COLUMBUS, Ohio - Nearly half of the military women in a recent study are not comfortable going on sick call for symptoms of genitourinary infections when they are deployed to a field duty station or multi-week ship duty.
Genitourinary infections include those of the vagina and urinary tract.
Almost one in four say they simply will not seek medical treatment while deployed, the study suggests.
Ohio State University researchers surveyed 841 women -- enlisted and officers - on their perspectives of military health care services and their health experiences at their home bases and when deployed to other parts of the world.
Women's health is an important issue for the military because female soldiers who are deployed may run an increased risk of developing vaginal or urinary tract infections, said Nancy Ryan-Wenger, a study co-author and a professor of nursing at Ohio State University. Many of the 367,000 women in the U.S. military may be deployed to developing countries, combat situations, sea duty or other situations in which normal hygiene practices may be impossible.
The study bears out that concern. Nearly half (42 percent) of the women reported that symptoms from urinary tract infections or vaginitis had at some time compromised their duty performance, while nearly one-quarter (24 percent) of the women said that symptoms had caused them to lose duty time - from several hours to an average of almost three and a half days per deployment.
The study appeared in a recent issue of the journal Women's Health Issues. Ryan-Wenger co-authored the study with Nancy Lowe, an associate professor of nursing at Ohio State.
The top three of 14 different reasons that women in this study cited for avoiding treatment during deployment were a lack of confidence in the provider's abilities and embarrassment (both 15 percent), and a lack of confidentiality (14 percent).
One reason many women may lack confidence is that the typical health care provider deployed with troops is a medic trained to save lives, not to treat primary care concerns, Ryan-Wenger said.
Moreover, women are often too embarrassed to seek medical attention because of the small community that forms in a military unit during deployment.
"Situations can get awkward - a woman may work, eat, relax and sleep in the same tent with the person who also gives her medical treatment," she said. "Confidentiality and privacy are difficult to maintain."
The researchers surveyed active duty and reserve women in the Army and Navy who had been deployed at some time during a five-year period. Women were asked about their deployments, available health care providers and risk factors for and symptoms of urinary tract infections and vaginitis.
The women surveyed were less likely to go to the available health care practitioner during deployment than when they were stationed at their home duty station - 49 percent said they weren't comfortable going while deployed, while 24 percent said they would not seek medical treatment at all.
The number of women deployed with their units has risen steadily since Operation Desert Shield/Desert Storm in the Middle East in the early 1990s, Ryan-Wenger said. "We are beginning to identify unique women's health issues during deployment."
The results of this study show that women's concerns about health care provider competence and confidentiality should be taken seriously by commanders and other unit leaders, she said.
She suggested that women on deployment could be given self-care kits that would allow them to treat many of these conditions on their own.
She and Lowe have developed a self-diagnosis and treatment kit to treat common genitourinary infections. The kit is portable, and contains medication for treatment along with information on how to prevent future infections. The researchers are currently seeking funds for further testing of the kits.
"In typical deployment circumstances, particularly during war or situations where the unit is constantly on the move, maintaining personal hygiene is difficult," Ryan-Wenger said. "Women need a reasonable self-care alternative to seeking medical treatment when deployed.
"The conditions like vaginitis that were the focus of this study are simply a fact of life for many women and are easily treated," she said. "Military women do not want special treatment but they do want to be treated with respect. Given the proper equipment and medications, women are fully capable of managing this type of problem themselves."
The study was funded by a grant from the Department of Defense TriService Nursing Research Program.