ESTROGEN, PROGESTERONE AND YOUR MENSTRUAL CYCLE

 

 

Dr Steven R. Goldstein MD, a hormone specialist in NYC, is the co-author of the books “The Estrogen Alternative” and “Could it be….Perimenopause?”. A past President of the International Menopause Society and a Certified Menopause Practitioner, Dr Goldstein has worked alongside thousands of his patients in over 2 decades of private practice using hormone replacement therapy (HRT) to help them cope with the symptoms of menopause and hormone imbalances that may result in gynecological conditions such as bleeding.

 

Let’s take a closer look at the hormones estrogen and progesterone. Estrogen is made from follicles that develop each month in the ovaries. A follicle is a saclike structure inside the ovary that contains an egg. At the end of a cycle, if pregnancy does not ensue, the menstrual lining of the uterus is shed. The first day of the period begins day one of a new cycle. At that point, both ovaries recruit about a half dozen follicles under the influence of the follicle stimulating hormone (FSH) from the pituitary gland in the brain. Around day nine, one follicle takes off geometrically and becomes the dominant follicle. It is a small 2.5 cm cystic structure prior to it bursting. This is ovulation.

At midcycle, (day fourteen), a surge of luteinizing hormone (LH) from the pituitary causes the follicle to rupture, releasing the ovum to be picked up by the fallopian tube.

 

The follicle is now known as the Corpus Luteum (CL), and it begins to produce large amounts of Progesterone.

 

Progesterone causes the glands of endometrium (lining of the uterus), to become lush in preparation for receiving the fertilized egg. If no pregnancy ensues, estrogen and progesterone levels decrease and the woman gets her period fourteen days after ovulation. Recall that the beginning of bleeding day one of the new cycle. Thus, in an idealized twenty eight day cycle, a woman ovulates on day fourteen and fourteen days later she gets a menses.

 

Dr Goldstein, one of the top hormone doctors in NYC, says that it is important to remember that a menses (or a period) is a bleed that is preceded by ovulation. Not all bleeding is a menses. Without progesterone to trigger menstruation, the endometrium can keep building up and eventually be shed, giving the woman the impression she has had her period.

 

These hormonal imbalances can lead to irregular bleeding, where there is estrogen but no progesterone. Irregular bleeding and a host of other symptoms can follow. Unopposed estrogen (estrogen without progesterone) for long periods of time can lead to pre cancer.

 

Dr Steven R. Goldstein MD is a leading hormone specialist in NYC who uses HRT such as Selective Estrogen Receptor Modulators to help women cope with symptoms of menopause. Women who are experiencing excessive bleeding should also see Dr Goldstein as it may be due to a hormonal imbalance that gives rise to a thick uterine lining. If you are experiencing those symptoms or irregular periods then a consultation with Dr Steven R. Goldstein may be appropriate.

 

THE IMPACT OF MENOPAUSE ON CHOLESTEROL LEVELS

 

Dr Steven R. Goldstein is a past President of the International Menopause Society and a Certified Menopause Practitioner. In private practice in NYC, this Menopause Specialist in NYC has helped thousands of women over decades to help cope with the symptoms of menopause. Menopause can have an impact on cholesterol levels in women. Typically, during menopause, there is a shift in hormonal balance, particularly a decrease in estrogen levels. Estrogen has been shown to have a protective effect on cholesterol levels, helping to maintain higher levels of HDL (high-density lipoprotein) cholesterol, often referred to as "good" cholesterol, and lower levels of LDL (low-density lipoprotein) cholesterol, known as "bad" cholesterol.

Estrogen has also been shown to have vasodilatory effects, meaning it relaxes the blood vessels, which can help maintain healthy blood pressure and improve blood flow. This effect contributes to overall cardiovascular health.

When estrogen levels decline during menopause, this protective effect diminishes, leading to potential changes in cholesterol levels. Specifically, LDL cholesterol levels may increase, which can contribute to a higher risk of heart disease and other cardiovascular issues.

 As one of NYC’s leading Menopause doctors, Dr Goldstein points out that post-menopausal women are more vulnerable to heart disease because of the aforementioned effect of estrogen on blood cholesterol levels. Total cholelsterol levels of postmenopausal women are about 25mg/dl higher than in women who have not reached menopause.

It’s important for women to know their numbers – total cholesterol number, HDL  (good cholesterol) number and LDL (bad cholesterol) number and the triglycerides number. A total cholesterol number of more than 240 is considered high. Heart attacks are very uncommon in people with cholesterol levels below 150, but that number may be hard to achieve.

An HDL number of 35 and above is good. You do not want to have a number below 35, because too little HDL can allow plaque to accumulate in your arteries. If your HDL number is too low, then try getting more aerobic exercise, at least thirty minutes three or four times a week.

An LDL number below 130 is considered okay. More than 160 is considered too high for your health. Avoid red meat, saturated fats, cheeses and so on. Check with your primary provider and monitor cholesterol levels.

 

Dr Steven R. Goldstein is also coauthor of the book “The Estrogen Alternative”. He uses hormone replacement therapy (HRT) to help menopausal women to cope with all the symptoms of menopause including effects on the skin and hair. If you are a woman suffering through Menopause and experiencing its symptoms, particularly in the skin and hair, then a consultation with Dr Goldstein, a  Menopause Specialist in NYC may be appropriate.

 

PERIMENOPAUSE - IT’S NOT ALL IN YOUR HEAD

 

Dr Steven R. Goldstein is a Perimenopause Specialist in NYC and co-author of the book “Could it be….Perimenopause?” Perimenopause is a stage of life which a woman enters into right before menopause and experienced by women in anywhere from the late thirties to mid to late forties. Perimenopause is a stage of life with symptoms and realities of its own that responds to specialized healthcare strategies. Perimenopause begins about a decade before the actual onset of menopause. Yet, even though every woman will go through Perimenopause, it is one of the least understood, most misdiagnosed, and most confounding stages in a woman life.

 When it first starts to happen to you, the symptoms are so subtle that by the time you start to worry, they’re often gone. You mention your anxiety, your fatigue, your bouts of forgetfulness to your friends. They nod knowingly, they’ve had them too.

 But still, there are these differences in the way you feel, these annoying symptoms. You think about making an appointment to see your doctor, but what will you say? That you feel vaguely anxious? That you’re suddenly having trouble putting names with faces? That you’ve taken going to bed an hour before your husband when you aren’t even tired, to avoid having another argument over sex? You wonder “maybe it’s all in my head”.

 A word of caution about these symptoms. There are a myriad of medical conditions that can cause you to feel tired and/or forgetful, anxious, etc. It’s when doctors see a “family” of symptoms that occur following a specific pattern of events that we make preliminary diagnosis. Not all of these symptoms are hormonally mediated. The last thing you may attribute such symptoms to is subtle changes in your menstrual cycle, but they are related. Irregular is regular at this time of your life. Shorter, longer, lighter, heavier, the character of your period can change so much during perimenopause that you wonder – is this normal?

 If what you’ve read so far sounds like you, then maybe a consultation with Dr Steven R. Goldstein, a  Perimenopause Specialist in NYC  may be appropriate.