As a woman going through or approaching menopause, it can be overwhelming to sift through all of the information available on the topic. From cosmetic treatments such as labiaplasty and Botox to hormonal treatments such as hormone replacement therapy and natural supplements, it can be challenging to decipher it all and determine what is right for your unique needs.
Peri-Menopausal Medicine is the practice of medicine specializing in health care for women around (just before, during, or after) menopause (cessation of menses). It is a complicated time with a multiplicity of health, hormonal, personal, psychic and familyrelated issues.
Women experiencing peri-menopause benefit greatly from yearly health maintenance and wellness exams. Other treatments available to improve women’s health during this time include:
· Hormone regulation and replacement therapy;
· Menopausal wellness with or without hormone replacement;
· Management of abnormal bleeding and menstrual abnormalities;
· Treatments for fatigue, depression, sexuality and mood-related problems as well as other disturbing systemic occurrences;
· “Sleep-Hygiene”—lifestyle suggestions, herbal/botanical, hormonal and medicinal therapies for common sleep difficulties.
Many women find it helpful to gain an understanding of the options available to them as they seek for treatments to maximize health and wellbeing throughout peri-menopause.
Dr. Goodman specializes in the following categories for menopausal medicine:
Hormone Replacement Therapy (HRT)
Hormone Replacement Therapy (HRT) actually encompasses both the use of natural and synthesized hormones (including hormonal sources from plants and food products) for both medical and comfort-related reasons and the use of hormonal therapy to regulate errant menses.
Hormone supplementation may be used for both symptoms of menopause and health enhancement in the areas of cardiovascular, cognative, skin, and bone health.
Dr. Goodman is one of the few practitioners in Northern California to have considerable experience in Bioidenticals ("BHRT"), compounding and sophisticated hormonal testing.
Successful HRT is that right product (or combination of) given to the right person for the right reasons.
There is always an alternative!
From lifestyle changes to herbs and botanicals. From acupuncture to manipulation to utilization of non-traditional medications, there are many paths. Included here are compounded ovarian and adrenal hormonal products for therapy of menopausal and fatigue issues. Dr. Goodman is well versed in compounding and integrating lifestyle alterations, alternatives and/or hormonal or pharmaceutical products to find the right fit. He has the time, knowledge, and inclination to work with lifestyle changes (dietary and exercise related), as well as mindfulness training.
Dr. Goodman excels in integrating lifestyle work with other therapies and is trained in personalized dietary planning, exercise programs and meditation techniques.
Sexuality and Lifestyle Issues Surrounding Menopause
Multiple sexuality and lifestyle issues surrounding menopause are rarely discussed at a 10- minute annual exam or consultation. Loss of sexual desire, vaginal dryness, blunted orgasms or a disparity in desire between partners is not infrequently encountered at this time.
Few things in life are fun and free – sex is one. Dr. Goodman is interested and trained in sexual medicine and is comfortable working with sexual issues with his patients and their partners. Understanding, counseling, "permission" specific suggestions and hormones are often utilized in therapy.
Labiaplasty and Vaginal Reconstruction and Rejuvenation
Women's labia come in varying shapes and sizes. Occasionally either anatomically or secondary to obstetric injury, the labia are quite large or irregular in shape and may cause discomfort, self-consciousness or interfere with sports or sexual activities. Dr. Goodman performs a relatively minor plastic surgery procedure—labiaplasty in California, also known as Labial Reconstruction designed to reduce the enlargement and sculpt the labia.
Additionally, after childbirth and with age, the upper vagina can become loose and lax. The vaginal opening can loosen and gape. Dr. Goodman specializes in remodeling, re-approximating muscles and tightening both the opening and the upper vagina. New Radiofrequency Wave Technology may also be utilized to tighten the weave in the upper vagina to support the base of the bladder and help with minimal incontinence, which sometimes accompanies vaginal relaxation. This exciting new technology revolutionizes the concept of "Vaginal Rejuvenation" and makes vaginal tightening a safe reality without the sometimes risky use of lasers. For more information about labiaplasty in California go to http://www.drmichaelgoodman.com/labiaplasty/ , or Google "Vulvovaginal Aesthetics" to learn more about the options available.
Techniques are also available to tighten the hymenal ring to encourage bleeding with consumation of marriage.
Urinary Incontinence, IC, and Vulvar Pain
These problems are embarrassing and reluctantly discussed, but can be well treated (usually without surgery).
Vulvar pain and/or irritation is not infrequently encountered. Vulvar Vestibulitis (VVS) is seen in women in their teens, 20s and 30s, and dysesthetic or generalized vulvodynia in later years. Both can be successfully treated with proper knowledge and experience. Dr. Goodman has many years of experience treating these disorders. He is a member of the National Vulvodynia Association, and is interested, supportive, and well-versed in all the treatments (non-surgical and surgical) for both VVS, vulvodynia and vulvar dystrophy.
Dr. Goodman has over 30 years of experience as a pelvic support surgeon, and always performs a proper diagnostic workup for the various causes of incontinence. In addition to working with medical (non-surgical) therapies, including the new Athena Pelvic Muscle Trainer, he performs a full range of support surgery. Most exciting is the new minimally invasive SURx outpatient Radiofrequency Wave Pelvic Support Procedure.
Health Maintenance & Enhancement; Weight Issues; Stress Reduction; Mindfulness Training
Good health involves yearly health maintenance evaluations with attention to maintaining wellness and looking ahead both to the prevention of illness and the fullest enjoyment of day-to-day living.
Towards this end, attention is paid to stress-reduction techniques and good nutrition and exercise, as well as herbal products and medications, as necessary. Mindfulness Training including the techniques of roll breathing, body scanning, and breath meditations are taught.
Dr. Goodman is experienced in the physiology involved in peri-menopausal weight gain and enjoys (and is successful in) working with women towards healthy, successful, longlasting weight reduction and healthy, joyful living! Dr. Goodman also works with multi-small meal, complex carbohydrate/protein dietary plans for avoidance of hypoglycemia and weight maintenance.
...Those who do not find time for exercise will have to find time for illness...
Menstrual abnormalities can occur at any phase of life and are always bothersome and frightening.
Whether caused by ovarian dysfunction, anatomical or environmental factors, or other reasons, an accurate diagnosis (shared with and explained to the patient) proceeds a therapeutic regimen chosen from all available options by a collaboration between patient and physician.
Dr. Goodman utilizes his experience, in-office sonography (pelvic ultrasound) and sonohysterography (Contrast Ultrasound) as well as hospital Operative Hysteroscopy for prompt and minimally invasive diagnosis and treatment.
Bone Densiometry and Osteoporosis Prevention
Osteoporosis is a bone-thinning disease which can lead to broken bones and can rob you of your independence. A bone density test is the only way to diagnose osteoporosis and learn your individual risk of future fracture. More women sustain osteoporotic fractures per year than die from cancer and cardiovascular disease combined.
Equipped with a GE Lunar Prodigy bone densiometer to perform state-of-the-art DXA scans as well as a Lunar Achilles Express peripheral (heel) scanner, The Bone Density Center is the only complete densiometry center in a private office in the area, with prompt and pleasant service.
Dr. Goodman works with lifestyle adjustment and both traditional and cutting-edge therapies to treat osteopenia and prevent osteoporosis.
DEXA scans are by appointment only, while peripheral scans may be performed on a drop-in basis.
A physician's referral is not necessary for DEXA or screening.
PMS (Pre-Menstrual Syndrome)
PMS ("Pre-Menstrual Syndrome") is now medically known as PMDD (Pre-Menstrual Dysphoric Disorder) when it is severe.
As its name applies, it refers to a disturbing series of events which makes the life of many women and their families (especially in peri-menopausal years) very difficult for several days or more each month. Very disturbing are the feelings of loss of control which accompany this situation. PMS changes are often accompanied by disabling migraine headaches.
Many different methods are available for women to re-establish control and alleviate disturbing symptoms, including lifestyle alterations, specialized vitamins and minerals, hormonal balancing, psychopharmaceuticals and more.
Pelleve™ Skin Tightening and Wrinkle-Removal System
Achieving a more youthful appearance without surgery is easier than ever before with the Pelleve™ Skin Tightening and Wrinkle-Removal System.
· Reduce facial, neck and chest wrinkles.
· Tighten loose skin.
· Achieve a lovely appearance and feel refreshed without surgery.
· Therapy performed in-office; no need for messy at-home procedures.
· Results guaranteed for one year and can last up to 2+ years.
Experience the results through the non-invasive, in-office procedure under the supervision of Dr. Goodman and enjoy one convenient price, covering the initial procedure as well as touch-ups.
What is Pelleve™?
Pelleve™ is a newly FDA-approved Category II, which means it can only be performed by or under the supervision of a licensed physician. It is a noninvasive procedure designed to tighten sagging skin and remove or soften wrinkles on a long-term basis. Pelleve™ delivers quick results, visibly tightening and smoothing the face and neck, and is one of the few wrinkle treatment systems approved by the FDA.
How Does Pelleve™ Work?
Pelleve™ utilizes RadioFrequency Wave Energy to precisely heat the collagen layer of the dermis, under the skin and above the fat layer, without in any way damaging the epidermis, or top layer, or any structures underneath. The closelycontrolled heat causes the collagen in your skin to contract and tighten. After the treatment, your skin will also start to produce new collagen. The result is an improvement in skin quality, firmness and tightness you can see and feel.
A Pelleve™ treatment lasts 1 hour, requires no anesthesia or incisions, is pain-free (you’ll feel moderate heat), and shows immediate results. Some patients will need only one treatment; others with more significant wrinkle depth or more advanced sagging will require a total of 2-3 treatments 3-4 weeks apart to achieve desired results but will still achieve noticeable improvement after the first treatment.
What Body Parts Can Be Treated?
· Upper and lower eyelids, under eyes, "crow’s feet"
· Sagging cheeks and jowls
· The wrinkle line between nose and mouth, lines around mouth, "chin groove"
· Skin sag and wrinkles of the neck
· Wrinkles on chest and décolletage
· Wrinkles on back of hand and wrist, etc.
Pelleve™ Skin Tightening and Wrinkle-Removal System is most appropriate for those with mild to moderate wrinkles and "flattening" or sagging of the face.
What are the results of Pelleve™?
Perhaps the most exciting aspect of a Pelleve™ treatment is that the patient will notice immediate results, including:
· Smoother skin
· Elimination or reduction of fine lines and wrinkles
· Tightening of sagging skin
· Results typically last from 1-2 years for the face; longer for the neck and chest.
This is a considerable improvement over other systems which must be redone or re-applied on a frequent basis, costing less initially, but much more (both financially and in loss of time during the many in-office or at-home treatments) in the long run.
Pelleve™ is a safe, FDA- approved option for those desiring a more youthful appearance and for those who "look old or tired" but are not needing or ready for a facelift. The procedure also provides a more affordable alternative to a traditional facelift.
What are the benefits of Pelleve™ over other similar treatments?
The main advantage of Pelleve™ is the fact that its results last a full year or longer. "Touch-ups" are provided for free within the first year; re-treatments after 1 year are provided at a guaranteed 20% discount. Also, the treatment is quick and painless. Finally, as an FDA approved procedure, Pelleve™ is a safe option for those desiring a more youthful appearance.
What is the cost?
- $700 per treatment area (face or neck); $1000 both face and neck
- $1400 series of 3 treatments oe area; $2000 face and neck, 1 month apart (X3)
- ***Holiday/New years special: Take 1/3 off all above prices November, December 2010, January & February 2011!!
One treatment usually suffices for younger patients with mild/fine wrinkles and minimal sagging, while 2-3 treatments is usually necessary for more challenging skin changes in mid-aged and older women.
For more information on achieving youthful, beautiful skin through Pelleve™ Skin Tightening and Wrinkle-Removal System, call Dr. Goodman at (530) 753-2787.
The use of transvaginal Pelvic Ultrasound for the ultra-early diagnosis of ovarian cancer is proven.
Although 1 in 100 women will get this dreaded disease (with well over 50% mortality because usually it is diagnosed too late), because of cost-effectiveness reasons, health plans and physicians do not routinely screen for ovarian cancer with the only reliable and specific early-diagnosis method: two-dimensional transvaginal ultrasound of the ovaries and surrounding structures.
This evaluation, similar to a "pelvic exam with an eye", takes typically only 5-10 minutes, is not uncomfortable and does not require a full bladder. Dr. Goodman has over 18 years of experience with endovaginal pelvic ultrasound and utilizes a Siemens Sonoline with switchable, steerable (comfortable!) 5.0/6.5/7.5 mHz probe-- in the office at the same time as the pelvic exam.
How wise is it to undergo major surgery relying only on the opinion of one physician, frequently one we've known for only a short period of time and have no idea of her/his skill or experience?
Likewise, if a surgical approach to a problem has been rejected by one's physician (or by one's health plan) do they have your best interests or their pocketbook foremost in mind? Similarly with treatments for infertility: What is the best path, what is warranted, whose interests are your health care providers serving?
The knowledge and peace of mind generated by a thoughtful, knowledgeable, and impartial second opinion can be extremely helpful. Dr. Goodman brings his 35 years of Gynecological and surgical experience to help guide you towards the therapeutic approach most likely to offer relief, discussing ALL alternatives in a non-judgemental and analytical way.