Dr. Steven R. Goldstein MD Female Hormone Replacement Therapy Gynecologist
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Dr Steven R. Goldstein MD has over 25 years of experience in practice and is considered one of the nation’s top gynecologists. He is a Professor of Obstetrics and Gynecology at New York School of Medicine, serves as Director of Gynecologic Ultrasound at New York University Medical Center and is a Certified Menopause Practitioner and expert in the field of female hormone replacement therapy.
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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�. It has been known for quite some time that estrogen promotes lean body mass.
Now for the interesting part. Estrogen is produced by ovaries in response to a substance that comes from the pituitary gland known as FSH (follicle stimulating hormone).
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Follicle stimulating hormone causes follicles in the ovary to produce estrogen. At menopause the ovary is incapable of producing estrogen and so the pituitary puts out more and more FSH in an attempt to get the ovary to respond. In premenopausal women there is what is called a negative feedback loop. That means that when estrogen is produced it drives the level of FSH from the pituitary to a very low level. Thus in menopause, FSH is high and estrogen is low, in premenopause estrogen is high and FSH is low.
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In the August 8th 2017 New York Times Science section, there was an extremely interesting article entitled, “Researchers Track an Unlikely Culprit in Weight Gain.� talks about the fact that it may be FSH by itself that results in the deposition of fat to the midriff as well as a loss of bone.
Those women who do choose to go on estrogen in the form of female hormone replacement therapy at the time of menopause will, in fact, drive down FSH levels. Thus, regardless of whether it is actually the elevation in FSH or the actual use of estrogen that helps maintain bone mass and prevent accumulation of central fat in the belly, the end result will be the same in menopausal women who use HRT.
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Fortunately, many of you have heard me speak of a new paradigm for delivering female hormone replacement therapy (HRT) in a much safer fashion than previously thought. The product, Duavee, is estrogen with a SERM rather than an estrogen with progesterone. 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 my patients who are on Duavee for hormone replacement therapy come and say to me that their friends all tell them, “you are crazy to be on HRT.” My comment to these patients is to tell their friends that, “this is not your mother’s HRT.”
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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 for a consultation to see if female hormone replacement therapy can work for you. All appointments are tailored to the patients and Dr Goldstein is the only medical specialist a patient will see.
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Dr. Steven R. Goldstein MD Female Hormone Replacement Therapy Gynecologist
530 First Avenue Suite 10N, New York - 10016 United States of America Call: 212.263.7416
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