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Women's Health

While women and men have many of the same health issues, women may be affected differently than men. And, some conditions are unique to women. 

Familiarity with women’s health issues, regular screenings and prevention are keys to maintaining good health.

  • TRICARE covers well woman exams annually for women under age 65. 
  • Exams include breast exams, pelvic exams, and Pap smears as needed. 
  • TRICARE covers these exams with no cost share or copayment.

Health Issues

Some of the common health issues female service members, family members and retirees should be aware of include:

Breast Diseases

Most women experience breast changes at some time. Age, hormone levels and medicines may cause lumps, bumps and discharges. Anyone with a breast lump, pain, discharge or skin irritation, should see a health care provider. Minor and serious breast problems have similar symptoms. Although many women fear cancer, most breast problems are not cancer.

Common causes of breast changes include: Fibrocystic breast condition (lumpiness, thickening and swelling, often associated with a woman's period); cysts (fluid-filled lumps); injury; fibroadenomas (solid, round, rubbery lumps that move easily when pushed, occurring most in younger women); intraductal papillomas (growths similar to warts near the nipple); blocked or clogged milk ducts; milk production when a woman is not breastfeeding.

Menopause

Menopause is the time in a woman's life when her menstrual cycle ceases. It usually occurs naturally, most often after age 45. Menopause happens because the woman's ovary stops producing the hormones estrogen and progesterone.

A woman has reached menopause when she has not had a period for one year. Changes and symptoms can start several years earlier. They include: a change in periods; hot flashes and/or night sweats; trouble sleeping; vaginal dryness; mood swings; trouble focusing; less hair on head, more on face.

Some symptoms require treatment. Talk to a doctor about how to best manage menopause. Make sure the doctor knows the medical history and the family's medical history. This includes information related to risks for heart diseaseosteoporosis or breast cancer.

Pregnancy

Women who are pregnant or are planning to get pregnant can help give babies a healthy start with regular visits to healthcare providers. These prenatal care visits are very important for your baby and yourself. Some things you might do when you are pregnant could hurt your baby, such as smoking or drinking. Some medicines can also be a problem, even ones that a doctor prescribed. You will need to drink plenty of fluids and eat a healthy diet. You may also be tired and need more rest.

Your body will change as your baby grows during the nine months of your pregnancy. Don't hesitate to call your health care provider if you think you have a problem or something is bothering or worrying you.

Reproductive Health

Reproductive health issues can impact fertility, overall health and a person's ability to enjoy a sexual relationship.

Reproductive health is influenced by many factors. These include age, lifestyle, habits, genetics, use of medicines and exposure to chemicals in the environment. Many problems of the reproductive system can be corrected.

Uterine Diseases

An early sign of uterine disease may be bleeding between periods or after sex. Causes of abnormal bleeding include hormones, thyroid problems, fibroids, polyps, cancer, infection or pregnancy.

Treatment depends on the cause. Sometimes birth control pills treat hormonal imbalances. If a thyroid problem is the cause, treating it may also stop the bleeding. If you have cancer or hyperplasia, an overgrowth of normal cells in the uterus, you may need surgery.

Other uterine problems are endometriosis and adenomyosis. In endometriosis, the kind of tissue that lines the uterus grows outside the uterus. With adenomyosis, the tissue grows in the uterus's outer walls. Pain medicine may help; other treatments include hormones and surgery.

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Gestational diabetes among pregnant service members, active component, U.S. Armed Forces 2012 – 2016

Infographic
1/5/2018
Gestational diabetes is an abnormal increase in blood sugar levels that can adversely affect the health of both a pregnant woman and her baby. During 2012 – 2016, 4,017 (6.3%) of active component female service members who had live births were affected by gestational diabetes. Women aged 25-34 and 35-49 years had consistently higher annual prevalences of gestational diabetes than younger females. The percentage of pregnant service members affected by gestational diabetes was more than twice as high for obese women as for non-obese women (12.4% vs. 5.5%). The percentage of live births affected by gestational diabetes increased with increasing age and was highest among Asians/Pacific Islanders. Access the full report in the November 2017 MSMR (Vol. 24, No. 11). Go to: www.Health.mil/MSMR

This infographic documents the incidence and prevalence of gestational diabetes pregnant service members, active component, U.S. Armed Forces, 2012 – 2016.

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Complications and Care Related to Pregnancy, Labor and Delivery among Active Component Service Women U.S. Armed Forces, 2012 – 2016

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1/5/2018
Maternal complications and delivery outcomes are important components of the overall health and well-being of reproductive-age service women. This analysis provides an update on pregnancy complications and characterizes the counts, rates, and trends of several specific pregnancy complications. FINDINGS •	55,601 U.S. service women whose pregnancies resulted in 63,879 live births had 657,060 medical encounters •	For all age groups, percentages of live births affected by preterm labor decreased, but during 2012 – 2016, the percentages of pregnant service members diagnosed with obesity increased. •	The percentage of pregnant service members affected by gestational diabetes was more than twice as high for obese women, compared with non-obese women (12.4% vs. 5.5%). Bar graph shows the number of medical encounters with a primary (first-listed) diagnosis of any pregnancy-related complication or indication for care decreased each year between 2012 and 2016. Access the full report in the November 2017 MSMR (Vol. 24, No. 11). Go to: www.Health.mil/MSMR  Background image: New born being provided medical attention by nurse. Secondary image: babies of diverse background on a blanket.

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Live births among female service members, active component, U.S. Armed Forces, 2012 – 2016

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12/21/2017
Did you know…?  •	From 2012 – 2016, there were 63,879 live births to women of childbearing potential in the active component. The overall live birth rate was 64.9 live births per 1,000 person-years (p-yrs). The live birth rate decreased steadily from 69.8 per 1,000 p-yrs in 2012 to 59.7 per 1,000 p-yrs in 2016. The decrease was primarily driven by declining rates among women in their 20s. Overall, live birth rates were highest among women who were: •	30-34 years old •	Army members •	In healthcare occupations •	Married Of the total 63,879 live birth deliveries: •	24.7% were cesarean •	75.3% were vaginal Pie chart depicting this information displays. United States map displays showing the highest numbers of deliveries during the surveillance period reported by military hospitals at: •	Naval Medical Center Portsmouth, VA (7.4%) •	Naval Medical Center San Diego, CA (6.1%) •	The Carl R. Darnall Army Medical Center, TX (4.1%) •	Womack Army Medical Center, NC (3.8%) •	Tripler Army Medical Center, HI (3.7%) Live birth rates were broadly similar among the race/ethnicity groups, although the overall rate was slightly higher among American Indians/ Alaska Natives. Access the full report in the November 2017 MSMR (Vol. 24, No.11). Go to: www.Health.mil/MSMR

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Pregnancies and live births among female service members

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12/21/2017
Women have been able to serve officially in the U.S. military since 1901. Both the number of women serving in the active component and their occupational roles have steadily increased and expanded. Currently, almost one in seven active component service members are female and more than 95% of military occupational specialties are open to women. This infographic summarizes data on the demographic and military characteristics of women including women of childbearing potential (WOCBP) in the active component of the U.S. Armed Forces during 2012 – 2016. Data on pregnancy-related care and birth rates are also presented. FINDINGS •	In 2016, WOCBP comprised the vast majority of active component service women. •	202,849 women served in the active component of the Army, Navy, Air Force, or Marine Corps. 197,947 (97.6%) were WOCBP. Pie chart displays depicting this information. •	In 2016, 13.1% of all WOCBP had at least one pregnancy-related event. Pie chat displays depicting this information. Female stick figures display to show visual of the largest proportions of WOCBP. Breakdown of WOCBP by service: •	Army (32.9%) •	Air Force (30.0%) •	Navy (29.7%) •	Marine Corps (7.5%) Pie chart displays to visually depict breakdown of WOCBP by service. The largest proportions of WOCBP were: •	In a communications / intelligence occupation (32.3%) •	Junior enlisted rank (46.5%) •	Non-Hispanic white (43.4%) •	20 – 24 years old (34.3%) Live births: •	There were 63,879 live births during the surveillance period. •	Overall live birth rate was 64.9 live births per 1,000 person-years (p-yrs). This rate of live births decreased steadily from 69.8 per 1,000 p-yrs in 2012 to 59.7 per 1,000 p-yrs in 2016. Line graph displays this information. Rates of live births were highest among: •	Women who were 30 – 34 years old •	Enlisted or junior officer rank •	Army •	In healthcare / intelligence occupations •	Married Access the full report in the November 2017 MSMR (Vol. 24, No. 11). Go to: www.Health.mil/MSMR

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Pregnancies among female service members, Active component, U.S. Armed Forces, 2012 – 2016

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12/21/2017
With the increasing numbers of service women and the expansion of roles available to women within the military, understanding the epidemiology of pregnancy is important for both the health of U.S. service women and the readiness of the U.S. fighting force, two closely related issues. Between 2012 – 2016, 344,536 unique women of childbearing potential (WOCBP) served at least 1 day in the military, and of those, 132,466 spend at least 1 day as a recruit trainee. Of the 224,718 WOCBP who served at any time in 2016, 13.1% had at least one pregnancy-related event during that year. A “pregnancy-related event,” refers to a health care encounter (visit) for which the record contains a diagnosis code for either pregnancy or a positive pregnancy test. In 2016, the highest prevalence of pregnancy-related events was among service women 30-34 years of age (16.8%) and among senior enlisted women (13.7%). Pie chart displays depicting the information. The annual prevalence of pregnancy-related events decreased slightly, from 14.2% in 2012 to 13.1% in 2016. Line plot graph displays this information. FINDINGS •	Prevalence of pregnancy-related events was approximately evenly distributed among the race/ethnicity categories and military occupation groups. •	A slightly higher percentage of WOCBP in the Army (14.5%) had pregnancy-related events compared to WOCBP in the other services. •	A higher percentage of women who were married (21.4%) had a pregnancy-related event, compared with those in the single (5.7%) or “other” (8.8) categories. •	Only 0.2% of women who served during a recruit training period in any given year had a pregnancy-related event. Access the full report in the November 2017 MSMR (Vol. 24, No. 11). Go to www.Health.mil/MSMR.  Graphic on infographic shows a pregnant service member.

With the increasing numbers of service women and the expansion of roles available to women within the military, understanding the epidemiology of pregnancy is important for both the health of U.S. service women and the readiness of the U.S. fighting force, two closely related issues. This infographic documents pregnancies among female service members, active component, U.S. Armed Forces from 2012 – 2016.

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Winning against breast cancer with the help of TRICARE

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11/3/2017
Air Force Col. Theresa Medina, 319th Medical Group commander, and her daughter Sophia, pose for a photo at a harvest festival Oct. 7, 2017 at Grand Forks, N.D. Medina was diagnosed with stage one breast cancer on Nov. 3, 2011, but with the help of TRICARE and the support of family and friends she is now cancer free. (Courtesy photo)

Fifteen minutes after finding out she landed a position as a squadron commander at Davis Monthan Air Force Base, Arizona, she found out she was diagnosed with cancer

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Breast reconstruction can aid psychological healing

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Army Lt. Col. Owen Johnson III, a plastic surgeon at William Beaumont Army Medical Center at Fort Bliss, Texas, discusses options available for reconstructive surgery with a patient. (U.S. Army photo by Marcy Sanchez)

Breast reconstruction as a part of cancer care is one of the procedures backed by national health care policy, requiring TRICARE and insurance companies to provide reconstructive services

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Women's monthly symptoms may indicate more serious conditions

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Nagging symptoms that are assumed to be the result of a woman’s monthly cycle can really be warning signs of two common diseases, both of which are treatable.

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More women are winning the battle against breast cancer

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10/26/2017
Navy Lt. Cmdr. Jada Leahy (right), a general surgeon at Naval Hospital Pensacola, and Michelle Wilkes, a breast health specialist, talks to a patient about breast cancer.  Some warning signs of breast cancer include a lump in the breast or armpit, nipple discharge, any change in the size or shape of the breast or pain in the breast. (U.S. Navy photo by Jason Bortz)

New treatments, better results for breast cancer

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Cancer vaccine for youth is effective, safe

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10/25/2017
The HPV vaccine is very safe, and most people don’t have any problems or side effects. Studies have shown the vaccine caused HPV rates to decline 64 percent among teenaged girls ages 14 to 19, and 34 percent among women ages 20 to 24. (U.S. Air Force photo by Senior Airman Kristin High)

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Annual mammograms recommended for women over 40

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10/23/2017
Wendy Elvis, lead mammography technician (left), demonstrates the use of a mammogram machine with Melissa McRae. Mammograms are recommended for women over the age of 40 and those whose family has a history of breast cancer. (U.S. Air Force photo by Staff Sgt. Teresa J. Cleveland)

Regular mammograms can better help your healthcare team in detecting cancer by giving them a progressive look at your breast over time

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Tdap vaccination coverage during pregnancy, active component service women, 2006 – 2014

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8/14/2017
Pertussis, commonly known as “whooping cough,” is a vaccine-preventable illness more common and more severe in children than in adults. Infections during the first few months of life can be particularly severe, with almost all deaths from pertussis occurring in infants less than 6 months of age. A vaccinated mother’s antibodies against pertussis protect the baby during pregnancy until it can receive the vaccine at two months of age. Approximately 400 probable and 50 confirmed cases occur annually among service members and other adult beneficiaries of the Military Health System. In 2012, the Advisory Committee on Immunization Practices recommended Tdap for every pregnancy to reduce the burden of pertussis in infants. This surveillance study assessed Tdap vaccination coverage among pregnant service women during 2006 through 2014. FINDINGS: •	There were records of a total of 137,133 live birth deliveries to service women •	Only 1%  – 3% of service women received a Tdap vaccine during pregnancy from 2006  – 2011 •	Tdap vaccination coverage increased substantially  – 8% in 2012 to 54% in 2014 •	Navy women had the highest  annual proportion of vaccine coverage at 65% in 2014 •	First deliveries had the highest vaccination coverage at 57% in 2014 •	Fourth or subsequent deliveries had the lowest coverage at 41% in 2014 More education and attention by military physicians and pregnant service women about the benefits of Tdap vaccination are needed to bring coverage closer to 100%. Learn more in MSMR Vol. 22 No. 5 May 2015 at Health.mil/MSMR  Images on graphic: •	Baby icon to depict live birth deliveries •	Pie charts showing the findings in visual form •	Line graph showing the percent vaccinated among Navy, Marine Corps, Army, Air Force and Coast Guard The line graph shows the annual percentages of active component service women with a live birth delivery who received a Tdap vaccine during pregnancy, by year of delivery and service, 2011– 2014.

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Interim Guidance for Prevention of Sexual Transmission of Zika Virus

Policy

With this update, CDC is expanding its existing recommendations to cover all pregnant couples, which includes pregnant women with female sex partners. This guidance also describes what other couples (those who are not pregnant or planning to become pregnant) can do to reduce the risk for Zika virus transmission. CDC’s recommendations for couples planning to become pregnant have been published separately (9).

Zika Virus and Pregnancy

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6/21/2016
infographic about Zika virus and pregnancy

Zika can cause certain birth defects. This infographic offers information to pregnant women about how to protect themselves from the Zika virus.

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