Dr. Steven R. Goldstein: Medications by Top Obgyn in Manhattan help with Breast Cancer & Bone Loss Prevention

Dr. Steven R. Goldstein MD is an expert obgyn in Manhattan, considered one of the nation’s top doctors in gynecology. In private practice for over 25 years, Dr. Goldstein has had patients who were excellent candidates for Evista (raloxifene) because of its dual effect of reducing breast cancer risk and preventing and treating osteoporosis.

Tamoxifen, raloxifene (also known as Evista) have been been shown to reduce breast cancer risk. Aromotase inhibitors are also, but they are not the focus of this article.

Tamoxifen is the only one approved for use in premenopausal women. Many of you are aware, however, that it results in formation of benign uterine polyps in 10-17% of women as well as a small but real number of uterine cancers in postmenopausal women. Evista, which is now generically available as raloxifene, has similar breast cancer prevention results as tamoxifen but does not have cancer or polyp producing potential in the uterus.

In addition, however, both tamoxifen and raloxifene prevent bone loss because of their selectivity in which they act like estrogen in bone, while being estrogen blockers in breast.

Since early detection of breast cancer will almost always result in a favorable outcome, and since women are routinely living much longer lives than previous generations, a fracture, especially of the hip, of a woman can be a much more life threatening and devastating event than an early breast cancer.

Thus Evista (raloxifene) because of its dual effect of reducing breast cancer risk and preventing and treating osteoporosis, remains an excellent choice for some patients.

To find out more about Dr. Steven R. Goldstein MD, an expert obgyn in Manhattan, or schedule an appointment to discuss your gynecological conditions, visit www.goldsteinmd.com.

Bone Loss & Female Hormone Replacement Therapy: Dr. Steven R. Goldstein

Dr. Steven R. Goldstein MD is considered one of the nation’s top doctors in Gynecology. He is the co-author of the book “The Estrogen Alternative’ and is a Certified Menopause Practitioner by the North American Menopause Society. He is also the Recipient of the Thomas A. Clarkson award for many outstanding contributions to menopause related clinical or basic science research. He has helped thousands of women alleviate the symptoms of menopause with female hormone replacement therapy.

As women age and the ovarian function ceases, estrogen production ceases and they enter menopause. Rapid bone loss due to the lack of estrogen is frequent during menopause and leads to osteoporotic fractures. Understand that bone is a dynamic organ. It is constantly being laid down and taken away until the day you die. Estrogen is a potent inhibitor of taking bone away. This is why when women at menopause stop making estrogen they lose bone rapidly.

Bone health is increasingly one of the most important issues for my patients. As longevity has increased dramatically over the last generation or two, so many women are living into their early 90s. Suffering a hip fracture will result in 25% of women never living independently again and 20 to 30% will be dead within one year. My patients should be as concerned about their bone health as any other aspect of their lives as they pursue “healthy aging.”

So what can a woman do during menopause to guard against the loss of estrogen that leads to bone loss? Dr. Goldstein prefers those approaches that combine the estrogen Premarin with a different category of drug than progesterone. That category is SERM (selective estrogen receptor modulator) used in female hormone replacement therapy. This synthetic estrogen is delivered via pills, patches or creams.

Dr. Goldstein is an expert on menopause and female hormone replacement therapy. He is a Professor of Obstetrics and Gynecology, New York University School of Medicine and a Director of Gynecologic Ultrasound, NYU Langone Medical Center. To learn more about Dr. Goldstein or to make an appointment, visit his website at www.goldsteinmd.com.