Medications That Help with Breast Cancer And Bone Loss Prevention Part 2: Dr. Steven R. Goldstein1/26/2020 Dr. Steven R. Goldstein MD is an expert Obgyn in Manhattan, considered one of the nation’s top doctors in gynecology. In private practice for over 25 years, Dr. Goldstein has had patients who were excellent candidates for Evista (raloxifene) because of its dual effect of reducing breast cancer risk and preventing and treating osteoporosis. Another type of drugs, Aromotase inhibitors, also reduce the risk of breast cancer. These aromatase inhibitors are pure anti-estrogens (unlike the first two drugs, which are selective for the breast but not in all aspects of the body) these drugs contribute to osteoporosis, joint pain, vaginal atrophy, etc. Thus, in my opinion, while the aromatase inhibitors are excellent drugs for women with advanced breast cancers and can be lifesaving in such cases, their use for prevention of breast cancer, in women who don’t already have that disease, is inappropriate and unnecessary, especially in light of the high treatability when breast cancers are detected early. Furthermore, bone health, is as, if not more, important of an issue for long term healthy aging and quality of life as breast health. Since early detection of breast cancer will almost always result in a favorable outcome, and since women are routinely living much longer lives than previous generations, a fracture, especially of the hip, of a woman can be a much more life threatening and devastating event than an early breast cancer. Thus, drugs to prevent breast cancer that actually cause bone loss, like the aromatase inhibitors, in my opinion, make no sense for this purpose. To find out more about Dr. Steven R. Goldstein MD, an expert Obgyn in Manhattan, or schedule an appointment to discuss your gynecological conditions, visit www.goldsteinmd.com.
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Dr. Steven R. Goldstein MD is one of the best obgyns in NYC. In private practice for over 25 years, Dr. Goldstein may encounter patients with suspected urinary tract infections (UTI), which he would treat as a courtesy instead of sending them to a urologist or their primary care physician. Dr. Goldstein has long held to the belief that there is a rising problem of antibiotic resistance, mainly with urinary tract infections primarily because many physicians and urgent care centers will do simple tests looking for a substance called leukocyte esterase in a patient’s urine. If it is found, then they begin treating it with antibiotics that are broad-spectrum, enough to kill virtually any organism in the urine. As one of the best obgyns in NYC, Dr. Goldstein prefers to treat presumed urinary tract infections by first taking a culture while starting the patient on a medication to take the discomfort (burning, urgency, frequency, sometimes even blood) away. If the culture shows bacteria in the urine, then the least broad-spectrum antibiotic for those particular bacteria would be prescribed. If the culture shows no true infection then such urinary tract inflammation can be successfully treated with one week of the urinary anesthetic (the drug that turns your urine in a dark orange color). This approach lowers the risk of antibiotic resistance. In the July 14th 2019 New York Times, a front-page article was entitled, “As a common infection evolves, drugs falter and patients suffer.” This article went into great detail talking about common urinary tract infections now requiring treatment with heavy duty intravenous antibiotics as a result of increasing drug resistance. In fact, the article mentioned that last year researchers reported in a study that one third of all urinary tract infections in Britain were resistant to “key antibiotics. Dr. Steven R. Goldstein MD is one of the best obgyns in NYC. Visit his website at www.goldsteinmd.com for more information or to schedule an appointment. Doctor Steven R. Goldstein MD is a top New York City gynecologist, specializing in Menopause and Perimenopause. He is a Certified Menopause Practitioner, a past President of the North American Menopause Society (NAMS), and President elect International Menopause Society and has helped thousands of women cope with the symptoms of menopause in his over 25 years of practice. In menopausal women the ovaries are no longer functioning and there is no production of estrogen or progesterone. Thus there is no stimulation of the endometrial lining so there should be no bleeding whatsoever. Therefore there must be an evaluation of the uterus. Dr Goldstein uses non-invasive methods such as a transvaginal ultrasound to do this evaluation. These are simple, inexpensive, well tolerated office procedures to triage these post-menopausal women into three basic categories. Based on the precise, clear, high resolution images from these procedures, a determination can be made as to whether the patient’s condition can be treated hormonally, are candidates for blind sampling, or are in need of visually directed sampling. Doctor Steven R. Goldstein, a top New York City gynecologist, is a Certified Menopause Practitioner and a past President of the North American Menopause Society (NAMS). He is also the Director of Gynecologic Ultrasound at New York University Medical Center and Past President of the American Institute of Ultrasound in Medicine. He is well qualified to evaluate any case of menopause bleeding with non-invasive vaginal sonograms and discuss with patients. If you are a woman who is either in menopause or are post-menopausal and are experiencing unscheduled bleeding, schedule an appointment with Dr. Goldstein by visiting his website at www.goldsteinmd.com. |
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December 2020
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