Dr Steven R. Goldstein is a leading NYC Gyn who has treated patients with abnormal uterine bleeding, heavy periods (menorrhagia), heavy bleeding for over twenty-five years in private practice on the East side of Manhattan.
It is not uncommon for women to come to Dr Goldstein’s practice with medical complaints ofbleeding. Someofthese women are menopausal.This meansthey should not be experiencing any bleeding since their ovaries are no longer functioning and therefore not making any estrogen or progesterone. There is no stimulation of the endometrial lining and there should be absolutely no further bleeding. Any post menopause bleeding must be evaluated atonce, and be considered “uterine cancer until proven otherwise”. Any menopause bleeding, even staining, regardless of how slight or short in duration must be evaluated.
However not every case of post menopause bleeding is because of cancer. Bleeding in post-menopausal women not on hormone replacement therapy, accounts for many medical interventions. In the past, the first clue to possible endometrial cancer was bleeding. Endometrial carcinoma has a peak prevalence at 55 years of age. Thus, 75% of cases occur in postmenopausal women. The role of unopposed estrogen in the development of this disease has been known for some time. Classic risk factors include obesity, diabetes, hypertension and low parity.
However, studies show that only about 3-7% of women with menopausal bleeding will actually have cancer. But in medicine, that is a relatively large number and all women
with any menopausal bleeding must have an evaluation of their uterus.
One of the causes of post-menopausal bleeding can be Endometrial atrophy, where the endometrial lining is very thin in a post menopause woman. In the absence of estrogen, thefunctionallayeratrophies(wastesawayordegenerates). Dr.Goldstein,aNYCGyn, was the first to describe the fact that in postmenopausal patients with bleeding, a thin uterine lining on transvaginal ultrasound meant there was no significant tissue and no biopsy or D&C or further intervention was necessary.
In patients with postmenopausal bleeding, a workup is necessary to rule out uterine cancer, hyperplasia and polyps first because Endometrial cancer can coexist with atrophic endometrium. In years gone by, this was often a D&C (dilatation and curettage) and for many years a simple uterine biopsy was the standard of care. It no longer is.
Dr Steven R. Goldstein MD uses non-invasive Transvaginal Ultrasounds to diagnose the cause of postmenopausal bleeding. These are simple, inexpensive, well tolerated office procedures to examine and generate clear, high-resolution images of the uterus and endometrium in order to make an accurate diagnosis.
Transvaginal ultrasounds are state of the art procedures which are non-invasive, meaning no painful surgeries are required. They are quick, painless procedures performed in the comfort of Dr Goldstein’s office. Dr Goldstein personally performs alltransvaginal ultrasounds and Sonohysterograms, examinations and discusses results and diagnoses with patients.
If you are a post menopausal woman and experiencing any form of bleeding, then a consultation with Dr Steven R. Goldstein, a leading NYC Gyn , may be appropriate.