Dr Steven R. Goldstein is a Menopause Specialist in NYC. He is a Certified Menopause Practitioner, a past President of the International Menopause Society, and the author of several books on Menopause.
Thirteen years ago, when I was president of NAMS (what was the North American Menopause Society, recently renamed The Menopause Society), if I were at a cocktail party speaking to a few women who found out I was a gynecologist, and I mentioned that I was president of the Menopause Society… It cleared the room. Menopause was in the closet and women did not want to think about it or talk about it.
This could not be more different today. Think about the fact that when the Women’s Health Initiative broke in July, 2002, with tremendous negative publicity about hormone replacement therapy, the average woman who is becoming menopausal today was not yet 30 years old. The interest in menopause and perimenopause today is extremely rewarding to someone like myself who has spent an entire career taking care of, doing research in, and teaching about, midlife women’s health; first in developing the use of vaginal sonograms, and more recently as a key opinion leader in the perimenopause and menopause space, with a particular interest in abnormal uterine bleeding, bone health, and hormones.
What does a male gynecologist know?
There is a tremendous advantage in my opinion to being a male gynecologist. This may seem counterintuitive to most women who would like to believe that a female practitioner would be more understanding, and empathetic of what they might be going through. However, it can be extremely inappropriate, even dangerous if a healthcare provider interjects their own experience and places some of that experience onto the patient sitting opposite them in a consultation room.
I will never have a menstrual cramp, I will never have a labor pain, I will never have a hot flash. I have seen the entire range and spectrum of these by listening and observing intelligent, articulate patients for more than 3 decades. I have no personal experience of my own to even subconsciously put onto a patient. Perimenopausal and menopausal medicine need to be practiced one patient at a time. The lack of qualified experts in this field have caused so many women to turn to online resources and physician influencers. Often these people offer advice that seems to be universal.
Recently, one such OBGYN with over 2 million followers, who, by the way, employs 20 people to keep her social media running, strongly advised women to take natural progesterone because “it is great for sleep.” Yes, this is true for many, many women. However, there are also many women who, upon taking natural progesterone before bed, feel zombie like the entire next day, and do not tolerate it. In addition, there are many women who are progesterone intolerant in general and have mood swings, breast, tenderness, water retention, bloating, and even headaches as a result of even small amounts of progesterone.
The important take-home message is “it is not one size fits all”!! Responsible expert care requires individual assessment of a patient’s history, her family history, her medications, her level of physical activity, and there is a synthesis which also involves shared decision-making to come up with a plan that is individualized for that particular person. A number of sites have sprung up where you can have a telehealth visit with a nurse practitioner who can prescribe hormones over the internet. It is a very sad state of affairs that many people in our country have been unable to find a healthcare provider knowledgeable enough or caring enough to take the time to allow for an individualized care plan. My patients realize that I operate my healthcare for them one person at a time on an individual basis.
If any of this information is helpful, perhaps to friends, family or others please feel free to share it.
Dr Steven R. Goldstein is a Menopause Specialist in NYC, and a Perimenopause Specialist in NYC
This post was last modified on March 7, 2025 1:10 pm