As a woman approaches midlife, her body begins to undergo a series of natural and sometimes disruptive changes. These transitions, particularly perimenopause and menopause, can significantly impact a woman's physical, emotional, and mental well-being. While menopause is frequently discussed, perimenopause—the transitional period leading up to it—often receives far less attention. Dr. Steven R. Goldstein, MD, is a Certified Menopause Practitioner and a Menopause Specialist in NYC.
With decades of experience treating thousands of women through every stage of this transition, Dr Goldstein would like to help you better understand what’s happening in your body and what your options are for feeling like yourself again.
What Is Perimenopause?
Perimenopause is the stage leading up to menopause, marked by a gradual decline in the hormones estrogen and progesterone. Most women begin to notice perimenopausal symptoms in their early 40s, though for some, these changes may begin as early as their 30s. This transition period can last anywhere from 4 to 7 years, though the timeline varies widely among individuals.
Symptoms of perimenopause can be diverse and, at times, disruptive. They often include irregular periods, occasional hot flashes, difficulty sleeping, mood swings, vaginal dryness, reduced concentration, and even episodes of free-floating anxiety. These symptoms are caused by fluctuating and destabilizing hormone levels, as ovulation becomes less regular.
It’s important to understand that if you're experiencing any of these symptoms, you are not alone—and more importantly, you’re not imagining things. These changes are real and physiologically based. As a specialist in perimenopause and menopause care, Dr Goldstein works with women every day to evaluate these symptoms and develop individualized plans to help manage them effectively.
Menopause: A Natural Life Stage
Menopause itself is officially diagnosed when a woman has gone twelve consecutive months without a menstrual period. While some women transition through menopause with few complications, others may experience significant symptoms that interfere with daily life. These may include hot flashes, night sweats, mood changes, low libido, vaginal atrophy, and changes in weight.
Beyond these more noticeable symptoms, menopause can also have serious implications for long-term health. Estrogen plays a critical role in maintaining bone density and cardiovascular health. As estrogen levels drop, the risk for osteoporosis and heart disease increases.
It’s crucial to recognize that menopause is not a disease—it is a natural biological process. However, that does not mean women need to suffer through it without support or treatment. Each woman’s experience is unique, and there is no “one-size-fits-all” approach to managing symptoms. Which is why Dr Goldstein, a Menopause Specialist in NYC, practices individualized patient care where he personally sits with each patient to understand their medical history, symptoms and more in order to come up with an individualized treatment plan for their Menopause.
How Hormone Replacement Therapy (HRT) Can Help
One of the most effective ways to manage moderate to severe symptoms of menopause is hormone replacement therapy (HRT). HRT involves replenishing the estrogen—and in some cases, progesterone—that your body is no longer producing at the same levels.
As a HRT Specialist NYC, Dr Goldstein assesses each patient's unique medical history, symptoms, and lifestyle before recommending any treatment. This careful, individualized approach ensures that any therapy is tailored to the patient's specific needs and health goals. While HRT is highly effective for many women, it is not suitable for everyone, and part of his job is helping you weigh the benefits and risks in the context of your overall health.
Post-Menopause: Monitoring for Important Signs
The post-menopausal phase begins after a woman has fully transitioned through menopause. At this stage, many of the earlier symptoms may ease or resolve. However, there are still important health considerations.
One of the most concerning symptoms that can occur post-menopause is any form of vaginal bleeding. Even light spotting, short in duration or infrequent, must be taken seriously. In medical training, we emphasize a rule of thumb: “Postmenopausal bleeding is uterine cancer until proven otherwise.” While the cause may often be benign, it is essential to conduct a thorough evaluation to rule out serious conditions, including endometrial cancer.
If you are postmenopausal and experience any bleeding, do not ignore it. Prompt assessment is key to ensuring your continued health and peace of mind.
Personalized Care from a Menopause Expert
In his practice, Dr Goldstein, an HRT Specialist in NYC, treats women at every stage of this journey—whether you're beginning to notice early signs of perimenopause, going through the height of menopausal symptoms, or are well into post-menopause. The goal is always the same: to provide compassionate, evidence-based care that helps you understand your body and make informed decisions about your health.
As a Certified Menopause Practitioner and a Past President of the International Menopause Society, Dr Goldstein brings both experience and a global perspective to his practice. He also co-authored The Estrogen Alternative, a book focused on empowering women to navigate hormone therapy options safely and effectively and textbooks on Menopause and Perimenopausal gynecology.
If you're experiencing symptoms of perimenopause, menopause, or post-menopause—or simply want a trusted medical professional to talk to about your concerns, schedule a consultation. Together, we can create a plan to support your health and well-being through this important stage of life.
