# Improving Health Care for Women Veterans:  Addressing Menopause and Mental Health

> **NIH VA IK2** · VETERANS AFFAIRS MED CTR SAN FRANCISCO · 2021 · —

## Abstract

Background. Women in midlife face increasing health risks related to menopause, a period of biological,
hormonal, and social change characterized by often disruptive menopausal symptoms.
Relevance and significance to Veterans’ Health. Almost half of women Veteran VA users are in midlife, with
prevalent risk factors for burdensome menopausal symptoms. Unaddressed menopausal symptoms contribute
to significant health care burden, impacting health risk behaviors, chronic health conditions, and mental health.
Specific Aims. Aim 1: To describe midlife women Veterans’ experience of menopausal symptoms, and
associations between menopausal symptom burden and mental health. H1a. High rates of hormone therapy
(HT) use and menopausal symptom prevalence and burden will be observed. H1b. Self-reported menopausal
symptoms will be more prevalent than suggested by VA clinical record categorization. H1c. Mental health
diagnoses and symptoms will be associated with more prevalent and burdensome menopausal symptoms, and
H1d. more prevalent HT use. Aim 2: To examine patient and provider preferences, experiences, and current
practices seeking and receiving care related to menopause in the VA. Information gathered through patient
and provider interviews will inform Aim 3, a Merit submission, and future intervention efforts focused on
improving menopause-related care. Aim 3: To develop a user-ready tool to increase access to gender-
sensitive menopause-related care in VA settings, and to activate self-management of menopausal symptoms.
A menopause-focused psychoeducation and symptom tracking mobile application tailored to the menopausal
Veteran population is planned, providing an evidence-based, low-resource intensive, high-yield intervention.
Methods. Aim 1: I will use an analytic dataset from the National Cohort Study (PI: Seal) to examine mental
health and menopause-related diagnoses in a national sample of women Veteran VA users aged 45-64
(current n=151,546). A sample (target n=200) of San Francisco VA Health Care System (SFVAHCS) enrollees
from the national cohort will be recruited to complete structured surveys to thoroughly assess menopause
status, menopausal symptoms, and current depression, anxiety, and posttraumatic stress disorder (PTSD)
symptoms, and briefly assess menopause-related care practices. I will link survey data to medical record data,
and use regression models to examine associations between self-reported and diagnosed menopausal
symptoms, mental health concerns, medical comorbidities, and HT use. Insights from Aim 1 will inform Aim 2
interviews and Aim 3, Merit, and future projects. Aim 2: I will use semi-structured phone interviews with VA
primary care providers and midlife women Veterans recruited from gender-specific and general primary care
settings in Women’s Health Practice-Based Research Network (WH-PBRN) sites across the country to
examine preferences, experiences, and current practices in menopause-related care. Interviews will provide
...

## Key facts

- **NIH application ID:** 10295189
- **Project number:** 5IK2HX002402-04
- **Recipient organization:** VETERANS AFFAIRS MED CTR SAN FRANCISCO
- **Principal Investigator:** Carolyn Gibson
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-06-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10295189

## Citation

> US National Institutes of Health, RePORTER application 10295189, Improving Health Care for Women Veterans:  Addressing Menopause and Mental Health (5IK2HX002402-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10295189. Licensed CC0.

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