Transvaginal Ultrasonography for Perimenopause.
If you’re a woman in your late thirties or forties, you may have noticed changes in your menstrual cycle, energy levels, mood, or overall health. These changes could be signs of perimenopause, the transitional stage leading up to menopause. While menopause is often discussed in terms of its later stages, perimenopause is just as important because it’s the period where symptoms begin and hormone levels fluctuate.
Dr. Steven R. Goldstein, a trusted perimenopause specialist NYC, has helped thousands of women navigate this complex stage of life. Understanding what is happening in your body during perimenopause can help you make informed decisions about your health and reduce unnecessary anxiety or discomfort.
What is Perimenopause?
Perimenopause is the period before menopause when your ovaries gradually produce less estrogen and progesterone, the hormones responsible for regulating your menstrual cycle. This stage can start in the late thirties or forties and may last anywhere from a few years to a decade. During perimenopause, many women notice changes such as:
• Irregular periods or heavier and lighter bleeding
• Hot flashes and night sweats
• Mood swings, irritability, or anxiety
• Difficulty sleeping
• Vaginal dryness or changes in sexual function
• Weight gain, especially around the abdomen
• While these symptoms are common, some changes, such as abnormal uterine bleeding, require closer evaluation to rule out underlying health issues.
Abnormal Uterine Bleeding in Perimenopause
One of the most common concerns for women during perimenopause is abnormal uterine bleeding. This can include unusually heavy periods, bleeding between periods, or prolonged menstrual cycles. In many cases, this bleeding is caused by hormonal fluctuations and is considered dysfunctional uterine bleeding.
According to Dr. Goldstein, a perimenopause specialist NYC, most cases of abnormal bleeding during perimenopause are related to anovulation, meaning the ovaries occasionally fail to release an egg. These cases can often be managed with hormonal treatment or careful monitoring, without any invasive procedures.
However, it is important to distinguish between bleeding caused by normal hormonal changes and bleeding caused by other conditions, such as polyps, fibroids, or rare cases of endometrial cancer. Accurate diagnosis is essential for safe and effective treatment.
How Abnormal Bleeding Was Historically Evaluated
In the past, abnormal uterine bleeding was often evaluated with curettage, a procedure that involves scraping the lining of the uterus to collect tissue for testing. While this method was considered standard for many years, studies showed that curettage missed endometrial abnormalities in a significant number of cases. Small growths or localized areas of abnormal tissue could easily go undetected.
Later, vacuum-suction devices, like the Pipelle biopsy, allowed doctors to sample the uterine lining in the office without general anesthesia. While this was a big improvement, it still had limitations. These methods work best for detecting widespread changes in the uterine lining but can miss small or localized issues such as polyps or small areas of abnormal cells.
Modern, Non-Invasive Options
Today, advances in technology allow perimenopause specialists to evaluate the uterus in ways that are safer, less invasive, and more comfortable for patients. One of the most effective tools is transvaginal ultrasonography, an ultrasound method where a small probe is inserted into the vagina to provide clear images of the uterus and ovaries. This test is quick, noninvasive, and widely available.
For women experiencing abnormal bleeding, saline infusion sonohysterography (SIS) may be added. During this procedure, a small
amount of saline is gently introduced into the uterus to expand the uterine cavity. This allows the doctor to see the lining more clearly and detect abnormalities such as:
• Focal growths like polyps or fibroids
• Areas of thickened endometrium
• Other structural changes
• These imaging techniques make it possible to separate women with simple hormonal bleeding issues from those who may need further evaluation or treatment, all without the discomfort of surgery.
Why Seeing a Perimenopause Specialist is Important
Women in perimenopause often face a lot of uncertainty. Symptoms can be confusing, cycles may be irregular, and health risks begin to change. Seeing a perimenopause specialist NYC like Dr. Goldstein can help you:
• Understand what is happening in your body during this transitional stage
• Identify whether symptoms are part of normal hormonal changes or require further evaluation
• Manage symptoms like hot flashes, sleep issues, mood changes, and irregular bleeding
• Avoid unnecessary invasive procedures while still ensuring proper care
• Dr. Goldstein, a perimenopause specialist NYC brings decades of experience in women’s health and is recognized nationally and internationally for his work in menopause and perimenopause care. He has served as president of both the Menopause Society and the International Menopause Society and is a certified menopause practitioner. His expertise ensures that women receive care tailored specifically to this stage of life.
Taking Control of Your Perimenopause Journey
Navigating perimenopause can feel overwhelming, but understanding your body and seeking the right care can make a significant difference. Early
evaluation of symptoms, especially abnormal uterine bleeding, allows women to maintain their health and prevent complications.
A perimenopause specialist NYC can guide you through:
• Hormonal testing and evaluation
• Non-invasive imaging techniques like ultrasound and sonohysterography
• Lifestyle and dietary changes to manage symptoms
• Hormone therapy or other medical treatments if necessary
• By working with an expert, you can address symptoms proactively, reduce anxiety, and make informed decisions about your health.
Conclusion
Perimenopause is a natural stage in every woman’s life, typically beginning in the late thirties to late forties. While many changes are normal, some symptoms, like irregular or heavy bleeding, deserve attention. With modern tools like transvaginal ultrasound and saline infusion sonohysterography, women can receive accurate diagnoses without invasive surgery.
For women experiencing perimenopausal symptoms, consulting an expert likeDr. Steven R. Goldstein can provide clarity, reassurance, and a personalized care plan. By addressing symptoms early and understanding the changes your body is undergoing, you can navigate perimenopause with confidence and comfort.