Clinical decision-making with the woman after menopause

Women visit physicians more often than men do, but women's medical care frequently remains fragmented and insufficient. The opportunity to establish a primary care relationship often occurs when patients present with an acute complaint. Integral parts of preventive health maintenance for middle-aged women include an evaluation of the risk for osteoporosis, coronary artery disease, depression, and domestic violence; a consideration of hormone replacement therapy; and screening for breast, cervical, and colon cancer. A primary care physician can address all of these issues in a comprehensive manner without specialty referrals.