"At the root is a system that has not been responsive to the needs of women veterans," said Patricia Hayes, the department's national director of women's health care.
The five veterans said women sometimes aren't properly informed upon discharge that health benefits are still available. They described how dealing with government is frustrating and confusing, and that often their unique needs, such as child care and sexual assault counseling, aren't understood by government officials.
"I looked to the VA for help when I most needed it, but never succeeded in completing my enrollment, let alone actually receiving the care I needed," said Genevieve Chase, the founder and executive director of the American Women Veterans organization.
Hayes agreed. "Women don't really know about VA services," she said.
Department representatives acknowledged Tuesday that they're struggling to adapt to the unique needs of female veterans. The idea that the military should provide pap smears and mammograms is still somewhat new, they said.
Chase recalled how, when serving in the Army in Afghanistan in 2006, her truck was hit by an improvised explosive device, "nearly disintegrating" the vehicle. Upon her discharge, she was given only a list of Web addresses and a five-minute briefing about the health care services she qualified for.
Seeking help for her post-traumatic stress disorder and traumatic brain injuries, Chase was frustrated by what she said was an "unclear" veterans' government Web site and "unfriendly" phone advice.
"In communicating with other veterans, I have found that I am hardly alone in this," she said. "Veterans should not need a third party to help them navigate the VA system."
The department officials pledged to do more, and described other problems that need fixing.
In addition to combat-related PTSD, at least 20 percent of women veterans must deal with mental issues from being sexually assaulted in the military, VA officials said.
In a recent assessment of the treatment women get through their department, Veterans Affairs officials found few of their facilities offered women-only counseling. Most women who have experienced sexual assault wouldn't want to attend co-ed group therapy, said Randall B. Williamson, the director of health care for the VA. Most clinics didn't have full-time gynecologists, it also found.
In May, the committee approved the Women Veterans Health Care Improvement Act, designed to address these problems. The full Senate has yet to take any action on the bill.
The House of Representatives passed similar legislation in June. The Tuesday hearing was to give the Senate more information on problems with access to health care at the department.
The Senate bill, introduced by Sen. Patty Murray, D-Wash., would require the department to study barriers to health care for female veterans, train more psychiatrists to treat PTSD sufferers and provide care for newborns.
"There's a knowledge gap at VA regarding issues of women's health," Murray said.
Technically barred from combat but serving alongside men in wars in Iraq and Afghanistan, some women find that veterans officials won't believe they served in combat and will try to deny them treatment.
"One of my closest friends was told by a VA doctor that she could not possibly have PTSD for just this reason: He did not believe that she as a woman could have been in combat," said Kayla Williams, a former soldier who served in Iraq in 2003.
Williams told committee members that her visit to the Veterans Affairs Medical Center in Washington in 2006 was "uncoordinated, stressful and confusing."
It was so bad, she said, that she and her husband had to rely on private health care, and the doctors were less familiar with battle injuries and mental issues.
"The facility did not smell clean and was crowded with veterans who seemed to have poorly managed mental health concerns," she said. "I was not given clear information about what services were available to me."