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.

 

A Paradigm for delivering Hormone Replacement Therapy

 

 Dr Steven R. Goldstein is a leading menopause specialist in NYC in private practice for over 25 years in NYC. He is a past President of the International Menopause Society, past President of the North American Menopause Society and a Certified Menopause Practitioner. He is considered one of the nation’s top gynecologists, his research having changed the way gynecology is practiced and recognized by the ACOG. In the field of hormone replacement therapy (HRT), Dr Goldstein, a hormone specialist in NYC, is the co author of The Estrogen Alternative.

 

Dr Goldstein speaks of a new paradigm for delivering hormone replacement therapy in a much safer fashion than previously thought. The product, Duavee, is estrogen with a SERM rather than an estrogen with progesterone.

What are SERMs? SERM stands for Selective Estrogen Receptor Modulator, which are pharmaceutical drugs that act like estrogen on some tissues but blocks the effect of estrogen on other tissues. They can be used to treat the symptoms of menopause / perimenopause, osteoporosis and more. For delivering hormone replacement therapy, both the estrogen in Duavee (Premarin) and SERMs, in general, have been shown to reduce breast cancer.

Thus, this new combination is a much better form of delivering the benefits of the estrogen (relief of any night sweats and hot flashes, prevention of bone loss, and promoting lean body mass, not to mention prevention of vaginal atrophy) than traditional estrogen plus progesterone. So many of Dr Goldstein’s patients who are on Duavee for hormone replacement therapy come to him and say that their friends all tell them, “you are crazy to be on HRT.” His comment to these patients is to tell their friends that, “this is not your mother’s HRT.”

Pfizer released this on June 5^th 2023 - Pfizer Inc. today announced that DUAVEE® (conjugated estrogens/bazedoxifene), an estrogen-based menopause hormone therapy, is now back in stock in the United States, with improved packaging, following a voluntary recall. The recall was due to an issue with the packaging and was not based on any efficacy or safety concerns with the product itself.

 

If you are a menopausal woman struggling with the effects of menopause and the loss of estrogen, then contact the office of Dr Steven R Goldstein MD, a hormone specialist in NYC for a consultation to see if Hormone Replacement Therapy is suitable for you.

 

Dr Steven R. Goldstein - The Benefits of Early Pregnancy Monitoring

 

 

Dr Steven R. Goldstein, an obgyn in NYC, works closely with pregnant patients or those considering a family in early pregnancy monitoring to make sure that all aspects of the pregnancy are covered and meeting established milestones.

One of the ways this is done is by analyzing the Human Chorionic Gonadotropin (HCG) levels. A developing pregnancy will produce detectable hormone of pregnancy by eight days post conception. That means it is there and present prior to being late for one’s menses. Home pregnancy tests turn positive at around the time of the expected menses (approximately fourteen days after conception). The rate of rise of hCG in normal healthy pregnancies is extremely well established.

Thus, if there is any concern for the health of a pregnancy, measuring the hCG rate of rise at 48 hour intervals will tell us a great deal about the health of the pregnancy (although, it does not tell us anything about the pregnancy’s location). Usually the hCG level doubles at 48 hours. However, there is a minimum rate of rise of approximately 35-45% in early pregnancy depending on the starting value of testing. Early pregnancy monitoring is particularly helpful for those patients who have had a previous miscarriage or those prone to recurrent miscarriages.

As a leading obgyn in NYC, Dr Goldstein uses non-invasive transvaginal ultrasounds to monitor pregnancies. Serial observation with transvaginal ultrasound allows gynecologists following such pregnancies to be sure that they maintain the milestones that are very predictable and that are the best sign of embryonic well being. If a pregnancy were to fail, Dr. Goldstein is able to make such a diagnosis prior to spontaneous passage (miscarriage) and allow for an elective D&C (dilatation and curettage) so that miscarriage in the middle of the night, and emergency D&C is unnecessary.

Dr. Goldstein has published and lectures extensively on early pregnancy, both its detection by transvaginal ultrasound and how to diagnose pregnancy failure before miscarriage, as well as, diagnosing ectopic pregnancy early enough to be treated non-surgically with medication.

Dr Steven R. Goldstein, an  obgyn in NYC, Dis a Professor of Obstetrics and Gynecology at New York University School of Medicine, a former Director of Gynecologic Ultrasound at NYU Langone Medical Center, a pioneer in the field of gynecologic ultrasound and considered one of the nation's top doctors in gynecology.