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Osteoporosis is a major cause of morbidity in the United States, resulting in approximately 2 million fractures and contributing to 65,000 deaths annually. Organizations have published guidelines for the diagnosis and management of the disease. However, a degree of conflict exists among some of the recommendations. Several screening tools have been developed to identify fracture risk, and although the Fracture Risk Assessment tool developed by the World Health Organization has been widely adopted, other screening tests are also potentially useful. A range of medications are available for the prevention of osteoporosis in individuals who are at high risk for the disease and for the treatment of individuals who already have osteoporosis. Although some of these medications are highly effective, all have adverse-effect profiles and other caveats that require both familiarity with the characteristics of the medication and detailed knowledge of patient needs and preferences. Effective therapy is only possible with strong patient adherence to the regimen, which in turn requires that the patient have an understanding of the risks and benefits and can participate in the treatment-selection process.

The perimenopause can be a time of many changes in the lives of women. Uncomfortable, nuisance, and sometimes serious symptoms and medical problems often accompany it. Some of these problems include concerns about fertility or contraception (or both), hot flashes, sleep disturbances, urogenital changes, and abnormal uterine bleeding. Common treatment options for perimenopausal problems include hormone replacement therapy with estrogen and progestins and surgical modes of therapy. In addition, many women will notice a change in their health during the perimenopausal years and a strategy for screening and health maintenance needs to be established.