COULD IT BE ENDOMETRIOSIS?

 

 

Dr Steven R. Goldstein is a NYC Gyn and specialist for Endometriosis in NYC. Endometriosis is an all-too-common gynecologic condition where the glands that lie inside the uterine cavity can come to lie outside the uterus in the pelvis. When the endometrial glands bleed (that is a period) these glands located outside the uterus bleed as well. This can cause some scar tissue. If there is a collection of this blood within the ovary, it is referred to as an endometrioma (or sometimes called a “chocolate cyst”).

Endometriosis can also take the form of small deep implants of endometrial tissue in many different places in the body, including the wall of the bladder, the anterior abdominal wall, the bowel wall and the uterosacral ligaments, as well as other pelvic sites. Rarely endometriosis can occur in sites such as the lung, potentially causing hemoptysis.

What are the symptoms of Endometriosis?

The exact cause of endometriosis is unknown and there are multiple theories. Endometriosis does not always show symptoms. There appears to be a higher incidence of endometriosis in women who are diagnosed with infertility and pelvic pain. Symptoms of Endometriosis include pelvic pain, painful periods, heavy bleeding during periods, or bleeding between periods.

 

Painless Diagnosis of Endometriosis by NYC Gyn

Increasingly, transvaginal ultrasound can make a very strong presumptive diagnosis of endometriosis without any surgical laparoscopy which, until recently, was the gold standard for making a definitive diagnosis. An endometrioma of the ovary has a classic appearance and, when present, can confirm the absolute diagnosis of endometriosis.

However, there are times where 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. Such abnormal mobility can be judged by transvaginal ultrasound but only if it is done dynamically. Unfortunately, this is not generally practiced here in the United States where a technician instead takes dozens of still two-dimensional images which are later read by the radiologist.

What is a dynamic Transvaginal Ultrasound for Endometriosis?

Dr. Goldstein, an Endometriosis Specialist NYC, as well as most European doctors, performs his own ultrasound, and movement of structures at the time of the exam can often give a strong clue to adhesions associated with endometriosis, as well as eliciting pain with the probe and the abdominal examining hand which can also be indicative of a high likelihood of endometriosis.

Dr. Goldstein, a leading NYC Gyn has helped to author a paper entitled, “An evidence-based approach to assessing surgical versus clinical diagnosis of symptomatic endometriosis.”

What can you do about Endometriosis in NYC?

If you suffer from pelvic pain and think there is a suspicion of any endometriosis, a dynamic ultrasound performed by an expert sonologist like Dr. Goldstein can be extremely helpful in making the diagnosis without surgery, and then beginning medical intervention for treatment. Schedule an appointment with Dr. Steven R. Goldstein, a top NYC Gyn for an evaluation.

 

 

 

 

LOCATIONS FOR FIBROIDS IN THE UTERUS

 

 Doctor Steven R. Goldstein is a top NYC Gynecologist for Fibroids. Uterine Fibroids are common growths found in the uterus and are also called leiomyomas or myomas. They can vary in size and there can be more than one. It is important to note that uterine fibroids are not cancerous and will not become cancerous. Secondly, the size of the uterine fibroid does not determine whether it is painful or causes bleeding. There are women with very large fibroids who experience no pain. On the other hand, very small fibroids can cause a lot of pain and bleeding if they impinge on the uterine lining.

 

Uterine Fibroids are further described by their location in the uterus. An Intramural fibroid occur within the confines of the muscular wall of the uterus (the myometrium). These are the most common types of fibroids.

 

A submucosal fibroid is one that protrudes into the endometrial cavity. It can have a “stalk” (known as pedunculated in medical terms) and slides down into the cervix as the uterus tries to expel it.

 

A subserosal fibroid is one that indents the serosal surface and gives a bumpy appearance of the outside of the uterus. It can grow outward and remain tethered to the uterus by a pedicle. This is called a pedunculated fibroid. Degenerating fibroids in the uterus most commonly appear as a donut mass with a thick wall, cystic center. This can cause severe pain and is more common during pregnancy.

 

Dr Goldstein, a NYC Gynecologist for Fibroids , uses painless Transvaginal Ultrasounds to find the reason for any pain or abnormal bleeding. Using Transvaginal Ultrasounds (water sonograms), Dr Goldstein is able to see the uterus, uterine lining, fallopian tubes, ovaries, cervix and pelvic area. He personally performs all transvaginal ultrasounds in his office in a few minutes and can show the patient on the screen or the clear, high resolution images, especially if the Doppler color flow is used.

 

Dr Steven R. Goldstein, a top Gynecologist in NYC, is a Professor of Obstetrics and Gynecology at New York School of Medicine, served as a former Director of Gynecologic Ultrasound at New York University Medical Center and is a past President of the American Institute of Ultrasound in Medicine. He is considered one of the nation’s top doctors in Gynecology, and is an internationally recognized expert in gynaecological ultrasound and imaging.

 

 

WHAT ARE ENDOMETRIAL POLYPS?

 

The inner lining of the uterus (womb) is referred to medically as the endometrium. Endometrial polyps are relatively common intra uterine lesions that are typically benign and many times there are no symptoms of it. The most common type of polyp is the proliferative polyp, representing an overgrowth of endometrial glands and stroma. Endometrial polyps can be associated with postmenopausal and abnormal uterine bleeding as well as infertility.

 

Dr Steven R. Goldstein is a top obgyn in Manhattan and specialist in non-invasive, painless Transvaginal Ultrasounds and Sonohysterograms for use in diagnosing the cause of pelvic pain, heavy periods (menorrhagia), abnormal uterine bleeding, fibroids, ovarian cysts, thick uterine lining, and more. The most common symptom of endometrial polyps is abnormal uterine bleeding, which occurs in approximately 68% of both pre and post-menopausal women.

 

Dr Goldstein, a leading obgyn in Manhattan , uses these transvaginal ultrasounds and Sonohysterograms to help diagnose endometrial polyps. The appearance of these polyps depends on whether the patient is pre-menopausal or post-menopausal. In pre-menopausal women the endometrium can be thick, which camouflages the polyps. In post-menopausal women, when the endometrium is at its thinnest, the polyps may be more obvious.

 

Due to the aforementioned difficulties in clearly seeing these polyps because of a thick endometrium or not thin enough, a Sonohysterogram is very helpful. During a saline infusion sonohysterogram (SIS), a tiny catheter, the size of a swizzle stick, goes into the cervix a couple of inches tops, and about a tablespoon of sterile saline is injected. The injection of a tablespoon of water into the uterus via catheter pushes the front and back walls of the uterus apart and enables us to see the uterine lining with microscopic precision.

Dr Goldstein personally performs all Sonohysterograms and Transvaginal ultrasounds. While painful endometrial biopsies only sample the area involved, these transvaginal ultrasounds and Sonohysterograms produce clear images of the entire area - uterus, fallopian tubes, ovaries, cervix and so on. These clear images help Dr. Goldstein properly diagnose the patient and recommend a course of treatment.

 

Dr Steven R. Goldstein MD, a gynecologist in Manhattan, is a pioneer in the field of gynecological ultrasounds. He is is highly regarded as one of the nation’s best gynecologists and a foremost authority on gynecological ultrasound and imaging. He served as Director of Gynecologic Ultrasound at New York University Medical Center and President of the American Institute of Ultrasound in Medicine among many other roles.

 

ESTROGEN AND YOUR BONES

 

 

Dr Steven R. Goldstein is a leading Menopause Specialist in NYC who has helped thousands of women find relief from and cope with the symptoms of menopause. He also serves as the Co-Directory of Bone Densitometry and Body Composition at NYU Langone Medical Center and is an Osteoporosis Specialist in NYC where he combines his knowledge of menopause and bone density to help patients.

 It is important to remember that Menopause is not a disease, it is a stage of life that a woman will enter, during which the body stops producing estrogen. There are over 300 tissues in a woman’s body that rely on estrogen (a female hormone) so cholesterol levels, the heart, the brain, bones and more areas of the body are affected by Menopause. 

 There are 206 bones in your body. They give you support; they allow you to go about your daily activities, and they protect your vital organs. Bone marrow even manufactures new blood cells. Although we may think of bone as inert and unchanging, it is living tissue, and like all living tissue, its is constantly changing, breaking down old cells, and replacing them with new cells, resorbed as well as formed. Bone mass, which is the total amount of bone in the skeleton, is maintained in a delicate balance between the breakdown (resorption) of old bone and the formulation of new bone.

 Ninety-nine percent of the calcium in your body is stored in your bones. Calcium is vital to the body and bone. Estrogen plays a role in keeping blood calcium levels normal by aiding absorption of calcium from food as well as promoting the uptake of calcium from the blood into the bone. Therefore, after menopause, a woman’s body may lose bone faster than it can be replaced due to estrogen loss.

 Dr Goldstein, a Menopause Specialist in NYC notes that fifty percent of a woman’s bone loss occurs in the first three years following menopause. Some women lose one third of the bone mass in their spine in as little as six years after menopause. This bone loss defines osteopenia and osteoporosis. Osteoporosis affects about eight million women in America.

 Dr Steven R. Goldstein, a Menopause Specialist in NYC , is a Certified Menopause Practitioner with the North American Menopause Society and a past President of the International Menopause Society as well as a past President of the North American Menopause society. In private practice for over 25 years in New York City, Dr Goldstein has successfully helped thousands of women cope with the symptoms of menopause, osteoporosis and osteopenia.