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Background: Women veterans have increased reports of sexual victimization compared to women in general, including childhood sexual assault (CSA) before military service, increasing the risk of military sexual trauma. Findings from recent studies reveal negative health effects following a history of CSA. There is a strong relationship between CSA and revictimization in civilian and military life, which may contribute to allostatic load., Objectives: (1) To determine the relationship between women veterans' CSA history and later sexual assault history and (2) to determine the relationships between women veterans' CSA and primary mediators and secondary and tertiary outcomes of allostasis., Research Design: Cross-sectional., Subjects: Women (N = 81), 18-70 years old, veterans of the U.S. Armed Services., Measures: Participants completed questionnaires and blood and hair samples were collected. Several scales were utilized: Posttraumatic Checklist-Military, Center for Epidemiological Studies-Depression Scale, Pain Outcomes Questionnaire-Short Form, Cohen's Perceived Stress Scale (PSS), Profile of Mood States, and an investigator-developed sexual harassment/assault instrument., Results: Thirty-three percent of participants reported CSA; of these, 38.5% reported military sexual assault and 70.3% sexual assault during civilian life. Those with CSA had higher cholesterol, triglycerides, perceived stress scores, and greater pain and fatigue than those without CSA. Hair cortisol was marginally lower in women with CSA when PSS was controlled, suggesting a dampened hypothalamic-pituitary-adrenal axis., Conclusions: These data suggest that some women veterans with a history of CSA may have increased allostatic load and be at increased risk for a variety of later life illnesses., (© The Author(s) 2016.)

Women serving in the military face many sources of stress, such as separation from home and family, sexual harassment and assault, and deployment to traumatic war zones. Some women are vulnerable to the effects of these stressors, resulting in deleterious mental and physical health outcomes. Understanding these risks through the theoretical model of allostasis can help identify those who will be most vulnerable and help healthcare providers prevent some negative outcomes and improve rehabilitation for some women when they return stateside. Women may be more likely than men to present with mental health problems such as posttraumatic stress disorder and depression after military service. They also may be at increased risk, based on their war-zone stress response, for disparate illness such as medically unexplained illness, cancer, and heart disease. The need for care for these women is expected to increase as more women are deployed to conflicts.