Should you be worried about an abnormal pap smear?

 

 

Abnormal pap smears are no need for alarm, as all they indicate is that there has been a change in the cervical cells can be due to infection, inflammation, or changes in the menstrual cycle. In some cases, pre-cancerous or cancerous cells are present.

 

Dr Steven R. Goldstein MD is a top Gynecologist in NYC who strongly recommends women have a Pap Smear exam done annually to help detect the presence of any cervical cancer cells. Cervical cancer has been on the decline over the last decade thanks to pap smears. Dr Goldstein, performs pap smear exams in his office and evaluates patients with abnormal pap smear results.

 

We now understand that abnormal cervical cells are related to the HPV virus. There are over 100 strains of HPV. Virtually all sexually active women will be exposed to HPV but most clear the virus on their own.  Pap smear recommendations should be closely aligned with sexual history and number of partners not just age.

 

In these cases Dr Goldstein, an Obgyn in NYC, will carefully review your case and determine if further tests are needed or if necessary, advise of the best available non-invasive treatment options available to you. There are several additional tests which can be performed in the case of abnormal pap smear results.

 

A Colposcopy is a procedure where a colposcope is used to see the vaginal and cervical cells in detail.

-         An Endocervical curettage is a procedure where a small spoon-shaped tool (curette) collects a sample of cells from the endocervical canal.

-         A Biopsy is where a small sample of cervical tissue is removed and sent to a lab to be studied under a microscope.

If additional testing determines treatment of the abnormal cells is needed, Dr. Goldstein may recommend one of the following options:

-         A Cyotherapy destroys abnormal tissue through freezing.

-         Laser therapy destroys or removes abnormal cells with the use of a narrow beam of intense light.

-         Conization is where a cone-shaped piece of tissue is removed with a knife, laser or LEEP technique.

 

Dr Goldstein, one of the best Gynecologist in NYC personally performs all these exams. If you are in need of a pap smear or have had a pap smear with abnormal results, then contact Dr Steven R. Goldstein MD.  Dr Goldstein is a Professor of Obstetrics and Gynecology at New York University School of Medicine, Director of Gynecologic Ultrasound at NYU Langone Medical Center and the author of over seven books on Gynecology. He is regarded as one of the best Gynecologists in the US.

 

Does having a thick uterine lining require surgical intervention?

 

 Many patients have been told that they have a thick uterine lining and possibly in need of invasive surgical procedures. Dr Steven R. Goldstein MD, an obgyn in Manhattan, was the first to suggest in 1991 that a thin, distinct endometrial echo on transvaginal ultrasound in postmenopausal bleeding did not indicate the need for a biopsy. This was finally adopted as the standard of care by the American Congress of Obstetricians and Gynecologists (ACOG) in 2009.

 

Unfortunately, many doctors, both radiologists and gynecologists, have misinterpreted all of the early data to believe that a thick lining without bleeding requires some sort of intervention. The data has shown that as many as 1 in 8 postmenopausal women will have thick uterine lining without any bleeding.

 

Such women do not require any type of biopsy or other intervention unless they have any bleeding or brown discharge. If you have had a vaginal sonogram and been told that your lining is thick but have had no bleeding do not allow any invasive intervention.

 

Dr. Goldstein, a gynecologist in Manhattan, has championed this concept, although unfortunately, it is not widely understood by many practitioners.

 

Dr. Steven R. Goldstein MD is long considered one of the nation’s top doctors in gynecology. Dr Goldstein is a Professor of Obstetrics and Gynecology at New York University School of Medicine, a Past Chairman of the American College of Obstetrics and Gynecology, New York Section, and Honorary Fellow, Royal College of Obstetrics and Gynecology and a Certified Menopause Practitioner. Dr Goldstein is the recipient of the Thomas A. Clarkson award for many outstanding contributions to menopause related clinical or basic science research.

 

If you have been told you have a thick uterine lining then contact Dr Steven R. Goldstein, a top obgyn in Manhattan for a consultation. You may visit his website at for more information on him and to schedule an appointment.

Are you a good female candidate for Hormone Replacement Therapy (HRT)?

 

Dr Steven R. Goldstein is a top Hormone Specialist in NYC, a Certified Menopause Practitioner, North American Medical Society, a past President of the International Menopause Society and a Past President of the North American Menopause Society. He is an expert on female hormone replacement therapy and co-author of the book “The Estrogen Alternative”.

 

Dr Goldstein is also a Professor of Obstetrics and Gynecology at New York University School of Medicine, Director of Gynecologic Ultrasound at NYU Langone Medical Center and the author of over seven books on Gynecology. He is regarded as one of the best Gynecologists in the US and is a leading gynecologist in NYC

 

Menopause is not a disease, and even though one can make an attempt to treat symptoms like hot flashes and dry vagina without medication, you are still losing the protective benefits of estrogen. At menopause, your body stops producing estrogen and you lose all the benefits of it.

 

Given the pros and cons, it’s important for every woman to consider her options and make her own choices. You need to consider your family history and your overall health. Women with suspected cancer of the breast, or liver dysfunction or disease should not take female hormone replacement therapy.

 

If your doctor says you are a candidate for female hormone replacement therapy (HRT), you need to weigh the risks and benefits. As a woman, you are ten times more likely to die from heart disease than from breast cancer. Ask yourself, “does the protection against a fatal heart attack outweigh a possibly greater risk of breast cancer?” Is it going to be a better thirty years down the road to have bypassed female hormone replacement therapy when you fracture your hip?

 

When Dr Goldstein prescribes female hormone replacement therapy, it’s after a long discussion in which he explains everything and helps the patient weigh her risks and benefits. HRT must be tailored to meet the needs and symptoms of each woman with her family history in mind as well.

 

Dr Goldstein believes it is important that a woman leaves his office not just with a prescription, but with the answers to her questions and a treatment designed specifically for her.

If you are already experiencing the symptoms of menopause such as hot flashes, foggy memory, vaginal dryness and so on and are interested in learning how female hormone replacement therapy can help you then arrange for a consultation with Dr Goldstein, a leading Hormone Specialist in NYC by contacting his office in New York City  

 

Do HPV vaccines give complete immunity to HPV?

 

 

Dr Steven R. Goldstein MD is a well-recognized Obgyn in Manhattan  who has worked with women for over three decades to improve their gynecological health. He is considered one of the nation’s top doctors in gynecology.

 

Some patients ask about the HPV vaccine. The problem with the HPV vaccine in Dr Goldstein’s opinion, is that when it first came out it only addressed 4 strains of HPV out of a hundred. These were the more serious types 16 and 18, and types 6 and 11 which caused warts, but not pre cancers. The numbers of patients who had this original vaccine still developed cervical pre cancers rather large.

 

Dr Goldstein felt that this vaccine sent the wrong message. For example, if one gets a polio shot, they are immune. If they get a Rubella vaccine, they are immune. However, the original HPV vaccine only addressed four strains and a woman could still develop pre cancers. The newer vaccine has nine strains, so now it makes more sense, but it still gives a false impression to patients, particularly younger ones, that they are protected.

 

This is why Dr Goldstein, a top Obgyn in Manhattan still champions the pap smear as a key procedure which can detect any strain of HPV which may lead to cervical cancer. Early measures can then be taken to ensure the patient does not get cervical cancer.

 

Half of the patients with cervical cancer are those who never had a pap smear, and another ten percent are those who have had an abnormal pap smear and do not follow up on it. So, the goal is not to prevent HPV, but to prevent cervical cancer, which is the real disease.

 

In all his decades of practice, Dr Goldstein has had only one patient present with cervical cancer, and she came to his practice with it. He has had many cases who developed pre cancer of the cervix, who were able to be treated quite effectively before it became cervical cancer.

 

If you are seeking a Gynecologist in Manhattan, then please contact the office of Dr Steven R. Goldstein, for an appointment. At Dr Goldstein’s office, individualized patient care is the norm and you will never feel rushed.

 

Birth Control Pills - Closer to Natural Than You Think

 

 Dr. Steven R. Goldstein MD, a leading NYC Gyn, at times suggests birth control pills for numerous non-contraceptive benefits in terms of bleeding control, less anemia, and so on. The response is often “they are not natural”.

 

So, what did nature expect for us? As higher order primates, women would have approximately eight children (along the way, statistically, three miscarriages). So if one does the math, women have approximately forty years of menstrual function (roughly age 11-51). There are 13 lunar months in a calendar year. Thus, most women can be expected to have approximately 520 menstrual cycles.

 

There is no bottle or formula in nature and, thus, breast feeding for at least fifteen months would be mandatory. Thus, modern women who have two children, for instance, and nurse them perhaps 3-6 months, end up with nearly 500 menstrual cycles. Left to nature, women would have perhaps 250.

 

One of the reasons, that ovarian, uterine and breast cancers are on the rise in modern industrialized nations is women are cycling too much. Suppressing the cycle with birth control pills is closer to “natural” than what we have socialized into. Dr Goldstein, a leading NYC Gyn, is not suggesting that his patients have eight children and nurse them all for fifteen months, but he is suggesting that we evaluate what is truly “natural” and what is not.

 

In studies, the use of birth control pills has been shown to reduce ovarian and uterine cancers in addition to controlling bleeding, less anemia and other benefits and are closer to being natural as proven above. Women who are prone to ovarian or uterine cancers based on their family history or are experiencing bleeding conditions should schedule a consultation with Dr Steven R Goldstein MD, a top NYC Gyn  to evaluate their condition further.