Common Medical and Behavioral Conditions Affecting Women
What the exam tests
These items emphasize how presentation and risk differ in women, and how to integrate medical and behavioral care without losing the gynecologic focus.
Core concepts
- Cardiovascular disease is the leading cause of death in women. Presentations can be atypical; do not anchor on anxiety in a woman with new exertional symptoms.
- Hypertension: ACC/AHA defines 130/80 or higher; pregnancy uses different thresholds (140/90).
- Diabetes: screen adults with overweight or obesity plus risk factors; PCOS increases risk.
- Thyroid disease is common; hypothyroidism can cause heavy menses, fatigue, and infertility. Levothyroxine requirements rise in pregnancy, so recheck TSH each trimester.
- Anemia: iron deficiency from heavy menses is common; check ferritin rather than relying on hemoglobin alone.
- Behavioral health: screen for depression (PHQ-2 then PHQ-9), anxiety, alcohol use, tobacco, and intimate partner violence. Women often present with somatic complaints.
- Weight and metabolic health affect fertility, contraception choice, and pregnancy risk.
- Migraine with aura raises stroke risk and constrains contraceptive choice.
Traps
- Treating fatigue as depression without checking CBC, ferritin, and TSH.
- Missing a mood disorder because the patient presented with pelvic pain.
- Continuing a teratogenic medication into pregnancy.
Rule of thumb
Before attributing symptoms to stress or menses, exclude pregnancy, anemia, and thyroid disease.
Worked example
A 38-year-old reports 6 months of fatigue and 8-day heavy periods. Check CBC and ferritin first. If ferritin is low, treat iron deficiency and evaluate the cause of heavy bleeding rather than starting an antidepressant.