Dr Steven R. Goldstein MD has over 25 years of experience in practice and is considered one of the nation’s top gynecologists. As a leading Gynecologist NYC, Dr Goldstein works with menopausal women to help them understand the changes in their body due to menopause and its symptoms.
As a hormone specialist NYC, Dr Goldstein encounters menopausal patients who experience the upsetting phenomenon of developing redistribution of weight to the abdomen; in medical terms known as “centripetal adiposity”. It has been known for quite some time that estrogen promotes lean body mass, so the lack of estrogen can lead to weight gain around the midsection.
Now for the interesting part. Estrogen is produced by ovaries in response to a substance that comes from the pituitary gland known as FSH (follicle stimulating hormone). Follicle stimulating hormone causes follicles in the ovary to produce estrogen. At menopause the ovary is incapable of producing estrogen and so the pituitary puts out more and more FSH in an attempt to get the ovary to respond. In premenopausal women there is what is called a negative feedback loop. That means that when estrogen is produced it drives the level of FSH from the pituitary to a very low level. Thus in menopause, FSH is high and estrogen is low, in premenopause estrogen is high and FSH is low.
Those women who do choose to go on estrogen in the form of female hormone replacement therapy at the time of menopause will, in fact, drive down FSH levels. Thus, regardless of whether it is actually the elevation in FSH or the actual use of estrogen that helps maintain bone mass and prevent accumulation of central fat in the belly, the end result will be the same in menopausal women who use HRT.
Dr Steven R. Goldstein MD is a Gynecologist NYC and a Past President of the International Menopause Society. He is also a Certified Menopause Practitioner and has co authored books on Hormone Replacement Therapy.
