Womens Health Issues最新文献

{"title":"Perception of Having Enough Information to Make Contraceptive Decisions: A Novel Metric of Person-Centered Contraceptive Access","authors":"Ariana H. Bennett DrPH, MPH ,&nbsp;Alex Schulte BA, BSPH ,&nbsp;Jennet Arcara PhD, MPH, MPP ,&nbsp;Jamie Bardwell MPP ,&nbsp;Denicia Cadena BA ,&nbsp;Aisha Chaudhri MA ,&nbsp;Laura Davis MA ,&nbsp;Brittni Frederiksen PhD, MPH ,&nbsp;Catherine Labiran MA ,&nbsp;Raegan McDonald-Mosley MD, MPH ,&nbsp;Ellen Pliska MHS ,&nbsp;Whitney Rice DrPH, MPH ,&nbsp;Ena Suseth Valladares MPH ,&nbsp;Cassondra Marshall DrPH, MPH ,&nbsp;Anu Manchikanti Gomez PhD, MSc","doi":"10.1016/j.whi.2025.04.003","DOIUrl":"10.1016/j.whi.2025.04.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Information is a critical component of contraceptive access. This study presents a new person-centered metric of contraceptive access: perception of having sufficient information to choose a contraceptive method.</div></div><div><h3>Methods</h3><div>Between January and March 2022, we fielded a nationally representative online survey among 15- to 44-year-olds assigned female sex at birth using NORC's AmeriSpeak panel. We describe whether respondents felt they had enough information for contraceptive decision making and types of information needed. We investigate bivariate associations between perception of having enough information and key respondent characteristics. We use logistic regression to investigate whether past experiences of sexual and reproductive health (SRH) care and contraceptive self-efficacy are associated with feeling one has enough information.</div></div><div><h3>Results</h3><div>Of the analytic sample (unweighted n = 3,037), 73.5% felt they had enough information to decide about contraception, 11.8% did not, and 14.7% were unsure. Those who did not feel they had enough information (unweighted <em>n</em> = 687) most commonly needed information about side effects (33.4%). In bivariate analyses, respondents who were younger, were gay/lesbian, had lower educational attainment, and were uninsured were less likely to feel they had adequate information. Regression analyses indicated a positive association between feeling one had enough information and past experiences of high-quality SRH care and contraceptive self-efficacy.</div></div><div><h3>Implications and Conclusions</h3><div>Our data indicate inequities in who felt they had enough information to make contraceptive decisions. Perception of having enough information is related to quality of care and perceived future ability to access contraception. This paper supports the importance of recognizing information as a key part of person-centered contraceptive access.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 233-244"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent and Young Adult Perspectives on Contraception Post-Dobbs: “The Next Closest Step to Having Control Over My Own Body”","authors":"Lauryn King PhD, MPP ,&nbsp;Julia Strasser DrPH, MPH ,&nbsp;Sara Luckenbill MPH ,&nbsp;Ellen Schenk MPP ,&nbsp;Danielle Tsevat MD, MSCR ,&nbsp;Julie Maslowsky PhD","doi":"10.1016/j.whi.2025.04.001","DOIUrl":"10.1016/j.whi.2025.04.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Adolescents and young adults (AYAs) face unique barriers to contraceptive care that may be exacerbated by the June 2022 <em>Dobbs v. Jackson Women's Health Organization</em> decision that removed federal protections for abortion rights. We examined AYA perspectives on contraception and measured changes in AYA contraceptive use pre- and post-<em>Dobbs</em>.</div></div><div><h3>Materials and Methods</h3><div>This study used a mixed-methods design. We analyzed qualitative data from the MyVoice project, an SMS-based survey among AYAs ages 14–24 in the United States. The research team analyzed open-ended responses to questions about the influence of changes to abortion access on AYA contraceptive decision making. We analyzed quantitative data from the IQVIA Longitudinal Pharmacy and Medical Claims data for patients ages 15–26. We identified monthly new contraceptive prescriptions and services for intrauterine device insertion and implant placement in 2021 and 2022. We used segmented regression analyses to test for changes in prescriptions and services post<em>-Dobbs.</em></div></div><div><h3>Main Findings</h3><div>Our qualitative analysis identified themes of risk aversion, urgency and fear, and access concerns in response to the <em>Dobbs</em> decision. Our quantitative analysis demonstrated a slight increase in both prescriptions and services in the months immediately after <em>Dobbs</em>, but there were no significant changes in the slope for monthly services post-<em>Dobbs</em> for any age group or method type. We also identified an overall decreasing trend for all age groups and all method types during the full study period of January 2021–December 2022.</div></div><div><h3>Conclusions</h3><div>Limited changes in contraceptive use despite AYA expressions of fear, feelings of lost agency, and concerns over access may reflect continued (or worsened) barriers to contraceptive access post-<em>Dobbs</em>.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 245-252"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144133199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Language and Differences in Administration of Analgesia for Pelvic Pain","authors":"Tierney Wolgemuth MD ,&nbsp;Annie Gauf MD ,&nbsp;Denise Monti MD, MPH ,&nbsp;Dhara Amin MD ,&nbsp;Julia Geynisman-Tan MD","doi":"10.1016/j.whi.2025.05.006","DOIUrl":"10.1016/j.whi.2025.05.006","url":null,"abstract":"<div><h3>Objectives</h3><div>Patient-provider language discordance is known to impact medical care; however, whether patient language is associated with differences in analgesia administration has not been well studied. This study aimed to evaluate the association between patients’ primary language and analgesia administration among women seeking emergency care for acute pelvic and abdominal pain.</div></div><div><h3>Study Design</h3><div>We conducted a retrospective cohort study to assess the association between patient language and differences in administration of analgesic medications to non-pregnant adult women presenting to the emergency department (ED) with a primary diagnosis of abdominal or pelvic pain. The primary outcome was the receipt of any analgesic medication. Secondary outcomes were receipt of opioid medications, receipt of intravenous analgesia, and association between diagnosis and receipt of analgesia.</div></div><div><h3>Results</h3><div>Among 817 patients, 427 spoke English and 390 spoke another primary language. More than half (53.7%) were given some form of pain medication, with 211 (25.8%) receiving an opioid and 228 (27.9%) receiving only non-opioids. On bivariate analysis, there is no difference between whether any analgesic was administered between those with and without English as their primary language (52.9% and 54.6%, respectively, <em>p</em> = .65). However, those who spoke English as a primary language were more likely to receive an opioid analgesic (53.1% vs. 42.7%, <em>p</em> = .038). Among individuals who received at least one analgesic, those with English as a primary language had an adjusted odds ratio [95% confidence interval] of 1.49 [1.02, 2.20], <em>p</em> = .04, for receipt of an opioid when adjusted for highest pain score. Patients with abdominal pain were more likely to receive any analgesic (55.6% vs. 45.0%, <em>p</em> = .049) and more likely to receive opioid pain medication compared with those with pelvic pain (52.4% vs. 22.1%, <em>p</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Abdominal and pelvic pain in women may be undertreated in the ED setting, particularly among those for whom English is not the primary language and those presenting with the primary diagnosis of pelvic pain.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 261-266"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting Improved Access to Tailored Hormonal Contraceptive Regimens for Menstrual Suppression","authors":"Beth Sundstrom PhD, MPH ,&nbsp;Angela Dempsey MD, MPH","doi":"10.1016/j.whi.2025.02.009","DOIUrl":"10.1016/j.whi.2025.02.009","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 219-224"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving the Health Care Service Model for Menopause With Digital Health","authors":"Constance Guille MD, MSCR ,&nbsp;Hannah Jahnke PhD,&nbsp;Neel Shah MD, MPP,&nbsp;Natalie Henrich PhD, MPH","doi":"10.1016/j.whi.2025.03.005","DOIUrl":"10.1016/j.whi.2025.03.005","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 230-232"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Dobbs v. Jackson Women's Health Organization on Obstetrics and Gynecology Training One Year Later: Qualitative Analysis of Physician Perspectives","authors":"Sarah E. Andiman MD ,&nbsp;A. Jenna Beckham MD, MSPH ,&nbsp;Gabriela E. Halder MD, MPH ,&nbsp;Angela DiCarlo-Meacham MD ,&nbsp;William D. Winkelman MD ,&nbsp;Shunaha Kim-Fine MD, MS ,&nbsp;Rebecca Rogers MD ,&nbsp;Cheryl Iglesia MD ,&nbsp;Cara L. Grimes MD, MAS ,&nbsp;Society of Gynecologic Surgeons Collaborative Research in Pelvic Surgery Consortium (SGS CoRPS)","doi":"10.1016/j.whi.2025.04.005","DOIUrl":"10.1016/j.whi.2025.04.005","url":null,"abstract":"<div><h3>Background</h3><div>On June 24, 2022, the Supreme Court of the United States' <em>Dobbs v. Jackson Women's Health Organization</em> decision ended constitutional protection for abortion, resulting in severely restricted access to reproductive health care and raising concerns about the repercussions on obstetrics and gynecology trainees.</div></div><div><h3>Objective</h3><div>This qualitative study examines the observed effects of the <em>Dobbs</em> decision on obstetrics and gynecology training and practice one year out.</div></div><div><h3>Methods</h3><div>Obstetrics and gynecology physicians involved in patient care and medical education were invited to participate in online focus groups. We attempted to recruit participants from a diversity of subspecialties and regions of the United States. Eighteen physicians participated in five sessions conducted July–October 2023. Using an iterative process, two independent researchers coded transcripts to identify themes and subthemes. An additional reviewer resolved discrepancies.</div></div><div><h3>Results</h3><div>Eight themes were identified: dichotomy of care in restrictive versus protective states, loss of the patient-physician relationship, moral distress to physicians, legal concerns for physicians, new issues for training programs, loss of patient care experiences for trainees, loss of access to care for patients, and disappointment and frustration with policy makers. Themes were grouped into their effects on patients, trainees, physicians, and society overall, reflecting negative changes in patient care, training, and physician morale.</div></div><div><h3>Conclusions</h3><div>This qualitative study found that physicians see the <em>Dobbs</em> ruling as having negative effects on patients, trainees, and physicians. Participants observed that these changes are leading to a dichotomy of care in which patients in restrictive and protective states receive different care and some patients may not receive medically necessary treatment.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 253-260"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating Payor-Segregated Outpatient OBGYN Care Models: The Clinician Perspective","authors":"Arina Chesnokova MD, MPH, MSHP ,&nbsp;Allison Schachter BA ,&nbsp;Elizabeth Clement MD ,&nbsp;Sarita Sonalkar MD, MPH ,&nbsp;Marilyn Schapira MD, MPH ,&nbsp;Florencia Polite MD ,&nbsp;Abike James MD, MPH ,&nbsp;Sindhu Srinivas MD, MSCE ,&nbsp;Elizabeth Howell MD, MPP ,&nbsp;Rebecca Hamm MD, MSCE","doi":"10.1016/j.whi.2025.04.002","DOIUrl":"10.1016/j.whi.2025.04.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Significant and unacceptable racial disparities in maternal health and gynecologic outcomes exist in the United States, with ambulatory care being a potential contributor. In many academic medical centers (AMCs), publicly insured and uninsured patients receive care in clinics staffed primarily by residents under attending supervision, whereas those with private insurance see attending physicians at a different site. This segregation by payor can translate to de facto racial segregation. This study explores clinician perspectives on payor-segregated care delivery by resident and attending sites in a major AMC and their opinions on integrating these sites.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews with attending physicians and advanced practice providers (APPs) from both sites. The interview guide focused on: 1) perceived value of the current care model, 2) attitudes toward care integration, and 3) barriers and facilitators to integration. Interviews were conducted from October 2022 to January 2023 until thematic saturation was achieved. Data analysis involved an integrated approach with grounded theory, with 20% of transcripts double-coded (k = .90).</div></div><div><h3>Results</h3><div>We interviewed 15 clinicians (10 attendings, five APPs). Although clinicians recognized some value in the existing segregated system, they supported ending it as a moral imperative to combat inequity. They also highlighted challenges and expressed concerns about feasibility of integration. Concerns encompassed maintaining patient-clinician continuity, acceptance of trainees by privately insured patients, potential erosion of mission-driven care, and the risk of racist interactions if a safe space for a vulnerable community is disrupted. Clinicians stressed the need for resources and small-scale trials before full-scale integration.</div></div><div><h3>Conclusion</h3><div>Although clinicians expressed unity around the concept of integrating ambulatory care delivery, a path toward implementing an alternative model of care remains unclear. This study provides initial insights into disparities in ambulatory OBGYN care and may guide health systems considering care integration.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 267-275"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopause-Related Service Needs in Veterans Health Administration Medical Centers: Findings From the Women's Health Practice-Based Research Network Menopause Practice Scan","authors":"Susan J. Diem MD, MPH ,&nbsp;Haley A. Miles-McLean PhD ,&nbsp;Diane V. Carney MA ,&nbsp;Jeanette E. Shekelle MPH ,&nbsp;Francesca Nicosia PhD ,&nbsp;Susan M. Frayne MD, MPH ,&nbsp;Elizabeth M. Yano PhD, MSPH ,&nbsp;Carolyn J. Gibson PhD, MPH, MSCP","doi":"10.1016/j.whi.2025.04.004","DOIUrl":"10.1016/j.whi.2025.04.004","url":null,"abstract":"<div><h3>Background</h3><div>Information about the state of menopause-related care in the Veterans Health Administration (VA) is needed to identify targets for intervention and resource development across the national VA Health Care System.</div></div><div><h3>Procedures</h3><div>A brief electronic key informant survey designed to assess current menopause-related services, resources, and needs in VA primary care was distributed to all active VA Women's Health Practice-Based Research Network (WH-PBRN) Site Leads. The survey included structured items, with responses summarized with descriptive statistics, and open-ended prompts, with answers analyzed using directed content analysis.</div></div><div><h3>Findings</h3><div>Key informant surveys were completed by 60 of 73 active WH-PBRN sites (response rate 82%). Most sites reported a range of available resources; 88% reported having VA-based consultants (e.g., gynecologists, pharmacists, and/or endocrinologists) available to assist primary care providers with pharmacological management of menopause symptoms. However, sites named a need for educational materials, menopause-focused classes or groups, and resources or support for a variety of menopause-associated issues. Sites overwhelmingly reported that menopause care was made easier by the availability and/or integration of menopause-trained specialty providers in the primary care setting, adequate menopause training for primary care providers, and time in appointments to address complex care issues.</div></div><div><h3>Conclusions</h3><div>In this survey of primary care settings at WH-PBRN sites across the VA Health Care System, sites highlighted the importance of available resources, time in appointments, training for primary care providers, and the availability and integration of menopause-informed specialty care services for comprehensive menopause care in the VA setting. Improving the VA's care model for menopause also has the potential to inform efforts to improve services in other health systems.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 283-291"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Birth-Intention Time Horizon as a Predictor of Contraceptive Method Effectiveness","authors":"Yuko Hara PhD ,&nbsp;Michael S. Rendall PhD","doi":"10.1016/j.whi.2025.04.006","DOIUrl":"10.1016/j.whi.2025.04.006","url":null,"abstract":"<div><h3>Background</h3><div>Both contraceptive method research and contraceptive program designs have given more attention to if a woman currently wants to have a child than to when she wants a child. We examine how predictive is a woman's intended duration to a (next) birth for her type of contraceptive method currently used, ranked by the method's effectiveness. We hypothesize that a longer intended duration will be associated with choosing a more effective method.</div></div><div><h3>Methods</h3><div>We pooled observations of women (<em>n</em> = 7,324 in total) across the two population-representative surveys in Delaware and Maryland: the Behavioral Risk Factor Surveillance System and the Survey of Women. We classified birth-timing intentions into wanting a child in less than 2 years, wanting a child but being uncertain when, wanting a child in 2 or more years, and not wanting (additional) children. Contraceptive method was classified as highly effective (intrauterine devices and implants), moderately effective (e.g., contraceptive pills), less effective (e.g., condoms), and no method. We used multinomial logistic regression to estimate relative risk ratios and predicted probabilities of using each method type, and no method, adjusting for sociodemographic characteristics.</div></div><div><h3>Results</h3><div>As a woman's birth-timing intention horizon lengthens, her probability of using a highly effective method increases, and her probability of using no method decreases. Being uncertain about birth timing is associated with a substantially lower probability of using any type of contraceptive method relative to having clear intentions.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the importance for contraceptive counseling and contraceptive access program design of considering birth-timing intentions beyond the year immediately ahead.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 292-299"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Military Exposures and Early Menopause: Findings From the Gulf War Era Cohort Study (GWECS)","authors":"Carolyn J. Gibson PhD, MPH ,&nbsp;Guichan Cao MS ,&nbsp;Sabra Inslicht PhD ,&nbsp;Allison D. Altman PhD ,&nbsp;Caitlin E. Haas BS, BA ,&nbsp;Aaron Schneiderman PhD, MPH, RN ,&nbsp;Erin Dursa PhD, MPH","doi":"10.1016/j.whi.2025.05.001","DOIUrl":"10.1016/j.whi.2025.05.001","url":null,"abstract":"<div><h3>Objective</h3><div>Traumatic and environmental exposures during military service may affect reproductive health and ovarian aging, putting women veterans at risk for early menopause. We examined relationships between military exposures and possible early menopause among women 1990–1991 Gulf War veterans.</div></div><div><h3>Methods</h3><div>This is a longitudinal analysis of data from the Gulf War Era Cohort Study. Women Gulf War veterans who completed baseline (1995) and follow-up assessments (2012) and were aged ≤45 at follow-up were included. Military exposures (Gulf War deployment, military environmental exposures [MEEs], Gulf War Illness, military sexual trauma [MST]) and posttraumatic stress disorder (PTSD) were assessed at baseline. Participants were categorized as having possible early menopause if in response to follow-up survey questions about menstruation they indicated menopause or having no periods for 1 year. Associations among military exposures, PTSD, and possible early menopause were examined with logistic regression models.</div></div><div><h3>Results</h3><div>The analytic sample included 668 women veterans. Among Gulf War–deployed veterans (<em>n</em> = 384), 63% reported MEEs and 26% reported MST during deployment. Within the total sample, 57% met criteria for Gulf War Illness, and 23% met criteria for probable PTSD. At follow-up, 15% had possible early menopause. In adjusted analyses, Gulf War Illness (odds ratio [OR] 1.83; 95% confidence interval [CI] [1.14, 2.95]) and probable PTSD (OR 2.45; 95% CI [1.54, 3.90]) were significantly associated with possible early menopause.</div></div><div><h3>Conclusion</h3><div>Women veterans may be vulnerable to early menopause (under age 45), which brings additional care considerations for health promotion and symptom management. Menopause care in the Department of Veterans Affairs should include consideration of PTSD and comorbid chronic conditions such as Gulf War Illness, key veteran-centric clinical correlates that may influence the onset and experience of menopause.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 4","pages":"Pages 276-282"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}