Gynecological and breast conditions: surgery, endometriosis and the exam

How VA rates gynecological and breast conditions

38 CFR 4.116

Gynecological conditions and disorders of the breast are rated in 38 CFR 4.116. Two notes at the top of the schedule matter before any rating level:

• Not disabilities: natural menopause, primary amenorrhea, and pregnancy and childbirth. Chronic residuals of medical or surgical complications of pregnancy may be rated.
• Special monthly compensation: when a claim involves loss or loss of use of one or more creative organs, or anatomical loss of one or both breasts, VA must check 38 CFR 3.350 for extra compensation. Codes marked with a footnote in the schedule are the ones that potentially qualify, but the schedule says almost any condition in this section might, under certain circumstances. See special monthly compensation.

Disease, injury or adhesions of the female reproductive organs

38 CFR 4.116, DC 7610 to 7615

The vulva or clitoris (including vulvovaginitis), vagina, cervix, uterus, fallopian tubes (including pelvic inflammatory disease) and ovaries all use one formula:

• 30%: symptoms not controlled by continuous treatment.
• 10%: symptoms that require continuous treatment.
• 0%: symptoms that do not require continuous treatment.

A note says that ovarian disease, injury or adhesions causing ovarian dysfunction that affects the menstrual cycle, such as dysmenorrhea and secondary amenorrhea, is rated under DC 7615.

Endometriosis

38 CFR 4.116, DC 7629

• 50%: lesions involving bowel or bladder confirmed by laparoscopy, pelvic pain or heavy or irregular bleeding not controlled by treatment, and bowel or bladder symptoms.
• 30%: pelvic pain or heavy or irregular bleeding not controlled by treatment.
• 10%: pelvic pain or heavy or irregular bleeding requiring continuous treatment for control.

The schedule says the diagnosis of endometriosis must be substantiated by laparoscopy.

Removal of the uterus or ovaries

38 CFR 4.116, DC 7617 to 7620

• Uterus and both ovaries removed (7617): 100% for three months, then 50%.
• Uterus removed (7618): 100% for three months, then 30%.
• Ovary removed (7619): 100% for three months, then 30% if both ovaries are completely removed, or 0% if one is removed with or without partial removal of the other. If one ovary was lost to a service-connected injury or disease and the other is absent or not working for an unrelated reason, the service-connected loss is rated 30%.
• Both ovaries completely atrophied (7620): 20%.

Each of these carries the footnote to review for special monthly compensation.

Pelvic organ prolapse and fistulas

38 CFR 4.116, DC 7621, 7624, 7625

• Pelvic organ prolapse (7621): 10%, for complete or incomplete prolapse due to injury, disease or surgical complications of pregnancy. Conditions include uterine or vaginal vault prolapse, cystocele, urethrocele, rectocele and enterocele. Any genitourinary, digestive or skin symptoms are rated separately and combined with the 10%.
• Rectovaginal fistula (7624): 100% for vaginal fecal leakage at least daily needing a pad; 60% for four or more times a week; 30% for one to three times a week; 10% for less than weekly; 0% without leakage.
• Urethrovaginal fistula (7625): 100% for multiple fistulae; 60% when an appliance or absorbent material changed more than four times a day is needed; 40% for two to four changes a day; 20% for fewer than two.

For the urinary levels used elsewhere, see urinary and prostate VA ratings.

Mastectomy and other breast surgery

38 CFR 4.116, DC 7626

• Radical mastectomy: both 80%; one 50%.
• Modified radical mastectomy: both 60%; one 40%.
• Simple mastectomy, or wide local excision with significant alteration of size or form: both 50%; one 30%.
• Wide local excision without significant alteration of size or form: 0%, one or both.

For VA purposes, a radical mastectomy removes the entire breast, the underlying chest muscles and the regional lymph nodes. A modified radical removes the breast and axillary lymph nodes with the chest muscles left intact. A simple (total) mastectomy removes all breast tissue, the nipple and a small portion of skin, with nodes and muscles left intact. A wide local excision (partial mastectomy, lumpectomy and similar) removes a portion of the breast. These ratings carry the footnote to review for special monthly compensation.

Cancer and benign growths

38 CFR 4.116, DC 7627, 7628, 7630, 7631

• Malignant gynecological cancer (7627) and breast cancer (7630): 100%, continuing after surgery, radiation or chemotherapy ends. Six months after treatment stops, a mandatory VA exam sets the rating. If there is no recurrence or spread, the residuals are rated.
• Residuals are rated under the body system affected, including scars, lymphedema, disfigurement, limited arm, shoulder or wrist motion, loss of grip strength, loss of sensation, and effects of muscle harvested for reconstruction. Breast residuals can also be rated under 7626.
• Benign growths (7628, 7631): rated on their residuals the same way.
• Female sexual arousal disorder (7632): 0%, with a footnote to review for special monthly compensation.

The PACT Act burn pit list includes cancers of the reproductive system, and VA also names male breast cancer. The lists and their rules are on presumptive conditions by era. Scar levels are on VA scar ratings.

What VA’s gynecological and breast exam forms cover

VA Gynecological Conditions DBQ (updated 2025-10-27) and Breast Conditions DBQ (updated 2024-07-16)

• Gynecological form, symptoms: pain (mild, moderate or severe; intermittent or constant), pelvic pressure, irregular menstruation, dysmenorrhea or secondary amenorrhea tied to ovarian dysfunction, and menstrual disturbances.
• Treatment: whether treatment is needed, and whether symptoms are not requiring continuous treatment, requiring it, or not controlled by it. This is the question that sets the 0, 10 or 30% level.
• Surgery and menopause: hysterectomy and ovary removal with dates, and whether menopause was natural, premature, surgical, chemical or radiation induced.
• Other sections: fistulas, endometriosis (with laparoscopy and anemia testing), pelvic organ prolapse, tumors and treatment dates, incontinence, female sexual arousal disorder and functional impact.
• Breast form: whether there is a breast disorder, benign or malignant growth, which breast, surgery and its type, radiation and chemotherapy dates, whether 25 percent or more of breast tissue was lost, residuals, scars and functional impact.

See Preparing for Your C&P Exam.

What I could not verify

• The rating levels come from the eCFR text of 38 CFR 4.116 (current as of October 16, 2026). eCFR is unofficial, and the official text wins over me. The schedule was last amended in 2018.
• I checked both exam forms through a text reader of VA’s PDFs, not line by line. The forms themselves are the authority.
• I did not restate the special monthly compensation rules. See 38 CFR 3.350 and the linked page.
• I did not research how VA handles military sexual trauma claims or mental health conditions connected to these conditions. See women veterans and secondary conditions.
• I did not research which gynecological or breast conditions are on VA’s presumptive lists beyond what the presumptive page says.