BEATING OSTEOPOROSIS IF YOU ARE MENOPAUSAL

 

 

Dr Steven R. Goldstein is a Menopause Specialist NYC and was the Co Directory of Bone Densitometry and Body Composition at NYU Langone Medical Center from 1997 to 2016. He writes the Bone Health update for the OBG Management Journal and has worked with thousands of women to help them through the menopause stage of life where many experience issues with bone health. One of the ways to strengthen bone and improve your bone health during menopause is by weight bearing exercises.

 

Many patients ask if they need to worry about doing weight bearing exercises, watching their diet and general health while on hormone replacement therapy for menopause. In a word, yes. If you are smoking cigarettes, find a way to stop. If you are overeating, find a way to lose weight and keep your weight under control. There are hundreds of apps and other means of finding help to lose weight.

 

It’s old news that women can benefit from weight bearing exercise, especially during menopause. Chances are if you aren’t already doing it, it’s because you tried it and didn’t enjoy it or didn’t get the benefit you wanted in the time you gave it. Or your experience might have been like one of my patients who told me:

 

 “The weight room at my health club is filled with twenty year old muscled men pumping major iron in a testosterone feast. It’s pretty intimidating to walk in there. Even so, I’d give it a try again if it wasn’t for the fact that I need to lose twenty pounds, and have little time as it is to exercise. I understand about my bones and all, but given half an hour three times a week, I’m just more motivated to burn off the piece of pie I ate the night before than do weight training. So I go for the aerobic stuff. At least on the Stairmaster, I can read briefs etc. and burn calories.”

 

Many people confuse the suggestion to do weight bearing exercises with working out with weights. Weight bearing is not the same as weight training. The Stairmaster is weight bearing exercise. Your own weight is what you are bearing. There are certainly options beyond the weight room for women who want to gain strength, flexibility, and bone mineral density.

 

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

 

PERIMENOPAUSE AND INSOMNIA

 

 

Imagine if you are a woman, early forties to late forties or so, and can’t remember the last time you had a good night’s sleep. Dr Steven R. Goldstein, a Perimenopause Specialist NYC has seen women come into his office with a range of symptoms that appear to have nothing to do with their menses or gynecological health. They have been to allergists, psychologists, psychiatrists and other specialists but never thought their issue was related to their gynecological health.

 

Perimenopause is the transition into menopause when a woman begins to slow the production of hormones. Some of the symptoms are irregular periods, hot flashes, and generally one of the least understood and most misdiagnosed stages of a woman’s life. One of the symptoms of Perimenopause is insomnia, the ability to sleep.

 

Insomnia generally gets worse as one gets closer to the last period. This is because night sweats – hot flashes that occur when you are sleeping – trouble many women when their bodies stop making estrogen.

 

While night sweats are a signal that you are close to actual menopause, many women complain about waking up in a sweat years before menopause happens. Or they complain that they wake up for no reason in the middle of the night and can’t go back to sleep.

 

Sleeping poorly is a big complaint for people, regardless of their age. For millions of people, bedtime is an invitation to hours of worry. Small annoyances like a truck driving by or a humidifier turning on interrupts sleep. Then come the worries of the day: Did I pay the gas bill or didn’t I?

 

If this is happening to you and you are a woman late thirties to late forties, then rule out stimulants such as the ones in cold medicines, some of the “natural” health pills, and diet sodas can keep you awake. Alcohol can send you to sleep only to wake up three hours later – for the rest of the night. A sedentary lifestyle and sleeping late can also be culprits.

 

Insomnia alone is not an indicator of Perimenopause. The stress of having subtle symptoms you’ve never experienced before can keep you up at night. Insomnia can exacerbate every other symptom of Perimenopause, so it’s important that if you’re having trouble sleeping, you talk to your doctor about it and formulate a plan for improving your sleep. The quality of your sleep is a major part of your sense of well being.

 

 Dr Steven R. Goldstein is a past president of the International Menopause Society, a Certified Menopause Practitioner and co author of the book “Could it be….Perimenopause?”. If you suspect you have Perimenopause, Dr Goldstein, a Perimenopause doctor in NYC  is available for consultation at his office in Manhattan

 

HORMONE REPLACMENT THERAPY – IS NATURAL BETTER?

 

 

Dr Steven R. Goldstein is co author of the book “The Estrogen Alternative” and a leading HRT Specialist NYC. He prescribes a form of Hormone Replacement Therapy (HRT) known as Selective Estrogen Receptor Modulators (SERMs) to help patients cope with they symptoms of menopause. They are a class of drugs that are approved by the FDA after undergone long periods of trials.

 Many patients ask about a “natural” approach to health after Menopause. Botanical remedies (over the counter remedies derived from herbs and plants) are what they usually mean by “natural”. The remedies most talked about include dong quai, black cohosh, yam root and soy. Before we discuss specific herbs, there is an important point about the difference between natural and risk free.  

 Natural isn’t risk free. Just because a supplement comes from plants and is available at a health food store doesn’t make it safe. Granted many of the over the counter botanicals are basically diluted medications that happen to come from plants, but this doesn’t guarantee their safety. Herbs and extracts can be potent. All of modern medicine gets its start from plants, however in the wrong doses they can hurt you.

 In terms of HRT, there is no reason to believe any of the botanicals are preferable to medication that is FDA regulated, tested on thousands of women, and successful with millions of patients. For the most part, all we have is anecdotal evidence – women taking the substance said it helped them. Before you decide that this is enough for you, realize that we do not, for the most part, have studies comparing women taking the substance to other women taking placebos, with the first group saying it helped them more.

 If a substance is relieving your hot flashes, you can bet your liver is seeing it as estrogen even if it is called something else. And if you think you are going to avoid the risk of any side effect by using natural remedies, the reality is, if they’re stopping your hot flashes, they’re affecting your body. They’re also going to pass through your liver on the way through your body, so purity is important. Are they pure? These natural remedies are not subject to the same intense scrutiny the FDA mandates for prescription drugs. Although they are touted as having medicinal properties, they aren’t labeled as such.

 Dr Steven R. Goldstein MD is a Menopause Specialist NYC and a Professor of Obstetrics and Gynecology at New York University School of Medicine.

Dr Goldstein is also a past President of the International Menopause Society, a Certified Menopause Practitioner and a Past President of the North American Society.