Cancer, as well as the HPV vaccine.

• Cervical Cancer can be detected by screening through a pap test, HPV test, or both. Women ages 21–29 should have a pap test every three years. Women ages 30-65 may complete a pap test every 3 years, an HPV test every 5 years, or a pap and HPV test every 5 years.

  • Nearly every person will get HPV in their lifetime if unvaccinated. It is spread through consensual and nonconsensual sexual activity. HPV can cause several types of cancer. The vaccine can prevent cancer and has been highly recommended since 2006 for anyone under age 26. Anyone under age 45 may benefit from the vaccine.

  • The HPV vaccine is available at the VA, however there is no clinical alert and it is not proactively offered by VA healthcare teams to veterans under age 45 who may benefit from it. Veterans who haven’t received the vaccine can contact their VA care team to begin the series. Click here for information about the vaccine from the CDC.

• Uterine Cancer is cancer of the uterus (also called endometrial cancer). It is the most common gynecologic cancer. Abnormal bleeding is the most common symptom, which includes bleeding after intercourse and any bleeding (even a small spot) in post-menopausal women. Any type of abnormal bleeding should be evaluated by a healthcare provider.

• Ovarian Cancer causes more deaths each year than any other gynecologic cancer. It occurs more often in older women. The symptoms can be subtle and include abnormal bleeding, pelvic or back pain, bloating, feeling full quickly when eating, and a change in bathroom habits.

  • Ovarian cancer is treatable when caught early. If any of these symptoms last 2 or more weeks, talk with a healthcare provider.

  • Ask your health care provider about genetic testing that is also available at VA if you have any family history of cancer.

• Vaginal cancer and vulvar cancer are rare; the risk of both may be lessened with an HPV vaccine. Vaginal cancer is marked by pelvic pain, discharge or bleeding, or a change in bathroom habits. Vulvar cancer usually appears on the labia outside the vagina and often causes a sore and itching.

VA recommends women begin annual screening mammograms for Breast Cancer by age 45 and every other year at age 55. Veterans may start annual screening at age 40 or earlier if they have additional risk factors. Since the Dr. Kate Hendricks Thomas SERVICE Act was signed into law on June 7, 2022, veterans under age 40 who may have an elevated risk for breast cancer now qualify to receive risk assessments and mammography screening at the VA.

• Veterans who have clinical symptoms, risk factors, family history of breast cancer, or in-service toxic exposures, such as to an open burn pit based on a record of service in specific locations during certain timeframes listed here, may receive receive a screening mammogram if determined to be clinically appropriate by a VA clinician.

Mammogram and Breast Care services generally available through VA include breast ultrasounds and MRI; breast biopsy and surgery; genetic counseling and testing; and breast cancer diagnosis and treatment. VA offers full-service oncology treatment including imaging, surgery, chemotherapy, radiation, enrollment in clinical trials, and other state of the art treatments in and through the VA.

VA offers Infertility and IVF services to help veterans build families, including:

• Infertility assessments and counseling

• Laboratory tests, including genetic counseling and testing

• Imaging services, such as ultrasounds and X-rays

• Hormone therapies

• Surgical correction (e.g., endometriosis, polyps, blockages, or scars)

• Fertility medications

• Intrauterine insemination (artificial insemination)

• Tubal ligation (tube tie) reversal

• Vasectomy reversal

• Oocyte cryopreservation (egg freezing) and sperm cryopreservation

• Sperm retrieval techniques (including sperm washing for intrauterine insemination)

Veterans may also be eligible for IVF and other forms of assisted reproductive technology (ART) services if they are legally married and:

• Male spouses can produce sperm (or have cryopreserved sperm)

• Female spouses have an intact uterus and can produce eggs

Donor eggs, donor sperm, donor embryos, surrogacy, and experimental treatments are not covered by the VA. Veterans with a service-connected condition that causes infertility may be eligible for adoption reimbursement for up to $2,000 per adoption.

3/11/2024 UPDATE: In response to lawsuits filed by veterans legal clinics in New York and Massachusetts alleging the existing IVF policy is discriminatory, VA announced in March 2024 it will expand access to IVF services for qualifying veterans regardless of marital status and that VA will allow the use of donor eggs, sperm, and embryos.

VA offers Comprehensive Contraception Care Services and offers a range of birth control options for enrolled veterans, including:

• Long Acting Reversible Contraceptives: Contraceptive Implant, Intrauterine Devices (IUDs)

• Hormonal methods: Pill, Patch, Ring, Injection

• Barrier Methods: Condoms, Sponges, Cervical Cap, Spermicides

• Sterilization: Tubal Ligation, Bilateral Salpingectomy (removal of both fallopian tubes)

Veterans who are taking or want to take a specific type of contraceptive can search the VA Formulary Advisor to see what is available. Veterans may also be approved to receive non-formulary contraceptives if necessary and recommended by their provider.

VA also offers Same-Day Emergency Contraception as well as limited Abortion Services. Abortion services including both counseling and access to abortions when carrying a pregnancy to term would endanger the pregnant veteran’s life or health or their pregnancy resulted from rape or incest.

• Counseling for eligible VA-enrolled beneficiaries is provided by VA healthcare professionals and can include information about pregnancy options, including abortion.

• VA employees, when working within the scope of their federal employment, may provide authorized counseling and abortion services regardless of any state restrictions.

CHAMPVA beneficiaries also have access to these services. VA beneficiaries should contact their VA health care provider to determine if these services are clinically appropriate and available to them.

VA supports women veterans’ Sexual Health, addressing sexual health problems resulting from:

• medical conditions (diabetes, high blood pressure, cancer, etc);

• medications (many types of medications may impact sexual health and functioning);

• hormonal changes (pregnancy, perimenopause, or menopause);

• surgery or radiation therapy;

• relationship problems with your partner;

• PTSD, depression, anxiety, or stress; and/or

• experiences involving Military Sexual Trauma (MST) and other sexual trauma.

Sexual problems such as lack of interest/desire, difficulty with arousal or orgasm, and sexual pain are common. Treatment is available if these concerns bother you or impact your quality of life. Services available to women veterans at the VA include:

• pelvic floor physical therapy;

• medications to treat specific conditions, such as hormone therapies for symptoms of menopause and non-hormonal medications that can improve sexual conditions;

• EROS clitoral therapy devices (EROS-CTD) for Female Sexual Arousal Disorder (FSAD);

• vaginal dilators, recommended by the American College of Obstetricians and Gynecologists for pain during sex and when necessary after radiation therapy that can damage vaginal tissues;

• specialty care, such as Gynecology; and

• mental health support and treatment, including couple’s counseling.

VHA recommends HIV Testing for all veterans and in veterans with ongoing risk factors at least annually. VHA also recommends screening for HIV in all pregnant veterans. If left untreated, HIV can lead to acquired immunodeficiency syndrome (AIDS)

• Veterans can ask their Primary Care Provider to review their risk factors to see how often they should be tested for HIV.

• VA offers full service resources to help with diagnosis, treatment, and living with HIV for those who may test positive.

The VA provides resources and services for Maternity Care, including maternity care coordination. VA maternity care services include:

• full physical exams and lab tests;

• prenatal education and screening;

• obstetrical ultrasounds;

• genetic tests and specialty consults;

• prescription drugs;

• newborn care on the date of birth and for 7 days immediately after birth;

• breastfeeding and lactation support, including nursing bras, nursing pads, breast/chest pumps, lactation pads, pumping bras, human milk storage bags, nipple shields, nipple cream, postpartum support belts, and connections to human milk banks and other resources needed for parents unable to breastfeed;

• support and services in case of miscarriage or stillbirth; and

• social work and reproductive mental health services before, during, and after pregnancy.

VA may not cover all services, such as home deliveries, doulas, or experimental procedures. A brochure outlining VA Maternity Care services is available here. Local Maternity Care Coordinators can answer questions on coverage and connect veterans to additional resources.

Women who haven’t had a period for at least a year are in menopause, which is normal for women in their 40s–50s. Women whose periods stop before age 40 may need a blood test to determine if it is due to menopause or if there is another cause. Women should talk with their provider if they have:

• a change in their monthly cycle;

• heavier bleeding or bleeding that lasts longer than usual;

• bleeding more often than every 3 weeks;

• bleeding after sexual intercourse;

• any blood spotting between menstrual periods; or

• any vaginal bleeding after menopause.

Women don't need medical treatment for menopause, but treatment is available at VA to manage bothersome symptoms, such as a hormone patch, hormone pills, and vaginal estrogen therapy to help with vaginal dryness.

Urinary Incontinence is a common, treatable condition that impacts around 1 in 5 women veterans. There are various types of urinary incontinence, including:

• Stress incontinence, leakage that occurs with coughing, laughing, sneezing, or activity;

• urge incontinence, a frequent strong urge to urinate and leakage happens before getting to the bathroom;

• overflow incontinence, a frequent dribbling of urine due to the bladder not completely emptying; and

• functional incontinence, which happens when something prevents you from making it to the toilet in time.

Urinary incontinence can be caused by medications, illnesses (diabetes, infections), pregnancy, weak pelvic muscles, obesity, or drinking too much liquid, alcohol, or caffeine. VA offers a number of services that can reduce urinary leakage depending on the cause, including:

• vaginal pessary, a small disc that when inserted can support your bladder muscles;

• medications and topical/vaginal estrogen treatments;

• pelvic floor physical therapy;

• Botox® injections in the bladder (or a generic brand);

• electrical stimulation; and

• minimally invasive surgeries.

Polycystic Ovary Syndrome (PCOS) is a common issue related to a hormone imbalance causing the ovaries to overproduce androgens. This can result in a variety of symptoms and complications that can be diagnosed and treated by VA providers.

PCOS may lead to irregular menstrual cycles; excessive hair on the face or chin; acne; thinning hair; weight gain or difficulty losing weight; or oily skin. If a person experiences at least two of the following symptoms, they may be diagnosed with PCOS:

• irregular periods;

• lab tests or symptoms of high androgen levels; or

• polycystic ovaries by ultrasound.

Women with PCOS may be at a higher risk for complications including infertility, diabetes, sleep apnea, high cholesterol, non-alcoholic fatty liver disease, heart disease, and depression. Relevant services available at VA include:

• medications;

• infertility treatments, pre-conception health care, and maternity care;

• healthy eating assistance through programs like the Healthy Teaching Kitchen;

• weight management through Move! and similar programs;

• assessment and treatment for metabolic disorders like heart disease, diabetes, pre-diabetes, elevated cholesterol levels, and high blood pressure; and

• mental health treatments for depression, which is associated with PCOS.

Chronic pelvic pain is common in women veterans. Chronic pelvic pain involves pain in the lower abdomen, genital area, lower back, or thighs that needs treatment and lasts more than six months. It can be consistent but may get worse when you are having your period, urinating, having sex, or walking. Chronic pelvic pain is often caused by one or more of the following:

• Irritable Bowel Syndrome

• Interstitial cystitis (bladder pain syndrome)

• Pelvic floor dysfunction

• Endometriosis

• Vulvodynia

• Pelvic injury or surgery

• Ovarian cysts

Veterans who have experienced trauma are 2–3 times more likely to have chronic pelvic pain than veterans without traumatic experiences. Chronic pelvic pain can lead to anxiety, depression, difficulty sleeping, and fatigue, and can affect relationships and overall health. Treatments depend on the cause, but may include:

• pelvic physical therapy;

• medications to treat specific conditions, such as IBS, endometriosis, or muscle spasms;

• surgery to treat endometriosis;

• injections with pain numbing medications;

• electrical nerve stimulation;

• behavioral pain management programs such as Cognitive Behavioral Therapy (CBT);

• mental health support and treatment; and/or

• tai chi, yoga, and acupressure.

In general, the entire VA Medical Benefits Package is available to all VA enrolled veterans, with specific care being provided when it is determined by a VA provider that it aligns with generally accepted practice standards and will promote, preserve, or restore the health of a particular veteran.

• Care preserves health if it maintains a veteran’s current quality of life or daily functioning, prevents disease progression, cures disease, or extends the veteran’s life span.

• Care promotes health if it enhances a veteran’s quality of life or daily functioning, prevents future disease, or identifies a predisposition for a condition or early disease onset which can be ameliorated to any extent through monitoring or early diagnosis and treatment.

• Care restores health if it restores a veteran’s quality of life or daily functioning lost due to illness or injury.

All VA patients have the right to receive prompt and appropriate treatment for any physical or emotional disability and to be treated with dignity in a humane environment that affords them both reasonable protection from harm and appropriate privacy with regard to their personal needs.

Implementation of evidence-based clinical practice guidelines is a way to improve care by reducing variation in practice and systematizing “best practices.” VA has established dozens of Clinical Practice Guidelines (including one for Pregnancy) intended to improve care and reduce inappropriate variations while supporting shared decision making with patients.

Over 400 VHA Directives establish mandatory VHA-wide policies pertaining to VA healthcare. Directives articulate the reason for issue of directives and related issues, definitions, background for policies and related authorities; exemptions; and the offices and individuals responsible for implementation, training, and oversight of policies at the national, regional, and local facility levels.

VHA Directives supersede other national, VISN-level, and facility-level policies or memos issued to the extent they are in conflict. 

Some VHA Directives of relevance to women veterans are linked below from the VA website. If a year is underlined, re-certification is overdue as of 2023, but the directives remain in effect as VHA-wide policy.

• Women Veterans Health Care (2023),  Mammograms (2018), and Maternity Care (2020)

• Fertility Evaluation & Treatment (2017) and IVF Counseling & Services (2021)

• Transgender & Intersex Veterans Healthcare (2018) and LGBQ Veterans (2022)

• Family Mental Health Services (2019) and Uniform Mental Health Services (2023)

• PTSD Programs (2017) and Substance Use Disorder Programs (2022)

• Military Sexual Trauma (2018) and Intimate Partner Violence Programs (2019)

• Social Work (2019) and Integrated Case Management Standards of Practice (2019)

• Patient Advocacy (2018) and Patient Experience (2020)

VHA directives are useful to understand what is supposed to be offered to veterans and to recognize/identify gaps in care.

To be eligible for CHAMPVA, you cannot be eligible for TRICARE. You must be the spouse or child of a veteran with a permanent and total service-connected disability rated by VA, or the surviving spouse or child of a veteran who had a permanent and total service-connected disability rating when they died or whose death was service-connected.

Although mostly excluded due to TRICARE eligibility, some surviving spouses and children of service members who died in the line of duty (not due to misconduct) may be eligible.

Primary Family Caregivers participating in the VA Program of Comprehensive Assistance for Caregivers who aren’t otherwise entitled to care or services under a health care plan may be eligible.

Surviving spouses become ineligible for CHAMPVA if they remarry before age 55. If the marriage is later terminated, CHAMPVA eligibility may be restored. However, if a stepchild leaves the sponsor’s household, the child is no longer CHAMPVA-eligible.

Having other health insurance may impact eligibility for CITI. By law, eligible CHAMPVA beneficiaries entitled to Medicare Part A may only use CITI if they also enroll in Medicare Part B  (unless they reached age 65 by June 5, 2001 and weren’t enrolled in Part B).

CHAMPVA is always the secondary payer to Medicare. Beneficiaries of any age who are eligible for it generally must enroll in Medicare Part A and Part B to maintain CHAMPVA coverage. Part D is not required in order to become or remain CHAMPVA-eligible.

The VA interprets 38 U.S.C. 1781(b) as meaning that CHAMPVA beneficiaries are not eligible for the CITI program once they enroll in any Medicare plan.

DAV’s Women Veterans: The Journey to Mental Wellness evaluates unique factors contributing to suicide among women veterans and details how the healthcare system can and must do better. The report demonstrates that women veterans are falling through the cracks due to gaps in lifesaving care.

• Among VA-enrolled veterans, 1 in 3 women report experiencing MST.

• Nearly 1 in 5 women veterans using VA primary care reported experiencing intimate partner violence in the past year.

• The risk of suicide death among women veterans with active substance use disorder is more than twice what it is for men.

• Women with a prior mental health diagnosis are at increased risk for receiving a mental health diagnosis or experiencing suicidality during pregnancy and in the year after giving birth.

• Menopause raises the risk for depression twofold and corresponds to the highest rates of suicide among U.S. women.

DAV made over 50 recommendations for policy makers and researcher to spark the necessary and urgent change needed to save lives.

WWP’s 2023 Women Warriors Report focused on the experiences of women veterans registered with their program through the lens of focus groups conducted in 2023, and responses to the 2022 WWP Annual Warrior Survey. You can access the full report and recommendations here.

The top five service-related injuries and health problems reported by WWP women warriors were:

• 83.7% – anxiety

• 81.2% – depression

• 76.8% – sleep problems

• 72.7% – PTSD

• 53% – migraines or chronic headaches

WWP women warriors were more likely than men survey to present with moderate or severe symptoms of depression, PTSD, and anxiety. WWP women warriors also reported:

• more suicidal ideation (56.1% vs. 50.8%), and

• a higher prevalence of suicide attempts (33.2% vs. 23.5%).

WWP women warriors were less likely to view their military experience positively (66% vs. 82.3%), to feel respected by their community as a veteran (78.3% vs. 83.7%), or to feel respected by their co-workers as a veteran (78.8% vs. 86%). They were also more likely than men surveyed:

• to have experienced moderate-high financial distress (72.8% vs. 68.6%) and financial strain in the previous year (65.4% vs. 64%);

• to have talked to family and friends to cope with challenges (71.1% vs. 64.2%) and to have used prescribed medications (66.6% vs. 57.4%) and used VAMC services (60.7% vs. 54%).

The Massachusetts Women Veterans’ Network worked with the Public Consulting Group to survey women veterans about their current needs, use of services, gaps in resources and support, and interactions with DVS and other service providers. In September 2022, PCG reported findings based on a demographic review, 581 valid survey responses, and 8 focus groups. 

• Women veterans didn’t know of any primary, up-to-date source of information about benefits.

• Women veterans didn’t feel connected to other women veterans across the state or that there was a wide or effective strategy to promote events focused on women veterans.

• Some women reported that events focusing on women veterans were in larger cities and not accessible to women veterans across the state.

• Women veterans weren’t well aware of benefits available to them – especially those outside of the VA system – and reported significant confusion around eligibility for benefits and services (including due to varying definitions of “veteran”).

• Women veterans reported sometimes limited access to women’s health services and found accessing both VA healthcare benefits and community health providers very confusing. 

• Women veterans tend to turn to national sources and publications and learn about benefits by word of mouth. Women veterans’ access to benefits hinges on their access to and the quality of local veterans’ services.

• Women veterans didn’t feel transition services answered all of their questions and follow up support for returning veterans was inconsistent and also somewhat dependent on local veterans’ services. 

• Some women perceived more transition support being provided to veterans of the current era compared to previous eras.

• Some women also expressed that childcare issues were less of a concern due to the age of their children by the time they transitioned from the military.

Click here to read the final report.

WWP’s 2021 Women Warriors Initiative Report draws from WWP’s annual survey of nearly 5,000 WWP-registered women veterans. Analysis of the results showed clear disparities between the men and women veterans surveyed.

• Nearly all of the women were enrolled in VA healthcare; less than half said VA met all of their medical needs.

• Women were more likely to have a college degree but less likely to find work. Women who were employed earned about $8,000 less per year on average than men surveyed.

• 80% of the women were experiencing loneliness, isolation, and disconnect from their peers.

When WWP converted to virtual programming in 2020, they found the proportion of women engaging in their programs increased from 26% to 43%. WWP women warriors also responded positively to the women-only virtual peer support groups. If you’re trying to connect with women veterans, you may want to consider offering virtual programs and access points.

Massachusetts is home to around 25,000 women veterans––your voice and experience truly does matter! Although women are the fastest growing cohort in the veterans community, they also face unique challenges during and after service.

In 2021, the Veterans Collaborative joined the Massachusetts Women Veterans Network and Brighton Marine to encourage women veterans in Massachusetts to complete a national survey of women veterans being conducted by the University of Alabama about their time in the service, and their experiences and their preferences and needs.

Many women aren't involved with veteran organizations, and they're often not recognized as veterans. One Purple Heart recipient surveyed said she was asked by VA hospital staff if she was there to pick up her grandfather. Experiences like this can have a real impact.

The survey was part of a research effort led by Dr. Karl Hamner and Dr. Kate Hendricks Thomas, a University of Alabama alum and Marine Corps veteran, who facilitated the project. State-level data was expected to be made available to stakeholders to inform local programs and services. Unfortunately, Dr. Hendricks Thomas was placed on hospice in March 2022.

We are so grateful for Dr. Hendricks Thomas’ work on this effort and for her tremendous advocacy shedding light on the rates of cancer women veterans experience while raising her young son and fighting Stage IV breast cancer related to exposure to the toxic smoke of burn pits during her deployment at Camp Fallujah in 2005.

She passed away peacefully surrounded by her loved ones April 5 after battling the cancer for four years. The Dr. Kate Hendricks Thomas Legacy Award will be awarded annually to someone who goes above and beyond to help women veterans to honor her lifetime of selfless service.

The Dr. Kate Hendricks Thomas SERVICE Act was signed into law on June 7, 2022 to ensure veterans under the age of 40 who may have an elevated risk for breast cancer can receive breast cancer risk assessments and mammography screening. On July 28, 2023, the VA published a notice in the Federal Register to inform the public around the implementation of the law.

Without regard to age, all veterans who have clinical symptoms, risk factors, family history of breast cancer, or in-service toxic exposures such as an open burn pit (based on a record of service in specific locations during certain timeframes listed here) are now eligible to receive a mammogram if determined to be clinically appropriate by a VA clinician.

You can explore 2022 American Community Survey 1-year estimates (the most current) for veterans using the links below by age, sex, and veteran status, median income, educational attainment, employment status, service-connected disability, service era, and age, disability, and poverty status. Five-year estimates for 2022 (the most accurate) are also available, covering 2018–2022.

The tables below break out Armed Forces data:

• Marital Status by sex and labor force participation;

• Presence of Own Children by age of children and family type and employment status;

• Educational Attainment by employment status; and

• Poverty Status by disability and employment status.

There are also tables that include Armed Forces by employment status by sex and age and in various Employment tables. Some tables also have racial iterations. You can explore more data with interactive maps and tables via the Census Reporter’s Military & Veterans page. Follow the links and use the menu to add geographies you need.

Public Law 114-315 expanded eligibility for veterans to participate in Supportive Services for Veterans & Families (SSVF) and Grant & Per Diem (GPD) in 2017 by defining individuals and families fleeing or attempting to flee domestic violence as homeless, increasing options for eligible veterans with children.

In the context of SSVF, women veterans with children were most likely to accept hotel rooms for emergency housing. SSVF lifted limits on spending on emergency shelter during the pandemic. Officials intended to continue offering hotels as an emergency housing option to keep families together, such as “when shelter options do not exist.”

SSVF served around 11,100 women veterans nationally each year from 2017–2021. Around 40% had children with them and a third were single parents. Veterans fleeing domestic violence are only eligible for SSVF if they meet all other program requirements, including having a gross annual income at or below 50% AMI. 

GPD funds organizations that provide supportive housing to veterans. In 2021, the GDP program served around 1,300 women veterans nationwide. Veterans fleeing domestic violence are only eligible for GPD if they meet all other program requirements, including having a substance use disorder, VA eligibility, and at least 30 days of sobriety.

Massachusetts offers SafeLink, a confidential statewide domestic hotline available 24/7 at (877) 785-2020. Advocates keep callers on the line while connecting them to a local shelter program to ensure they can get help with one call, rather than having to make calls to different shelter programs.

• The Massachusetts Coalition for the Homeless offers a statewide listing of DV shelters.

• The Massachusetts Coalition Against Sexual Assault and Domestic Violence offers an interactive search engine, which allows you to locate programs by city or zip code.

Massachusetts residents who are homeless, including those fleeing domestic violence currently or in the past year who are pregnant or have children under age 21 and meet the gross income requirements of 115% of the Federal Poverty Level may qualify for Emergency Assistance. Those found eligible also qualify for the Short-Term Housing Transition and HomeBASE programs.