Mental Health Across the Reproductive Cycle in Women Veterans

Premenstrual, perinatal, and/or perimenopausal psychiatric problems require specific screening, assessment, and treatment strategies. The scope of these reproductive-linked psychiatric symptoms among women veterans is unknown. Due to high rates of sexual trauma among women veterans, it is also important to ascertain relationships between sexual trauma experiences and reproductive cycle mood problems. This pilot study investigates the prevalence of self-reported premenstrual, perinatal, and perimenopausal emotional problems and whether these correlate with pre-military sexual abuse, military sexual harassment, and/or military sexual assault, among veterans receiving psychiatric evaluations within a Veterans Administration Women's Health Clinic.

Participants included all women veterans (N = 186) who received psychiatric evaluations within a Veterans Administration Women's Health Clinic over a 13-mo period. Evaluations included a clinical questionnaire, a psychiatric interview, and medical record review. De-identified data were extracted from a clinical data repository for this descriptive study.

High proportions of study participants reported emotional problems premenstrually (43.3%), during pregnancy (35.1%), postpartum (30.4%), or during perimenopause (31.2%). Unintended pregnancy (73.3% of pregnancies) and pregnancy loss (56.6% of women who had been pregnant) were prominent perinatal stressors. Military sexual harassment was significantly associated with emotional problems during pregnancy and postpartum.

These pilot data suggest the need for further study of the reproductive mental health needs of women veterans and their relationship with sexual trauma. The findings underscore the need for Veterans Administration facilities and other providers of veterans' health care to be prepared to detect, diagnose, and treat premenstrual, perinatal, and perimenopausal mental health problems.