Dr Steven R. Goldstein - Perimenopause and its signs

 

 

 Dr. Steven R. Goldstein MD is the co-author of the book “Could it be….Perimenopause”. As a Menopause Specialist in NYC, Dr Goldstein has helped thousands of women over the years to cope with the symptoms of menopause. However, many are not that familiar with Perimenopause, and when the symptoms of perimenopause present, they may think this is all in their heads.

 

What is Perimenopause?

Perimenopause can occur in women in their late thirties to forties and last for four to seven years before menopause begins. It is a period when a woman’s body begins to slow the production of hormones. When a woman doesn’t ovulate, no progesterone is produced. The presence of estrogen without progesterone to balance it out can cause a variety of symptoms unrelated to a woman’s menstrual cycle.

 For instance, fairly constant estrogen levels without progesterone (due to the lack of ovulation in Perimenopause) in a woman will cause her not to bleed at all for weeks or months.

 Secondly, this condition of estrogen without progesterone to balance it (which occurs during Perimenopause) can result in these other symptoms as well such as Salt and Fluid retention, Low blood sugar levels, blood clotting, fibroid tumor enhancement, altered thyroid hormone function (leading to weight gain or feelings of exhaustion), increased production of body fat, feelings of sluggishness and low energy.

 That’s not to say that if a woman is experiencing any of the above that Perimenopause is definitely the cause, but it should certainly be considered. Menopause Specialist in NYC, Dr Steven R. Goldstein, says doctors need to see a “family” of symptoms that occur following a specific pattern of events in order to make a preliminary diagnosis.

 Perimenopause is one of the least understood and most confounding stage in a woman’s life. It is also the most misdiagnosed. Do understand that Perimenopause is not the same as “early menopause”. Early menopause is that stage when women stop menstruating completely before the age of 45.

 

What are some of the signs of Perimenopause?

Some of the signs of Perimenopause are occasional hot flashes, irregular periods, sleep problems, vaginal dryness, mood changes, the inability to concentrate, free floating anxiety and so on.

 

 What can be done about Perimenopause?

At some point, women, as they age, will need to make a decision as to whether they will take estrogen. Dr Goldstein is co author of the book “The Estrogen Alternative” and a hormone specialist in NYC. He works with women in perimenopause and menopause to replace the hormones they are losing at those stages of their life.

 Dr Steven R. Goldstein MD is a Professor of Obstetrics and Gynecology at New York University School of Medicine,  a past President of the International Menopause Society and a Certified Menopause Practitioner.

 To schedule a consultation with Dr Goldstein,please visit his website at www.goldsteinmd.com for more information.

 

Dr Steven R. Goldstein - Uterine Fibroids do not become cancerous

 

Some women experience heavy menstrual bleeding, painful pressure symptoms, increased urinary frequency, iron deficiency (with or without anemia), and also reproductive issues. These are all symptoms of uterine fibroids, and upon examination by a gynecologist, they may be diagnosed as such, having uterine fibroids.

 However, rather large fibroids that originate in the muscle and grow outward may result in no bleeding or fertility issues. In fact, patients may be totally unaware or never suspect that they have them, until they are found during an examination.

 Unfortunately, anxiety may build in these women and they begin to wonder whether these uterine fibroids can become cancerous. Many years ago it was thought that a small percentage of them (less than 1%) could undergo a transformation and actually become cancer.

 Dr Steven R. Goldstein, a leading obgyn in NYC, says true uterine fibroids have no malignant potential. In other words, they do not become cancer. Fibroids are not cancerous, nor do they increase the risk of a woman having uterine cancer.

 What can be diagnosed as cancerous are sarcomas, which are rare malignant tumors of the uterine muscle. These are not fibroids. These sarcomas will exist by themselves, and not in a group or in multiples. Transvaginal ultrasound using color flow Doppler Ultrasound Technology are used to distinguish between uterine fibroids and sarcomas, as it shows blood flow and vascularity. 

 Typical fibroids have a circumferential pattern of blood flow with very little vascularity centrally located. Some benign fibroids can have vascularity if they are extremely cellular and still be benign. The blood flow will show a vascularity pattern very different from typical fibroids.

 Dr Goldstein, a top obgyn in NYC uses transvaginal ultrasounds with color flow doppler liberally to look at the vascularity pattern or blood flow to evaluate any uterine fibroids or sarcomas.

 Dr Goldstein is a pioneer in the field of transvaginal ultrasound and Sonohysterograms which he personally performs. He does not rely on a technician or a report. Dr Goldstein is the 2023 recipient of the William J. Fry Memorial Lecture Award from the American Institute of Ultrasound in Medicine in recognition of his pioneering and vast work in the field of gynecologic ultrasound.

 Schedule a consultation with this top obgyn in NYC if you have  symptoms of fibroids, or have been told you may have uterine cancer and you need a second opinion.

Dr Steven R. Goldstein MD - Hormone Specialist in NYC for Menopause symptoms

 

 

Dr Steven R. Goldstein MD is the co-author of the book “The Estrogen Alternative”, the first book of its kind addressing the use of synthetic hormones, and an expert hormone specialist in NYC.

 Why would a woman need hormone replacement therapy and synthetic hormones? The answer is because as a woman ages, less Estrogen and Progesterone is produced by her body. This produces two major symptoms - vaginal dryness and hot flashes. Other symptoms associated with a lack of estrogen include a lack of concentration, hot flashes, foggy memory, sleep disturbances, irritability and so on. This is known as the menopause stage of life for a woman and the aforementioned are symptoms of the menopause.

 In menopause, there are even greater symptoms to consider than just those mentioned previously, which are all very obvious and felt by women. There are unseen consequences of a lack of estrogen brought on by menopause. There are over three hundred tissues from brain to bone to skin in a woman’s body that contain receptors for Estrogen. All of a woman’s most important body tissues contain Estrogen receptors. When the secretion of Estrogen changes, a woman’s health and well-being reflect those changes. Breasts, skin and blood vessels rely on Estrogen to stay flexible and toned. Estrogen keeps the uterus, vagina and the base of the bladder moist.

 There are also sites in the brain where Estrogen receptors are found. Therefore when a woman enters menopause and the body produces less estrogen, there is a significant impact on a woman’s overall health above and beyond the symptoms like hot flashes.

 Consider estrogen and a woman’s heart. In survey after survey, women list breast cancer or other cancer as their primary health concern. But heart disease is still the number one killer of women. One in three women over sixty-five will develop the disease. It is estimated that 500,000 a year die from coronary artery disease. That is twice as many women as die each year from cancer. In Nurses’ Health study, it was found that women who took estrogen after menopause had about half the incidence of fatal heart attacks as those not on hormone therapy.

 To combat this decrease in estrogen during menopause and the resulting symptoms, disease and adverse impact, Dr Goldstein, a Menopause specialist in NYC, prescribes pills, patches or creams to supply estrogen synthetically. The amount of estrogen prescribed is only a small fraction of what the ovaries normally produce, however it is enough to help alleviate the symptoms of a lack of Estrogen.

 If you are a menopausal woman struggling with the effects of menopause and the loss of estrogen, then contact the office of Dr Steven R Goldstein MD for a consultation to determine if hormone replacement therapy will work for you.

 

Dr Steven R. Goldstein - Obgyn in NYC for evaluation of Fibroids

 

 

Dr. Steven R. Goldstein MD is an Obgyn in NYC for the evaluation of fibroids. What are fibroids? Uterine fibroids are very common pelvic tumors, though they are benign (non-cancerous). They never appear prior to a woman getting her first period, because they are responsive to the hormone estrogen. When a woman’s ovaries ceases to produce estrogen any longer at menopause, these fibroids will shrink.

 By age 50 many women will have some occurrence of uterine fibroids (to be precise, approximately 70% of white women, and 80% of black women). Most of these will have no symptoms and incidental. However, roughly 25-50% of these women will have heavy menstrual bleeding, painful pressure symptoms, increased urinary frequency, iron deficiency (with or without anemia), and also reproductive issues.

 When transvaginal ultrasound is used, uterine fibroids are easily visualized. However, one must understand the difference between incidental uterine fibroids and significant uterine fibroids. Dr Goldstein says “fibroids are like fingerprints, no two are ever alike.”

 Fibroids are also like real estate – location, location, location. It is not necessarily the size of the uterine fibroid that matters. It is the location. For instance, even relatively small fibroids that impinge on the endometrial cavity can cause a lot of bleeding and result in fertility issues.

 Rather large fibroids that originate in the muscle and grow outward may result in no bleeding or fertility issues. In fact, patients may be totally unaware or never suspect that they have them, until they are found during an examination.

 Dr Goldstein, an Obgyn in Manhattan, uses transvaginal ultrasound liberally in examining his patients. He personally performs these transvaginal ultrasounds and does not rely on a technician or a report. Dr Goldstein is a pioneer in the field of transvaginal ultrasound and Sonohysterograms. His research and practice has had a significant influence on the way gynecology is practiced, he is a fierce advocate of painless, non-invasive means of first diagnosis.

 

If you are a woman suffering from heavy menstrual bleeding, painful pressure or anyof the aforementioned symptoms, you may schedule a consultation with Dr Goldstein. If you have been told you have fibroids, you may also see Dr Goldstein for a second opinion.