Why Expert Evaluation Matters: Understanding Abnormal Uterine Bleeding and the Advanced Diagnostic Approach of Dr. Steven R. Goldstein

 

 

 Abnormal uterine bleeding is one of the most common—and often most distressing—gynecologic complaints women face. Whether the bleeding is unusually heavy, occurs between periods, lasts longer than normal, or happens after menopause, it often causes fear, confusion, and significant disruption to daily life. Women naturally want answers, and they want those answers delivered with accuracy, compassion, and modern medical expertise.

 

That is why so many individuals turn to a leading abnormal uterine bleeding specialist NYC  Dr. Steven R. Goldstein. Dr. Goldstein is widely regarded as one of the nation’s top Obstetricians and Gynecologists and an internationally recognized authority on gynecologic ultrasound and imaging. A Professor of Obstetrics and Gynecology at the New York School of Medicine, he serves as the Director of Gynecologic Ultrasound at New York University Medical Center and is a past President of the American Institute of Ultrasound in Medicine. His deep expertise, coupled with decades of innovation in women’s health imaging, has made him a trusted resource not only for patients but also for physicians seeking guidance in complex cases.

 

Women in New York and from around the world seek his care because his approach is rooted in advanced, non-invasive, high-precision diagnostics—especially important for women who have been told by another provider that they need a Dilation and Curettage (D&C). When an experienced gynecologist in Manhattan can offer accurate diagnosis without unnecessary surgery, patients benefit on every level: physically, emotionally, and financially.

 

The Problem With Unnecessary D&Cs

A frequent complaint of women visiting their gynecologist is abnormal bleeding. Unfortunately, many of these women are told they need a Dilation and Curettage (D&C) to determine the cause of their abnormal bleeding. A D&C involves dilation of the cervix followed by scraping of the endometrial lining of the uterus. It is a painful and costly procedure, comes with anesthesia-related risks, and requires recovery time.

Even more concerning is the fact that three-fourths of these operations turn up nothing. In other words, the majority of them are unnecessary.

 

Many women also fear that their abnormal bleeding may be a sign of cancer. While that fear is understandable, most bleeding is caused by benign and treatable conditions. The key is obtaining an accurate diagnosis before undergoing any invasive procedure. This is where the skills of an expert obgyn in Manhattan become especially valuable.

 

A Modern, Non-Invasive Approach to Diagnosing Abnormal Uterine Bleeding

As an abnormal uterine bleeding specialist NYC patients trust, Dr. Goldstein takes a dramatically different approach from the traditional D&C-first model. Instead of defaulting to surgery, he uses painless, non-invasive transvaginal ultrasounds (vaginal sonograms) and Sonohysterography, all performed right in his office.

 

These procedures:

• Are completed within minutes
• Require no anesthesia
• Are highly accurate
• Allow for real-time visualization of the uterus
• Avoid the pain, cost, and risks of a surgical D&C
•  

This modern diagnostic method, pioneered and refined by experts like Dr. Goldstein, has made it possible to identify the true cause of abnormal bleeding with clarity and precision.

 

Common Causes of Abnormal Uterine Bleeding

 

Abnormal uterine bleeding can occur for many reasons. Among the most common are:

• Uterine polyps
• Fibroids
• Miscarriage
• Onset of menopause
• Hormonal imbalances, including unopposed estrogen
• Endometrial hyperplasia (pre-cancer) or cancer

 

Using the clear, high-resolution images provided by non-invasive Sonohysterography or vaginal sonograms, Dr. Goldstein is able to isolate the cause of the abnormal uterine bleeding with a level of accuracy that often eliminates the need for invasive procedures.

 

For example, examination of high-resolution images of the uterine lining may show that the bleeding is due to a hormonal imbalance. In women who are not ovulating regularly—often during perimenopause—unopposed estrogen can cause the uterine lining to thicken excessively, leading to heavy or spotty bleeding. Without progesterone to balance estrogen, the lining becomes unstable and sheds irregularly.

 

Ruling Out Cancer Without Surgery

One of the greatest benefits of advanced imaging is the ability to differentiate benign causes from potentially serious ones without performing a D&C. Abnormal bleeding may also occur from cancer or hyperplasia (pre-cancer). Even in these cases, vaginal probe ultrasounds and fluid-enhanced Sonohysterography can eliminate the need for almost all diagnostic D&Cs and the pain, cost, and risks associated with them.

This is one reason Dr. Goldstein remains one of the most sought-after specialists not only in New York but across the country. His ability to provide accurate diagnosis using non-invasive imaging gives women peace of mind and avoids unnecessary surgical intervention. Women seeking a highly skilled gynecologist in Manhattan often turn to him for his expertise, compassion, and commitment to evidence-based medicine.

 

Understanding Hormonal Causes: The Role of Unopposed Estrogen

 

Hormonal imbalance is one of the most overlooked yet common causes of abnormal uterine bleeding. In perimenopausal women—those in their 40s and early 50s—ovulation often becomes irregular. When ovulation does not occur, progesterone is not produced. This leads to a situation known as unopposed estrogen, where the uterine lining continues to thicken without the balancing effect of progesterone.

 

The result can be:

• Prolonged periods
• Sporadic heavy bleeding
• Spotting
• Thickened endometrium
• A higher risk of hyperplasia

 

High-resolution ultrasounds enable physicians to visualize the thickness and texture of the endometrial lining, helping determine whether hormonal imbalance is playing a role.

 

Why Dr. Goldstein Is a Trusted Leader in Women’s Health

 

With decades of clinical experience, extensive research contributions, and international recognition, Dr. Steven R. Goldstein is considered one of the top abnormal uterine bleeding specialists in New York. Women trust him not only for his diagnostic skill but also for his leadership in the field of gynecologic imaging.

 

In addition to diagnosing abnormal bleeding, Dr. Goldstein also screens women for ovarian and cervical cancer, using cutting-edge imaging tools to identify abnormalities at the earliest stages.

 

Women no longer need to rely on outdated diagnostic procedures that are invasive, painful, or unreliable. With the advanced technology and expertise available through an abnormal uterine bleeding specialist NYC patients consistently recommend, they can receive answers quickly, safely, and comfortably.

 

When to Seek Evaluation

 

Women should seek evaluation promptly if they experience:

• Bleeding between periods
• Heavy menstrual bleeding
• Bleeding after intercourse
• Postmenopausal bleeding
• Periods lasting longer than normal
• Irregular or unpredictable bleeding
• Passing large blood clots
• Pelvic pain accompanied by bleeding

 

A skilled obgyn in Manhattan can determine the cause, rule out dangerous conditions,

and offer treatment tailored to the individual’s needs.

 

Take the First Step Toward Answers

If you are a woman suffering from abnormal uterine bleeding and need to determine whether it is from a cancerous condition—or if you need ovarian and cervical cancer screening—contact Dr. Steven R. Goldstein, MD, an internationally renowned expert that patients rely on for accurate, compassionate care.

 

Your health, peace of mind, and quality of life matter. Accurate diagnosis should never require unnecessary surgery. With the guidance of Dr Steven R. Goldstein you can get clear answers and effective solutions quickly and safely.

 

Understanding Pelvic Adhesions: Insights from a top Gynecologist

 

 

 

Pelvic pain can be one of the most frustrating and complex conditions for women to experience. While the cause is often difficult to pinpoint, one common and frequently overlooked culprit is pelvic adhesions—bands of scar tissue that cause internal organs to stick together. These adhesions can lead to chronic pain, painful intercourse, painful ovulation, and even infertility.

 

For women in New York City struggling with unexplained pelvic discomfort, Dr. Steven R. Goldstein, a world-renowned gynecologist in NYC, offers advanced diagnostic methods that go beyond standard imaging. His expertise in dynamic ultrasonography has helped countless women find answers and relief without unnecessary exploratory surgery.

 

What Are Pelvic Adhesions?

Pelvic adhesions are bands of fibrous scar tissue that form between pelvic organs and tissues, often as a result of surgery, infection, endometriosis, or inflammation. These adhesions can tether organs—such as the uterus, ovaries, fallopian tubes, and intestines—causing them to stick together or become restricted in movement.

When this happens, women may experience:

 

• Chronic pelvic pain
• Pain during intercourse
• Painful ovulation or menstruation
• Digestive discomfort
• Difficulty conceiving (infertility)

 

Although these symptoms can mimic other gynecologic conditions, the key challenge lies in accurately identifying adhesions. Traditional ultrasound imaging often falls short, leading to frustration and, in many cases, misdiagnosis.

 

Why Standard Ultrasounds Often Miss Pelvic Adhesions

Most gynecologists rely on static ultrasound images or still snapshots to assess the pelvic organs. While this approach can reveal anatomical structures and abnormalities such as cysts or fibroids, it cannot evaluate how these structures move—or fail to move—relative to one another.

 

As Dr. Goldstein explains, pain is a dynamic experience, and therefore, it requires a dynamic assessment. You can’t fully understand or diagnose pelvic pain through still images alone. The motion, interaction, and restriction between pelvic organs often tell a much deeper story—one that traditional imaging can easily miss.

 

Dynamic Ultrasonography: A Game-Changer in Diagnosing Pelvic Pain

This is where dynamic ultrasonography comes in—a specialized imaging technique that Dr. Goldstein has helped advance and write about extensively. As a leading NYC GYN and former Director of Gynecologic Ultrasound at NYU Langone Medical Center, Dr. Goldstein uses this innovative approach to identify adhesions and other subtle causes of pelvic discomfort.

 

Dynamic ultrasonography involves using a transvaginal probe to visualize the uterus, ovaries, and surrounding tissues while applying gentle movement. The process allows the examiner to observe how the organs shift—or fail to shift—against each other in real time.

 

As noted by Dr. Ilan Timor-Tritsch in Transvaginal Sonography, this “sliding organ sign” is critical for diagnosing pelvic adhesions. When no adhesions are present, organs move freely and independently within the pelvis. However, if adhesions are present, the structures move together in tandem, indicating restriction. This simple, yet sophisticated observation allows for a precise, non-invasive diagnosis.

 

Why Dr. Goldstein’s Hands-On Approach Matters

Unlike many practitioners who rely solely on technicians to perform ultrasounds, Dr. Goldstein conducts the dynamic ultrasonography procedure himself. This hands-on approach allows him to directly observe how the patient’s organs respond to movement—and, importantly, when and where pain occurs during the exam.

 

This real-time feedback gives him valuable insight into the source of discomfort. By correlating physical sensations with visual findings, Dr. Goldstein can often determine whether adhesions are the cause of the pain without resorting to exploratory surgery.

For patients, this means faster answers, a clearer understanding of their condition, and access to targeted treatment plans that address the root cause of their symptoms.

 

Avoid Unnecessary Surgery with Dynamic Diagnosis

Women with chronic pelvic pain are often told they need “exploratory surgery” to determine the cause of their symptoms. However, with dynamic ultrasonography, that invasive step can frequently be avoided. The ability to visualize adhesions through movement-based imaging not only enhances diagnostic accuracy but also reduces the risks, costs, and recovery time associated with surgical exploration.

 

As a top gynecologist in NYC, Dr. Goldstein has seen countless cases where dynamic imaging revealed pelvic adhesions that static sonograms or MRIs missed entirely. For many of these women, this advanced diagnostic method has been life-changing—offering clarity and a clear treatment path where uncertainty once reigned.

 

Expertise and Innovation in Women’s Health

Dr. Steven R. Goldstein is widely regarded as one of the world’s foremost experts in gynecologic ultrasound and women’s health. His work has shaped how modern gynecology approaches pelvic pain and imaging. With decades of clinical experience, academic leadership, and a reputation for compassionate care, Dr. Goldstein continues to be a trusted resource for women seeking answers to complex pelvic conditions.

 

When to See a Gynecologist for Pelvic Pain

If you’ve been struggling with unexplained pelvic pain, discomfort during intercourse, or have been told that surgery may be necessary to determine the cause, it’s worth seeking a second opinion. A consultation with Dr. Steven R. Goldstein, leading NYC GYN and specialist in dynamic ultrasonography, could provide the non-invasive insight you need.

 

Dynamic ultrasound offers a modern, precise, and patient-centered way to understand pelvic adhesions and related issues—helping women take control of their health with confidence and clarity.

 

REDUCING THE CONFUSION ABOUT ABNORMAL UTERINE BLEEDING

 

 

Dr Steven R. Goldstein is a Gynecologist in Manhattan who has helped thousands of women with abnormal uterine bleeding (AUB). If you've ever felt confused about your period — whether it's coming too often, lasting too long, or showing up when it's not supposed to — you're not alone. As an abnormal uterine bleeding specialist NYC, Dr Goldstein sees women every day who are frustrated, concerned, or just plain tired of dealing with unpredictable cycles and abnormal bleeding.

 

Let’s break down what’s normal, what’s not, and what could be going on if your period seems to be writing its own rules.

 

What Is Abnormal Uterine Bleeding (AUB)?

Abnormal Uterine Bleeding, or AUB, is a medical term we use when bleeding from the uterus doesn't follow a typical menstrual pattern. That might mean:

• Your period comes too often
• It lasts longer than usual
• You bleed between periods
• Your flow is much heavier or lighter than normal
  
  

While these symptoms might feel alarming, the good news is there are usually explanations — and treatments — available.

 

Types of Abnormal Bleeding

Let’s go over some common patterns of abnormal bleeding and what they mean in plain language:

1.    Intermenstrual Bleeding
This is when you bleed between your regular periods. Spotting now and then can be normal, especially if you're on birth control, but frequent or heavy mid-cycle bleeding should be checked out.

2.    Metrorrhagia
This refers to bleeding that’s irregular — you might bleed a little one week, then nothing for a few days, then bleed again. It’s unpredictable and can be frustrating.

3.    Menorrhagia
This is the medical term for periods that are too heavy but come at regular intervals. If you're soaking through a pad or tampon every hour or passing large clots, that qualifies as heavy.

4.    Polymenorrhea
If your period comes too frequently — less than 21 days apart — this is called polymenorrhea. That’s more than one period a month, and it can be exhausting.

5.    Oligomenorrhea
This is the opposite — periods that are too far apart, more than 37 days between them. While some women naturally have longer cycles, a sudden change can be a sign of a hormonal issue or another underlying problem.

 

What Causes Abnormal Uterine Bleeding?

There are many possible reasons why your uterus may be misbehaving. Some are temporary, while others may need medical treatment. Here are a few of the most common culprits:

 

1. Hormonal Imbalances

Your menstrual cycle is controlled by hormones. If something throws them off — like stress, weight changes, thyroid issues, or polycystic ovary syndrome (PCOS) — it can lead to irregular bleeding.

2. Anovulation (Not Ovulating)

If you're not ovulating regularly, your periods may become irregular or unusually heavy. This kind of bleeding is often referred to as “dysfunctional” because it’s not following the usual monthly cycle. Anovulatory cycles are especially common during puberty and perimenopause.

3. Uterine Fibroids (Leiomyomas)

Fibroids are non-cancerous growths in the uterus. They’re common — especially in women in their 30s and 40s — and they can cause heavy or prolonged periods. Fibroids that grow inside the uterine lining (called submucosal fibroids) are particularly known to cause bleeding.

Interestingly, we don’t fully understand why fibroids cause bleeding, but one reason may be that as they grow, they increase the surface area inside your uterus. More surface = more bleeding.

4. Pregnancy-Related Bleeding

Always rule out pregnancy first! Even if you weren’t trying to conceive, unexpected bleeding might be related to pregnancy or even a miscarriage.

5. Other Causes

Sometimes, bleeding can come from the cervix or vagina, not the uterus. Infections, inflammation, or, in rare cases, precancerous or cancerous changes could be the source. This is why it’s so important to get checked if you notice something unusual.

 

When Should You See a Doctor?

Here are a few signs it’s time to book an appointment:

• You bleed between periods more than once or twice
• Your period is coming too often or skipping months
• You’re soaking through pads/tampons every hour
• You’ve noticed a big change in your cycle
• You’re feeling tired, dizzy, or weak (which could mean anemia from blood loss)

 

What Can Be Done?

The treatment for Abnormal Uterine Bleeding depends on the cause. Your period is a window into your overall health. If something seems off, don’t ignore it. As an abnormal uterine bleeding specialist in NYC, Dr Goldstein is here to help you figure out what’s going on and how to get things back on track.

 

To determine the cause of the abnormal uterine bleeding, Dr Goldstein uses minimally invasive, painless transvaginal ultrasounds or Sonohysterograms to see the uterus, uterine lining, fallopian tubes, ovaries, cervix live. He is known as pioneer in the field of gynecologic ultrasounds and personally performs all these procedures.

 

Dr Goldstein, a leading Gynecologist in Manhattan encourages women not to suffer in silence. Irregular or heavy periods are not something you “just have to live with.” There are solutions, and we’re here to help you find them.