Dr Steven R. Goldstein MD - Unscheduled bleeding in perimenopausal women

 

Dr Steven R. Goldstein MD is a Menopause Specialist in NYC who has helped thousands of women safely navigate the menopause and perimenopause stage of life.

 As a certified menopause practitioner and a past President of the North American Menopause Society (NAMS) and the International Menopause Society, Dr Goldstein works with women experiencing perimenopause and menopause to understand the changes their bodies are undergoing, lifestyle changes necessary, and what treatments are available.

 As a woman enters perimenopause and ovulation is on the decline, unscheduled bleeding may occur and cause alarm. This dysfunctional uterine bleeding in perimenopausal patients can be caused by a lack of ovulation, which is better treated hormonally, not surgically. 

 So how can a gynecologist determine whether the bleeding is caused by a lack of ovulation without doing any surgical procedures to diagnose the condition? The answer is a non-invasive, painless procedure called Sonohysterography which is performed in a few minutes right in the office.

 Traditionally diagnostic procedures such as biopsy, suction aspiration, suction curettage, and diagnostic hysteroscopy were performed. However, these are invasive procedures which are painful, costly, and inconvenient to the patient. Dr Goldstein, a leading Gynecologist in NYC,  prefers to use non-invasive procedures such as the aforementioned sonohysterography.

 Sonohysterography, by assessing endometrial thickness, can reliably distinguish between patients whose bleeding is as a result of a lack of ovulation and those who are in need of formal curettage and hysteroscopy.

 Since in both transvaginal ultrasounds and Sonohysterography the skill of the operator is very important, Dr Goldstein performs both these procedures himself to see the uterus, the lining etc. himself. Clear, high definition images are produced for analysis and diagnosis. Dr Goldstein is not just a Gynecologist in NYC, but he is also a former Director of Gynecologic Ultrasound at NYU Langone Medical Center and a Professor of Obstetrics and Gynecology, New York University School of Medicine. Thus he is very well qualified to perform Sonohysterograms and properly diagnose the cause of any abnormal uterine bleeding.

 Dr Goldstein has found that in the vast amount of patients abnormal uterine bleeding is associated with episodes of no ovulation. This condition can be managed hormonally in premenopausal patients.

 If you are in perimenopause, pre menopausal or post menopausal and experiencing unscheduled bleeding, then schedule and appointment with Dr Steven R. Goldstein, a Menopause Specialist in NYC.

Dr Steven R. Goldstein MD - Weight Gain in Menopausal Women

 

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.