Correlates of Sexual Functioning in Women Veterans: Mental Health, Gynecologic Health, Health Status, and Sexual Assault History

ABSTRACT

Military women are a unique population with occupational risks that may influence their sexual health, yet relatively little is known about specific correlates associated with servicewomen's sexual functioning. One thousand and four Midwestern U.S. women veterans aged 52 years of age and younger completed a telephone interview assessing sexual assault history, mental health, gynecologic health, and health-related quality of life. Half experienced at least one completed sexual assault during their lifetime. Most (68%) reported sex was important in their lives, and three quarters (74%) indicated that they had engaged in sex with a partner during the past 6 months. Almost one quarter of sexually active participants reported painful sexual intercourse, and approximately one third (35%) acknowledged using lubricants often to make sex comfortable. Mental health disorders (posttraumatic stress disorder, depression, and substance use disorder), gynecologic injuries resulting from completed sexual assault, and poor health-related quality of life were common in this sample and were associated with compromised sexual functioning. Most sexually active women endorsing these correlates were more likely to report not being emotionally satisfied with their main partner. Problems with sexual functioning and pain during intercourse were associated with even a single completed lifetime sexual assault (cLSA). These correlates should alert health care providers to inquire regarding sensitive topics such as LSA exposure and other factors (e.g., painful sex, same-sex partners, and mental health). Sexual health problems are important to address and may also signal other important health concerns.

KEYWORDS:

• Sexual assault
• women
• veteran
• childhood abuse
• sexual health
• sexual functioning
• painful intercourse
• posttraumatic stress disorder
• mental health disorders

Acknowledgments

This work was funded by the Department of Veterans Affairs Health Services Research and Development: NRI 04-194.

Notes

**p < .01.

***p < .001.

¹Self-reported lifetime diagnosis of gonorrhea, chlamydia, syphilis, genital herpes, venereal warts (or human papillomavirus), and/or HIV/AIDS.

²Era of Service is defined as the most recent service era.

^aTwenty-seven participants responded “Don't know” when asked if it hurts to have sexual intercourse and are not included.

**p < .01.

***p < .001.

*p < .05.

**p < .01.

***p < .001.

¹All bivariate odds ratios with p-values < .25 were included.

²Era of Service is defined as the most recent service era.

³Completed Lifetime Sexual Assault.

*p < .05.

**p < .01.

***p < .001.

¹All bivariate odds ratios with p-values < .25 were included.

²Era of Service is defined as the most recent service era.

³Completed Lifetime Sexual Assault.