PELVIC PAIN AND ENDOMETRIOSIS

 

 

Dr Steven R. Goldstein MD is a top obgyn in Manhattan in private practice for over 25 years. He is also a Professor of Obstetrics and Gynecology at New York University School of medicine, a former Director of Gynecologic Ultrasound at NYU Langone Medical Center and a Past President of the American Institute of Ultrasound in Medicine. He is one of the most highly regarded individuals in the field of gynecologic ultrasound in the world.

 

Many patients present with painful periods (dysmenorrhea), pelvic pain, cramping, way before the start of the menstrual period and may continue after the menstrual period has ended. Painful intercourse, excessive bleeding, painful urination / bowel movements and infertility are also symptoms. However, these symptoms do not always appear. Some women find out only when they cannot get pregnant.

 

Dr Goldstein can diagnose this condition. Endometriosis is a very unusual gynecologic disease, whereby the glands that normally lie inside the uterine cavity and are the ones that are shed with a normal period, somehow come to lie outside the uterine cavity almost always in other places in the pelvis. Thus, when bleeding from a period occurs, these glands will have a tiny amount of bleeding internally. This can cause some scarring (adhesions) as well as inflammatory changes that are a well-known source of pelvic pain and sometimes infertility. Usually, the pain is worse with the menstrual period, although it can often occur between periods as well.

 

Originally, laparoscopy (a surgical procedure to look inside the abdomen) was the gold standard for making a differentiation for pain that might be from endometriosis versus normal severe painful periods. Dr Goldstein does not recommend laparoscopies, but uses painless, non-invasive Transvaginal Ultrasounds to diagnose your condition. At times there is no obvious endometrioma, but the presence of scar tissue can result in structures becoming adherent to each other and be a source of pain. Transvaginal ultrasound can detect the abnormal mobility if the transvaginal ultrasound is done dynamically. The skill of the operator is very important. Dr Goldstein is one of the world’s most renowned individuals in the field of Transvaginal Ultrasounds for gynecology.

 Transvaginal ultrasounds performed dynamically, Dynamic Ultrasonography, are far superior to a technician taking dozens of still two-dimensional images which are later read by a radiologist.

 Women experiencing painful periods or heavy bleeding during periods may schedule a consultation with Dr Steven R. Goldstein MD, a leading gynecologist in Manhattan  to diagnose the root cause of their symptoms.

 

HEALTHY AGING

 

Dr Steven R. Goldstein MD, Hormone Specialist NYC, has worked closely with his patients for over twenty five years in private practice to help them through Perimenopause, Menopause and various gynecologic changes in their bodies as they age.

 

For thousands of years people have been searching for the fountain of youth and never found it. Dr Goldstein believes that the key is healthy aging. He says Ponce de León left Spain six hundred years ago looking for the fountain of youth. We are still looking. The key is “healthy aging” not anti-aging.

 

As women age and enter Menopause (average age 51), the ovaries stop producing estrogen. Twelve consecutive months without a period is generally accepted as the transition of a reproductive woman over to a menopausal one. The lack of estrogen in a woman’s body negatively impacts over three hundred tissues and over two hundred bones. While the vasomotor symptoms such as hot flashes and night sweats are well known and are devastating to endure, there are even more severe effects on a woman’s body. Consider that a lack of estrogen during menopause can affect cardiovascular health as studies have shown an escalation of LDL (bad cholesterol) in menopausal women.

 

There are also effects on bone health, as estrogen helps to reduce the risk of osteoporosis related fractures in women. Women without estrogen will experience brittle bones (osteopenia) and eventually osteoporosis. Muscles are also affected by the loss of estrogen, and sarcopenia (muscle wasting) results. Women in Menopause will also notice an increase in their waist line as central adiposity increases because of a lack of estrogen. Add to the above vaginal atrophy and vaginal dryness, both of which result in painful intercourse and affect intimate relations with a partner.

 

Faced with all of the aforementioned, how is a woman to age healthy? Eating right, exercising, doing all the right things to stay healthy. However it is not enough to ward off the devastating effects of a lack of the hormone estrogen.

 

Dr Steven R. Goldstein, a Hormone Specialist NYC, uses hormone replacement therapy (HRT) to replace the estrogen lost during Menopause. Hormone replacement therapy for menopause is not a one size fits all approach. Dr Goldstein works with each patient to custom tailor a therapy for them. Unfortunately, a lot of “therapists” who are part of the anti-aging movement believe that simply flooding the body with estrogen via “natural” means such as compounded substances is the answer. It is not so.

 Proper Hormone Replacement Therapy (HRT) focuses on the woman’s symptoms, not her levels of estrogen. And the estrogen needs to be balanced with sufficient progesterone (progestin) to avoid cancer.

With estrogen replacement via Hormone Replacement Therapy (HRT), exercise, proper diet and a healthy lifestyle with healthy habits such as not smoking, a woman will continue to age but will age healthy and without the ailments brought on by a loss of estrogen.

 Dr Steven R. Goldstein MD is a Certified Menopause Practitioner, a past President of the International Menopause Society, and a Past President of the North American Menopause Society in addition to many other accreditations and positions held.