Introduction: The Veterans Administration Health Care System is one of the largest providers of medical care across the United States. Within the VA system, many female veterans are establishing medical care and anecdotally it has been suggested that female veterans are more difficult to sedate leading to more incomplete and rescheduled procedures. Additionally, many of these females appear to have significant history of post-traumatic stress disorder (PTSD) while in the military. Currently within the VA system, anesthesia support has been limited to more conventional indications of severe cardiopulmonary disease, OSA, morbid obesity or pts who previously failed sedation. The majority of female veterans do not qualify for anesthesia care which increases their risk of sedation failure. Rescheduling incomplete procedures increases overall cost as well as wait times in the endoscopy lab. Methods: A retrospective chart review of colonoscopies performed at Hines VA from 1/2013 to 12/2014 was performed using a database of endoscopic procedures and the electronic medical record. All females undergoing colonoscopy were identified. Data collected included dosage of sedation used and diagnosis of PTSD. A matched group of males undergoing colonoscopy during the same time period was included with data points as listed above. T tests were used to compare mean sedation requirements of the two groups, and chi square analysis was completed for categorical variables. Results: Using the endoscopy database, 173 females and 174 males undergoing colonoscopy were identifi ed. Female veterans required significantly higher doses of versed (p 0.0001) and fentanyl than males (p 0.0001). Females were significantly more likely to receive Benadryl than males (p 0.005). Within the female veteran group, females with a history of PTSD were more likely to require Benadryl for adequate sedation than those without PTSD (p 0.01). Females were significantly more likely to have an incomplete procedure (p 0.003). Conclusion: Females within the VA medical system are approaching colorectal cancer screening age. They have significantly increased sedation requirements compared to their male counterparts, in addition to higher risk of incomplete procedures due to sedation failure. Females with a diagnosis of PTSD are more likely to require adjunctive medical therapy to increase completion rate of colonoscopy. Recognition of this risk factor is essential to properly caring for our female veterans.