COULD IT BE DUE TO ADENOMYOSIS?

 

 

Are you one of those women who suffers from painful or heavy periods? While it is common for around 80% of women to experience painful periods at some stage in their life (according to the group “Women’s Health Concern”), for five to ten percent of women, painful periods actually disrupt their lives. Dysmenorrhoea is the medical term for painful periods.

 There are also women who suffer with prolonged, heavy bleeding from menstruation and also painful menstruation. These women will benefit from a visit to a gynecologist to see if it is due to “Adenomyosis” a painful, yet benign condition due to the inner lining of the uterus protruding through the muscle wall of the uterus. The condition is sometimes misdiagnosed as a uterine fibroid. Dr Steven R. Goldstein MD is a gynecologist in NYC who sees patients who are suffering from abnormal uterine bleeding, and painful, heavy periods.

 This displaced tissue (the inner lining of the uterus) continues to act normally during each menstrual cycle by thickening, then breaking down and bleeding. This can cause an enlarged uterus and painful, heavy periods.

 Diagnosing the cause of painful, heavy periods doesn’t require a painful examination by some surgical procedure like a biopsy. Dr Goldstein, believes in using non-invasive methods such as Transvaginal Ultrasounds to diagnose the cause of heavy periods and painful menstruation. Using transvaginal ultrasounds, Dr Goldstein is able to see clear, high-resolution images of the uterus, the lining of the uterus, and the wall of the uterus to properly diagnose the cause of the heavy periods. He is able to see if any heavy bleeding is due to Adenomyosis, see if there is displaced tissue, an enlarged uterus and so on.

 Another tool for painless diagnosis of painful, heavy periods is Sonohysterography. This is the process whereby a saline solution is instilled into the uterus while an endovaginal ultrasound is performed. This also produces very clear, high-resolution images of the uterus which leads to an accurate diagnosis for the heavy periods. Both Sonohysterography and Transvaginal Ultrasounds are painless, non-invasive procedures.

Dr Goldstein personally performs all Sonohysterograms and Transvaginal Ultrasounds right in the comfort of his medical office. These procedures take a matter of minutes, or at the very least less than an hour.

 Doctor Steven R. Goldstein MD is a top NYC Gyn with over 25 years of experience in private practice. He is a professor of Obstetrics and Gynecology at New York University School of Medicine, and a former Director for Gynecologic Ultrasound, Department of Obstetrics and Gynecology at New York University Medical Center.  He is considered one of nation’s most highly recognized and regarded individuals in the field of gynecologic ultrasound.

 Women experiencing very heavy periods (heavy bleeding known also as menorrhagia) and painful menstruation every month or frequently may be best served by having a gynecologic examination with a leading gynecologist in NYC like Dr Steven. R. Goldstein. With the advancements in gynecologic ultrasound, much of it due to Dr Goldstein’s clinical research, women no longer have to endure painful mehods of diagnosis for painful or heavy periods.  

 

The Importance of Early Pregnancy Monitoring

 

 

Dr. Steven R. Goldstein MD is a top Obstetrician and Gynecologist in Manhattan. In practice for over 25 years, Dr Goldstein works closely with pregnant patients or those considering a family to make sure all aspects of the pregnancy are covered. As an early pregnancy monitoring doctor in New York, Dr. Goldstein ensures that the pregnancy meets 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). Ectopic pregnancy can occasionally result in a relatively normal early development, which may follow normal doubling times of hCG.

Ectopic pregnancy is when the developing embryo is located outside of the normal uterine cavity. 98% of these are in the fallopian tube. If they develop and rupture, they can cause hemorrhage requiring emergency surgery and transfusion

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. Dr. Goldstein has published and lectures extensively on early pregnancy, both its detection by 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 MD, is a top obgyn in Manhattan, who does early pregnancy monitoring to ensure that there is a healthy pregnancy and to prevent miscarriage. Miscarriage is the spontaneous passage of the pregnancy tissue after the pregnancy loses its viability. Early pregnancy monitoring detects that the pregnancy has lost its viability, so that a Dilation and Curettage procedure can be performed instead of the patient winding up in the emergency room with a painful miscarriage.

 

Dr Goldstein has not had a patient miscarry in more than 30 years of private practice. Although he has patients who experienced pregnancy failure. He was able to detect it and schedule a Dilation and Curettage (D&C) procedure to avoid a painful miscarriage.

 If you are a pregnant woman or planning a family, then a consultation with Dr Goldstein, an obgyn in Manhattan for pregnancy monitoring may be in order.

 

ESTROGEN, PROGESTERONE AND YOUR MENSTRUAL CYCLE

 

 

Dr Steven R. Goldstein MD, a hormone specialist in NYC, is the co-author of the books “The Estrogen Alternative” and “Could it be….Perimenopause?”. A past President of the International Menopause Society and a Certified Menopause Practitioner, Dr Goldstein has worked alongside thousands of his patients in over 2 decades of private practice using hormone replacement therapy (HRT) to help them cope with the symptoms of menopause and hormone imbalances that may result in gynecological conditions such as bleeding.

 

Let’s take a closer look at the hormones estrogen and progesterone. Estrogen is made from follicles that develop each month in the ovaries. A follicle is a saclike structure inside the ovary that contains an egg. At the end of a cycle, if pregnancy does not ensue, the menstrual lining of the uterus is shed. The first day of the period begins day one of a new cycle. At that point, both ovaries recruit about a half dozen follicles under the influence of the follicle stimulating hormone (FSH) from the pituitary gland in the brain. Around day nine, one follicle takes off geometrically and becomes the dominant follicle. It is a small 2.5 cm cystic structure prior to it bursting. This is ovulation.

At midcycle, (day fourteen), a surge of luteinizing hormone (LH) from the pituitary causes the follicle to rupture, releasing the ovum to be picked up by the fallopian tube.

 

The follicle is now known as the Corpus Luteum (CL), and it begins to produce large amounts of Progesterone.

 

Progesterone causes the glands of endometrium (lining of the uterus), to become lush in preparation for receiving the fertilized egg. If no pregnancy ensues, estrogen and progesterone levels decrease and the woman gets her period fourteen days after ovulation. Recall that the beginning of bleeding day one of the new cycle. Thus, in an idealized twenty eight day cycle, a woman ovulates on day fourteen and fourteen days later she gets a menses.

 

Dr Goldstein, one of the top hormone doctors in NYC, says that it is important to remember that a menses (or a period) is a bleed that is preceded by ovulation. Not all bleeding is a menses. Without progesterone to trigger menstruation, the endometrium can keep building up and eventually be shed, giving the woman the impression she has had her period.

 

These hormonal imbalances can lead to irregular bleeding, where there is estrogen but no progesterone. Irregular bleeding and a host of other symptoms can follow. Unopposed estrogen (estrogen without progesterone) for long periods of time can lead to pre cancer.

 

Dr Steven R. Goldstein MD is a leading hormone specialist in NYC who uses HRT such as Selective Estrogen Receptor Modulators to help women cope with symptoms of menopause. Women who are experiencing excessive bleeding should also see Dr Goldstein as it may be due to a hormonal imbalance that gives rise to a thick uterine lining. If you are experiencing those symptoms or irregular periods then a consultation with Dr Steven R. Goldstein may be appropriate.