In this sample of 2,784 sexually active female twins, adolescent cannabis use was strongly associated with rVUS (unadjusted OR 2.69, 95% CI 2.24-3.22; Table 2) and the association persisted even when never users were excluded (OR 2.55, 95% CI 2.01-3.24). Even after adjustment for covariates, women who used cannabis prior to age 17 were at over two times increased odds relative to their never user/late-onset user co-twin to report rVUS.