Perimenopausal Bleeding or Spotting

  Much is said about Menopause, but less about Perimenopause and the related perimenopausal bleeding or spotting.  Women have lots of questions about Perimenopause, particularly regarding the menstrual cycle, bleeding or spotting during this stage.   What is Perimenopause? Perimenopause is the transition into menopause when a woman’s body begins to slow the production of hormones. Women most often experience perimenopause signs and symptoms in their early 40s, but for some it ...

The Burden of Osteoporosis, Poor Bone Health, and Fragility Fractures – Dr Steven R. Goldstein

Bone Health is more than just Osteoporosis In my office almost all women are cognizant of breast health, have a great fear of breast cancer, and for the most part are attuned to the importance of competent periodic breast imaging… the key to earliest detection. The goal is not to have a better bone density score on a Dexa test at age 82, the goal is to not break a hip at age 82 Bone health IS more than just osteoporosis. My hope is to get these same patients to be just as concerned about ...

Update from World Congress of the International Menopause Society

To my patients, I am writing this email blast from Lisbon, Portugal where the 18th World Congress of the International Menopause Society has just concluded. As many of you know, I have been the president of this society for the last two years and this meeting was the culmination of that term. There were over 1,700 healthcare providers from 76 countries, 183 invited speakers with dozens of scientific sessions, debates, “meet the expert” sessions, and over 200 oral or poster communications. I...

Commentary on a NY Times article on Menopause

To my patients, In a recent Sunday New York Times there was an article entitled, “Why do we dread menopause” by a professor named Susan Mattern from the University of Georgia. In it she highlights that if you Google search “menopause and…” you come up with a whole assortment of very negative symptoms like weight gain, depression, hair loss, etc. She goes on to state that such a bleak view of menopause is unique to only modern cultures. She goes into great length about the ...

Menopausal changes that don’t have to be

Menopausal changes that don't have to be In last Tuesday's Science Times there was an article entitled, "Menopausal vagina monologues." It was an excellent article talking about the fact that without any estrogen in menopause the vagina becomes atrophic. It loses blood supply and elasticity. It loses its normal pH (acid/base balance) because it cannot support the normal predominant bacteria called lactobacillus that feasts on glycogen and produces lactic acid, thus lowering the pH. Studies have...

Still More News About Maintaining Bone Health

Still More News About Maintaining Bone Health In today's New York Times Science Section, there is an excellent article by Jane Brody entitled, "Fear of Drugs' Hazards may Put Bones at Risk." She reiterates a problem that I have seen evolving in clinical practice over the last several years. As the reimbursement for performing bone density tests had gotten so low that many facilities (including ours) could not stay open without losing money, the number of bone density tests being ordered nationw...

Researchers track an unlikely culprit in weight gain

In yesterday's New York Times Science section, there was an extremely interesting article entitled, "Researchers Track an Unlikely Culprit in Weight Gain." It has been known for quite some time that estrogen promotes lean body mass. At menopause, women no longer make estrogen and many patients experience the upsetting phenomenon of developing redistribution of weight to the abdomen; in medical terms known as "centripetal adiposity," or what it says in the article, turning women from "pears" to "...

Calcium and Atherosclerosis

  This is the current issue of the journal OBG Management and, as you can see, the cover story is by Dr. Goldstein. It is an update in bone health specifically addressing calcium supplements and their role in cardiovascular disease. In 2001 a National Institutes of Health (NIH) consensus panel on osteoporosis concluded that calcium intake is indeed crucial to maintain bone mass and should be maintained at 1,000-1,500 mg/day in older adults. That panel felt that the majority of old...

Dr. Goldstein receives Prestigious Clarkson Award

Dr. Goldstein is the recipient of the North American Menopause Society's 2016 Thomas B. Clarkson Award. The award is for life time achievement in menopause research and is mainly related to his work in transvaginal ultrasound and SERMs (the estrogen alternative). Click on the link below to view the Society's announcement of their awards. NAMS Prestigious Thomas B Clarkson Award ...

Improving Sexual Comfort in Menopausal Patients

03/05/2013 This past week there has been a lot of news emanating from the FDA that concerns menopausal and perimenopausal women.  I would like to share some of this with you. A week ago the FDA, without using an Advisory Panel of outside experts, approved Ophena (generic name Ospemifene) for “treatment of moderate to severe dyspareunia (medical term for painful intercourse) a symptom of vulvar and vaginal atrophy due to menopause (the vaginal changes seen with no more estrogen production)�...