SURGERY FOR FIBROIDS?

 

 

Dr Steven R. Goldstein, an Obgyn in Manhattan, regularly sees patients who come in with fibroids and are very concerned that they are cancerous.

One can hear the word tumor and feel terrified. But a fibroid tumor isn’t cancer. It’s a mass of muscle and connective tissue in the uterus. Fibroids arise in the wall of the uterus. If a fibroid stays within the wall, it’s called intramural. If it grows into the endometrial cavity, it’s called submucosal.

 Fibroids range in size from as small as a pea to the size of an orange and occasionally even to the size of a basketball. But even patients with relatively large benign fibroids do not necessarily need to be operated on.

 Today, transvaginal ultrasound imaging makes it possible to look closely at the ovaries despite the presence of fibroids. In the past, without transvaginal ultrasounds, physicians recommended that large fibroids be removed so they could evaluate the ovaries. Thanks to advances in ultrasound, this is no longer the case, and there is no absolute size at which fibroids must be removed. Dr Goldstein, a Gynecologist in Manhattan, received the Ian Donald Gold Award from the International Society of Ultrasound in Obstetrics in Gynecology for changing the way ultrasound is practiced through research and innovation.

 Women with fibroids often talk about pressure symptoms. Fibroids sometimes lean on the bladder. Still, fibroids are slow growing, and the adjacent organs accommodate very nicely in the overwhelming majority of cases. In addition, if you operate for “symptoms” from fibroids, these symptoms are not relieved. As women get older, they tend to feel the need to urinate more frequently. This is often unrelated to fibroids.

 If your fibroids are not large, not causing extreme bleeding, and not growing rapidly, it may be fine to watch and wait. If you bleed heavily, you will want to include plenty of iron in your diet to ward off the possibility of iron deficiency anaemia.

 The decision to opt for surgery is ultimately yours. After menopause, when estrogen levels are lower, fibroids shrink naturally. However, if you are having painful cramps or heavy menstrual bleeding, you may want to consider surgery. Consider it only if you have been thoroughly evaluated with transvaginal ultrasound and possibly saline infusion Sonohysterography.

 Myomectomy – surgical removal of the fibroid while leaving the uterus in place, is one possibility for women who still want to have children. However, this type of surgery is every bit as complicated from a surgical point of view as a hysterectomy.

 Make sure you check with your gynecologist and evaluate all your options first before deciding on surgery. The above is presented for informational purposes only.

 Dr Goldstein is a Professor of Obstetrics and Gynecology at New York School of Medicine, and a former Director of Gynecologic Ultrasound at New York University Medical Center. If you are suffering from fibroids and  are in the NY area, then a consultation with Dr Steven R. Goldstein, a leading

Obgyn in Manhattan, may be in order.

 

PERIMENOPAUSE AND THE PERIOD THAT DISAPPEARS FOR MONTHS

 

 

 

Have you noticed that you are waking up perspiring heavily during the night? Are you enduring profuse sweating, weakness, or faintness during the day? These are signs of estrogen depletion. However, a woman’s period can be quite erratic when she is still making estrogen, and not nearly as close to menopause as she thinks.

 

Dr Steven R. Goldstein, a Perimenopause Specialist in NYC says that nine times out of ten, if you are between the ages of thirty five and fifty, the answer to your missing period is PERIMENOPAUSE. Perimenopause is when a woman’s body begins to slow the production of hormones and is the transitional phase into Menopause. Symptoms are irregular periods, free floating anxiety, mood swings, inability to concentrate, memory lapses, sleep disturbances and a period that disappears for one or more months.

 

A missing period for several months could be signalling menopause. An FSH test and a test for estrogen will give you the answer whether it is perimenopause.

 

However, this is not the only cause of missing periods. Disorders of the pituitary gland are a common reason for a periods that disappears for months for women who are not in menopause. An underactive or overactive thyroid gland, known respectively as hypothyroidism and hyperthyroidism can be the culprit. A simple blood test can tell if you are suffering from either of these.

 

Also, excess prolactin, a pituitary hormone that stimulates breast milk production, can cause lack of periods. This is often associated with discharge from the nipple. Dilatation and Curettage (D&C) that hasn’t healed properly and left scar tissue can also cause a loss of your period. A pelvic exam can rule out ovarian cysts or other growths that can cause you to skip your period.

 

There are other, less frequent reasons women can stop having their menstrual cycles. Very heavy drinkers can develop cirrhosis of liver, and their menstrual cycles will stop. Generally, this will not be the first sign of such a disorder. You will have experienced jaundice, gastrointestinal problems, a distended stomach from fluid retention, and an all-over ill feeling.

 

Dr Steven R. Goldstein is a Perimenopause Specialist in NYC who has worked with numerous women to help them cope with the symptoms of Perimenopause for his over 30 years in private practice. Perimenopause is a transitionary phase to menopause which can begin as early as the late thirties and as late as up to the late forties.

 

A past president of the International Menopause Society, a Certified Menopause Practitioner and co author of the book “Could it be….Perimenopause?”, Dr Goldstein is available for consultation at his office in Manhattan.

 

ESTROGEN DEFICIENCY AND SLEEP

 

 

Doctor Steven R. Goldstein MD is a Certified Menopause Practitioner and a Menopause Specialist in NYC in private practice. He has helped thousands of women cope with menopausal symptoms over his 25 plus years in private practice.

When women reach menopause, they often don’t sleep as well as they once did because of the estrogen deficiency. Two very common problems are having trouble falling asleep and waking up in the middle of the night and being unable to fall back to sleep sometimes for an hour or two.

It's true that women who take estrogen often report that they sleep better. Here are three things women can do to improve their chances of getting a good night’s rest. There will be a second part to this article with more points.

1. Wake up at the same time every day. If that doesn’t help, wake up half an hour earlier. This is easier said than done. You’ve tossed and turned, perhaps because of night sweats or tension and ended up watching the 4 am movie. Just as the alarm goes off, you finally feel sleepy. Forget thinking that you need those eight hours of sleep and deciding to crawl back into bed. You will do more damage to your body clock and eventual body well being by over sleeping. For many women, the key to not being able to fall asleep is getting up even earlier. Force yourself to keep a regular schedule, and you’ll reap the benefits of deeper sleep.

2. Beware of hidden caffeine. Chocolate is one source of caffeine that can keep you awake. Excedrin before bedtime keeps some women up for hours. And read the ingredients of cold medicines. The over the counter lose-weight-quick pills of too many names and varieties to list are also full of caffeine.

3. Make your largest meal lunch. Why add major digestion to your night time list of things your body needs to do to finally settle down and relax enough to sleep. The full stomach that makes you nod off in front of the TV at seven at night has a habit of waking you up just when you gather yourself up off the couch and head for bed.

If you are menopausal and need help coping with its symptoms, an appointment with Dr Steven R. Goldstein MD, a doctor for Menopause in NYC. He is a past President of the North American Menopause Society and a past President of the International Menopause Society. He has also coauthored several books on hormone replacement therapy such as “The Estrogen Alternative”.

Dr Goldstein also specializes in hormone replacement therapy (HRT) to help women with the symptoms of menopause. His practice offers individualized patient care and Dr Goldstein will personally see you from the beginning to the end of your visit.