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Dr. Steven R. Goldstein MD, a widely renowned menopause specialist in NYC, a Certified Menopause Practitioner and a Past President of the International Menopause Society. He works closely with women to educate them on the changes happening in their bodies during menopause and perimenopause, identify possible health risks and customize hormone replacement therapies to manage their perimenopause and menopause-related symptoms.
As a menopause doctor in NYC for over 25 years, here are some of the most frequently asked questions from women who are entering or in the Menopause stage of life.
Menopause is defined as the end of menstruation. It is confirmed medically after a women has no period for 12 consecutive months due to a depletion of ovarian follicles (eggs). To confirm that this lack of menstruation is the result of the onset of menopause, doctors recommend a test to measure FSH (follicle stimulating hormone). If this simple blood test reveals high levels of FSH then the transition period into menopause has begun. There is also a surgically induced menopause due to a complete hysterectomy where a woman’s ovaries are removed.
Typically, women will begin the transition to menopause between the average age of 45 and 55.
In menopause, by definition, the ovaries are no longer functioning and, therefore, not making any estrogen or progesterone. Thus, there is no stimulation of the endometrial lining and there should be absolutely no further bleeding. Any menopause bleeding, even staining, regardless of how slight or short in duration must be evaluated to make sure it is not uterine cancer!
Common symptoms and health issues related to menopause include:
Dr Goldstein, a Menopause Specialist in NYC, has seen some menopausal women experience depression. Estrogen creates a sense of well-being in women by boosting serotonin levels, thus women who already have low levels of serotonin will have even lower levels during menopause due to the absence of estrogen.
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 it is known as “centripetal adiposity”. It has been known for quite some time that estrogen promotes lean body mass, therefore the lack of it during Menopause will certainly contribute to weight gain.
Typically, during menopause, there is a shift in hormonal balance, particularly a decrease in estrogen levels. Estrogen has been shown to have a protective effect on cholesterol levels, helping to maintain higher levels of HDL (high-density lipoprotein) cholesterol, often referred to as “good” cholesterol, and lower levels of LDL (low-density lipoprotein) cholesterol, known as “bad” cholesterol.
Estrogen has also been shown to have vasodilatory effects, meaning it relaxes the blood vessels, which can help maintain healthy blood pressure and improve blood flow. This effect contributes to overall cardiovascular health.
When estrogen levels decline during menopause, this protective effect diminishes, leading to potential changes in cholesterol levels. Specifically, LDL cholesterol levels may increase, which can contribute to a higher risk of heart disease and other cardiovascular issues.
HRT is not a one size fits all solution. It depends on the symptoms you are experiencing, your gynecological health, an examination and more before discussing possible HRT treatment options with you. HRT is not for everyone, as there are some medical conditions that may preclude you from HRT
Women experiencing menopause often have a higher risk of bone loss and osteoporosis. Estrogen helps control bone loss, and decreasing estrogen levels during menopause impacts the body’s ability to replace bone. There are approximately 1 million osteoporotic fractures among women in the U.S. each year. Reducing the risk of osteoporotic fractures in women at high risk is essential. Dr. Goldstein provides insight on patients’ risk of developing osteoporosis and will recommend if a bone density scan or a bone loss management plan is necessary.
It is unfortunate that so many women are unaware that intercourse during the menopausal stage of their lives does not have to be painful. In this video, Dr. Goldstein discusses painful intercourse during menopause and the options available to avoid it.
Menopause is a natural occurring process as women grow older. Many women don’t seek treatment for it unless their symptoms are so severe that their day-to-day life is impacted. However, menopause management is more than just about the symptoms.
There are women who are making no estrogen, eating healthily, and doing all the right things to stay healthy, and they feel great. However well they are doing, estrogen replacement will improve their cholesterol, and be good for their heart and bones. It is not just about surviving the symptoms of menopause but improving or maintaining your overall health as you age.
Proper care and attention to the Menopause is essential because the lack of female hormones causes more than hot flashes, mood swings, night sweats and so on. There are over 300 tissues in a woman’s body that rely on estrogen (a female hormone) so cholesterol levels, the heart, the brain, the muscles, bones and more areas of the body are affected by Menopause.
Hot flashes and night sweats may eventually subside over time, but the lack of estrogen in a woman during menopause can produce symptoms like vaginal dryness and atrophy that can ruin a relationship and prevent a woman from having a normal, healthy sex life.
If your menopause symptoms are upsetting or uncomfortable, you don’t have to suffer through them. There are treatments that can help.
Menopausal women often have many questions, ranging from the signs and symptoms, treatment options and emotional support. Dr. Goldstein focuses on each individual woman, taking into account family history, medical history, symptoms, health concerns and issues before recommending the best course of treatment for his patient.
An examination of each patient is a must. Dr Goldstein’s examination includes state of the art Transvaginal Ultrasound to examine the endometrium (lining of the uterus or womb). The lining of the uterus is a biomarker for what is going on with the ovaries and must be evaluated as part of any discussion on menopause. Unfortunately, many physicians do not do this and instead they immediately resort to hormone therapies.
Treatments for Menopause have to be tailored to the individual. Which is why Dr Goldstein personally sits with each patient to discuss her case, examine her, and come up with a mutually agreed upon treatment plan to help alleviate her symptoms of menopause and general health during menopause.
Dr Goldstein uses prescription hormone replacement therapy to help women cope with the symptoms of menopause and improve their overall health during the menopause stage of life. The symptoms of menopause are not addressed simply by flooding the body with more estrogen. The right kind of Hormone Replacement Therapy (HRT) is one that addresses the symptoms a woman is having. HRT is not a one size fits all approach, and sadly this is exactly what many doctors do. Dr Goldstein personally evaluates each patient before customizing a HRT plan.
The first step to relieving the symptoms of menopause is to switch to a healthy lifestyle. This may help reduce symptoms and also lower your risk of heart disease and other long-term problems related to aging.
Schedule a consultation with Dr Goldstein, a Certified Menopause Practitioner in NYC, for relief from the symptoms of menopause like hot flashes, night sweats, mood swings, anxiety, vaginal dryness, weight gain etc. Moreover protect the over 300 tissues in your body that rely on Estrogen.
See Dr Goldstein’s interview with Dr Marla Shapiro on Tissue Specific Estrogen Complexes (TSECs) for use in menopausal women.
Dr. Steven R. Goldstein MD has that rare blend of experience, exceptional patient care and credentials. He has helped thousands of women through the menopausal stage of their life.
You may schedule an appointment with Dr. Goldstein for an evaluation of any menopause symptoms, menopause bleeding, osteoporosis or bone loss by clicking on the appointment request button below or calling the office at 212-717-5554
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