Our expertise as gynecologists go beyond fertility, and include endometriosis, hormone imbalances, and perimenopause. We help women feel healthy and happy. Work with the top gynecologists in NYC today.
As women and gynecologists, we have seen that women’s healthcare is largely focused on matters pertaining to fertility. At TārāMD, while we acknowledge the wonder of pregnancy and motherhood, we believe that there is much more to our health. While we are happy to use our unique skill set to care for fertility issues, we also believe that more attention should be given to women facing other concerns. A woman gets so much focus and care when she is pregnant, but not when she is experiencing perimenopause, hormonal imbalances, endometriosis, and sexual issues (to name just a few). We believe that women need just as much attention regarding all of the above. We want to make sure that all women, in all stages of life, feel vibrant, balanced, healthy, and happy.
Much of women’s health is related to our hormones and their balancing. Whether it is irregular periods, PCOS, fertility concerns, PMS, and sometimes heavy bleeding - all of these are linked to our hormonal health. The often rocky transitions of puberty, pregnancy/postpartum, and menopause are also examples of major hormonal transitions that can impact how we feel - from heavy periods to stress, weight gain, sleep quality, and even hair loss. And, although most women think of estrogen as their primary hormone, in reality, our bodies make about 50 different types! At TārāMD, we look at your whole hormonal health and take into account other major hormonal players such as cortisol (your stress hormone), and insulin (sugar balancing hormone). Through personalized, integrative medicine including diet, lifestyle changes, supplements, and medications when needed, we can help restore hormonal balance.
MENOPAUSE AND PERIMENOPAUSE
What is menopausal transition?
“Menopausal transition,” also called PERImenopause, refers to the time period between the initial shift away from our predictably fluctuating hormones of regular menstrual cycle, to 1 year after the final menstrual period, when we are officially IN menopause. In the US, about 1.3 million women enter menopause each year, usually around age 51-52 but the range is quite varied. Perimenopause, marked by major hormonal shifts, can last for 10 years before, with many women experiencing its effects in their early 40s or even earlier! For some (lucky!) women it is a mild transition, but for others, it carries with it a number of bothersome symptoms. The symptoms stem from shifts in our major sex hormones, estrogen, progesterone, and testosterone, and their interactions with other hormonal systems, including thyroid, insulin, and cortisol. Like puberty and pregnancy, perimenopause and menopause are normal hormonal events in the life of a woman, but the transition can affect both our current wellbeing and has implications for future general long-term health. At TārāMD, we believe in empowering our patients with hormonal knowledge and sharing all the integrative tools applicable to this transition, to help us thrive through perimenopause and beyond.
What are its symptoms?
Some are commonly known, like hot flashes and night sweats, but others often accompany it as well: sleep problems, mood swings, anxiety, weight gain, skin, and libido changes - there are over 34 recognized! Symptom patterns also differ based on where one is along this transition, as our hormonal patterns shift from a balance of estrogen and progesterone to relative progesterone deficiency /estrogen dominance, to low levels of both. This often gives rise to different symptoms along the different phases of the perimenopause to menopause transition, with mood swings, PMS, and sleep issues creeping in in early perimenopause, and the more traditional symptoms of hot flashes and dryness later on. Our hormonal systems are beautiful in their complexity, so these changes also affect other hormones and of course, symptoms can be due to not just the menopausal transition. It’s also important to remember that not all of us experience all or any of these and that there are some positives to menopause as well!
What is our approach to menopause and perimenopause?
We are here to support you and make both perimenopause and menopause a time of thriving, inspiration, and positive change. At TārāMD, we use our knowledge of both traditional menopause medicine AND integrative medicine to empower you through this transition and beyond - from nutrition to mindbody tools to science-based herbal supplements, to hormone therapy/HRT, including bioidentical hormone regimens or bHRT. Far from a one-size-fits-all approach, we believe in a very personalized hormonal solution that depends on your goals, symptoms, preferences, medical history, even genetics.
At TārāMD, we are proud to offer you expert menopause care as integrative medicine physicians and board-certified OBGYNs. Additionally, Dr. Suzanne Fenske is also a certified NAMS (North American Menopause Society) practitioner. Menopause is not an end - it is an opportunity to transition into the next, vibrant phase of life.
What is pelvic pain?
Pelvic pain is pain felt in the lower abdomen. This pain can be “acute” which means sudden onset or it can be “chronic” which means it has been going on for at least 6 months. Pelvic pain can be caused by reproductive, digestive, urinary or musculoskeletal causes.
What are the symptoms of pelvic pain?
Pelvic pain can manifest in a variety of ways. Sometimes it is experienced as pain related to certain events such as menstruation, urination, consuming food, having a bowel movement or having penetrative sex. Other times it is felt randomly or constantly. Pain can be “pressure,” “twisting,” “stabbing,” “aching” or “burning”. Sometimes this pain is associated with a change in urination, change in bowel movements, bloating, nausea, vomiting, blood in urine, blood in stool or irregular vaginal bleeding.
How do we treat pelvic pain differently?
At TārāMD, we treat pelvic pain differently starting with your evaluation as a whole person. We take our time to hear your story and ask questions that allow us to delve into all contributing factors. Through our thorough communication and assessment, we are able to find the root cause of the pain. We then create a treatment plan that not only treats the cause, but also all contributing factors. We provide you with the tools to help your body heal, alleviate your pain and make you feel vital again.
What is endometriosis?
Endometriosis is a disease that affects about 10% of women during their reproductive years. This condition occurs when cells from the inside lining of the uterus (the endometrium) grow in abnormal locations. In endometriosis, these cells are often found in the lower pelvis near the ovaries, fallopian tubes, uterus and intestines. These cells respond to the menstrual cycle hormones like they would when they are located in the lining of the uterus. With hormonal changes, they will bleed and produce inflammation. This results in painful ovarian cysts, scar tissue and, sometimes, bleeding in the bowel and bladder.
What are the symptoms of endometriosis?
Endometriosis has a broad spectrum of symptoms. Women with endometriosis may be asymptomatic or have debilitating pain. Endometriosis can cause painful periods, non-menstrual pelvic pain, pain with penetrative intercourse, pain with or without bleeding during urination, pain with or without bleeding with bowel movements, and fertility problems.
How do we treat endometriosis differently?
At TārāMD, we treat endometriosis through a more comprehensive approach. We work together with specialists in acupuncture, nutrition, pelvic physical therapy and health coaching as well as judiciously utilizing medications, surgery, supplements and botanicals to create a unique and personalized treatment plan to address all aspects of endometriosis and put you back in control of your life and your body.
Sexual health is a vast topic. Sexual health sometimes focuses on assessment and prevention of sexually transmitted diseases with appropriate screenings and treatment and contraception, but this is just the beginning. At TārāMD, we believe that your gynecologic care should encompass other aspects of sexual health as well: libido, satisfaction, intimacy, and sexual safety. We can help address issues such as:
- vaginal dryness
- pain with penetrative sex
- low libido/ desire
- issues with orgasms
- vestibulodynia/ vulvodynia
- sexually transmitted infections
- abnormal pap smears
- birth control options
At TārāMD, we use a personalized approach to hormonal balancing, carefully considering your personal health, family history, goals, preferences and risks and benefits for YOU. We also use the results of your hormonal assessment, including advanced functional hormonal testing through the DUTCH or ZRT test when indicated. For perimenopause and menopause especially, hormone therapy, or HRT for short, involves a careful selection of the hormones, doses and regimens. As integrative medicine physicians and NAMS (North American Menopause Society) certified practitioners, we offer our expertise in personalized hormone therapy, including both FDA-approved and, when indicated, compounded bioidentical hormones to help you regain balance.