Endometriosis: There’s No Need To Live In Pain

Endometriosis is a gynecological medical condition in which cells from the lining of the uterus appear and flourish outside the uterine cavity, most commonly on the ovaries. Its main, but not universal symptom is severe recurring pelvic pain.

The pain can be mild to severe cramping on both sides of the pelvis, radiating to the lower back and rectal area, and even down the legs.

“The amount of pain a woman feels is not necessarily related to the extent or stage of endometriosis,” says ob/gyn Steven C. Goldberg, M.D., FACOG.

“Some women will have little or no pain despite having extensive endometriosis affecting large areas, or having endometriosis with scarring. On the other hand, women may have severe pain even though they have only a few small areas of endometriosis.”

Endometriosis occurs in an estimated 6 to 10 percent of women in their reproductive years and can lead to infertility, painful and disabling menstrual cramps, irregular bleeding, abdominal and lower back pain, leg pain, painful sex, and painful urination and bowel movements.

“Some women spend needless years in pain caused by undiagnosed endometriosis,” says Dr. Goldberg. “Diagnosis begins with a pelvic exam and is confirmed, in most cases, by a trans-vaginal ultrasound Performed comfortably right here in our office. With some patients, we need to perform other testing, such as a biopsy or a minimally invasive pelvic laparoscopy, where a tiny surgical viewing instrument is inserted through the patient’s navel.”

Treatment options include beginning a course of low-dose birth control pills, which suppress the growth of endometrium, other medications, localized cauterization of the endometrial sites, and sometimes, surgical intervention. “While there is no cure for endometriosis, treatment can help relieve some or all of the symptoms in many women for years,” says Dr. Goldberg. “Talk to your doctor if you think you may be experiencing symptoms related to endometriosis. With the treatments and medication available, there is no need to live with pain, and your physician can help.”

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On December 6th, 2012, posted in: News by

Promoting Breast health Through Early Detection – The statistics still Startle:

• Except for skin cancers, breast cancer is the most common type of cancer among American women.

• Breast cancer is second only to lung cancer as a cause of death among women.

• Breast cancer accounts for 1 of every 3 cancer diagnosis in the U.S.

• About 200,000 women will be diagnosed with breast cancer in the U.S. this year.

“The good news,” says ob/gyn Eumena M. Divino, MD, FACOG, “is that there are about two and a half million breast cancer survivors alive today, and the number of deaths due to breast cancer seems to be declining, thanks to a combination of early detection and more effective treatments.”

“We urge women to have an annual mammogram beginning at age 40, and even earlier if they have a family history of breast cancer,” says Dr. Divino.

The Center for Women at Raritan Bay Medical Center provides convenient, state-ofthe- art testing for all women’s special health needs, including digital mammography, stereotactic vacuum-assisted core needle biopsy, ultrasound guided core biopsy and bone densitometry. The new Perth Amboy location is one of only a few Central New Jersey sites providing breast MRI imaging and MRI-guided biopsy in combination.

The Center for Women is a designated Pink Ribbon Facility™ in recognition of its superior imaging capabilities for early breast cancer detection and the advancement of women’s health, and is affiliated with the Cancer Institute of New Jersey.

“Don’t skip this simple test,” urges Dr. Divino. “The earlier a breast cancer is detected, the greater the chance for a cure.”

Call 732-324-5270 for a convenient appointment, including Saturdays. For additional information, call 732-324-5135.

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On November 20th, 2012, posted in: News by

Varicose Veins and Pregnancy

“The extra volume of blood produced during pregnancy is essential to support you and your baby,” says ob/gyn Steven R. Berkman, M.D., FACOG, FACS. “However, it puts extra pressure on your blood vessels, especially the veins in your legs, which have to work against gravity to push all that extra blood back up to your heart. Add to that the pressure your burgeoning uterus puts on your pelvic blood vessels, and the vessel-relaxing effects of the extra progesterone your body is producing, and you have the perfect recipe for varicose veins.”

“The good news,” continues Dr. Berkman, “is that while you may not like the way varicose veins look, they’re unlikely to put either you or your baby at any risk. In most cases, if you didn’t have them before you got pregnant, your varicose veins shrink or disappear altogether within a few months after you give birth. If you have another baby, though, your varicose veins are likely to reappear.”

If the veins don’t go away after the baby has arrived, you can consider having them medically treated or surgically removed then — but not during pregnancy.

Here are a few tips to prevent varicose veins during pregnancy:

• Keep your blood circulating.
Get off your feet whenever you can, and keep your legs elevated when sitting. When standing, put one foot on a low stool and alternate legs. Flex your ankles every so often, and break the habit of sitting with your legs crossed. Exercise helps prevent varicose veins. Take a walk each day or do some other form of circulationincreasing exercises.

• Keep your weight gain down during pregnancy.
Extra weight increases the demands on your already overworked circulatory system.

• Get a daily dose of vitamin C.
Vitamin C as part of a balanced diet helps keep veins healthy.

• Sleep on your left side.
Avoid pressure on your main blood vessels, and keep circulation going strong.

• Wear clothes that don’t bind.
Wear clothes that fit comfortably, especially around the tops of your legs. Don’t wear tight belts or socks with tight elastic tops, and stay away from tightfitting shoes and high heels.

• Support hose.
Perhaps not the most attractive look, but support hose can counteract the downward pressure of your belly and give the veins in your legs a little extra upward push.

• Don’t strain.
Heavy lifting or straining can add to vein visibility.


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On November 20th, 2012, posted in: News by

Menopause…A New Chapter in Life

Menopause is defined as the final menstrual period, after missing periods for 12 consecutive months (perimenopause).  Menopause is associated with reduced functioning of the ovaries, resulting in lower levels of estrogen and other hormones. It marks the permanent end of fertility and occurs, on average, at age 51. The perimenopausal period is quite variable and its symptoms can last for months or years.

Because hormone levels are fluctuating, women will experience irregular menstrual period, hot flashes, sleep disturbances and mood swings. These are all normal signs of menopause.  Some women may experience low sex drive and vaginal dryness.  Although fertility is low, conception is still a possibility and contraception is necessary until menopause is reached.

“When a woman believes she may be experiencing perimenopause, it is an excellent time to have a complete medical exam,” says Dr. Goldberg. “A review of one’s personal and family medical
history and a regular check-up can help women achieve optimal health. For example, regular mammograms are important for women over 40. Pap tests are also recommended, even after
menopause,” cautions Dr. Goldberg. “Height measurements can detect loss of height, possibly an indicator of osteoporosis. The risk of osteoporosis increases after menopause. Blood, urine and
other tests to screen for existing and increased risk for various diseases, such as diabetes, cancer, heart disease and thyroid disorder are also timely.”

“The news certainly isn’t all bad,” Dr. Goldberg says. “Women entering menopause should incorporate exercise, a healthy diet, and relaxation into their day. Continue sexual activity as long as you wish, especially as concern about pregnancy lessens. Your age is not an issue, and this is a time to focus
on your overall well being and satisfaction.” Dr. Goldberg believes that this healthy approach can relieve stress, quiet the mind, promote positive emotional well being, learning, concentration and creativity, and can even help to reduce such symptoms as hot flashes and insomnia.

“Sign-up for exercise and wellness programs at your local Community Y, and check out the complimentary therapies available at Raritan Bay Medical Center’s Division of Integrative Medicine,” Dr. Goldberg advises. “Explore the mind-body-spirit connection as you welcome this new chapter in your life.”

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On November 15th, 2011, posted in: News by

know your UTI

It’s an all too common scenario for more than 50 million women in the U.S. each year. You feel like you need to pass urine all day, but when you try, not much comes out. When you do urinate, it burns and smells bad, and looks cloudy, too. This frequent need to urinate lasts day and night for a couple of days, accompanied by a general feeling of pressure or tenderness in your lower belly.

Welcome to a UTI, or urinary tract infection.

“A UTI is an infection anywhere in the urinary tract,” says board certified OB/GYN Steven R. Berkman, M.D., FACOG, FACS. Parts of the urinary tract include the kidneys, ureters, which carry urine from the kidneys to the bladder, the bladder, and the urethra, a short tube that carries urine from the bladder out of your body.

What Causes UTIs?
Urinary tract infections are caused by bacteria that enter the urinary tract through activities of normal life like sexual intercourse or tampon use.  Women with diabetes or other immune suppressing health conditions have a harder time fighting infection, and a UTI can develop. Menopausal women experience a loss of estrogen, which can make UTIs more common.

What are the Signs of a UTI?

  • A burning sensation when you urinate.
  • Feeling like you need to urinate a lot, but not much actually comes out.
  • Leaking a little urine.
  • Pressure and tenderness in the lower belly.
  • Urine that smells bad or looks cloudy.

“If you experience these symptoms plus have lower back pain, feel shaky or have a fever, feel nauseous, or see blood in your urine, call your doctor immediately,” says Dr. Berkman. “You may have a kidney infection or other serious condition.”

How is a UTI treated?
A simple urine test can confirm your condition. UTIs are usually treated with antibiotics, and women feel better in a day or two. UTIs in pregnant women can cause premature labor. Also, UTIs in pregnant women are more likely to travel to the kidneys, so see your doctor right away. Recurrent UTIs can cause lasting kidney damage. “Make sure you take all of the medication your doctor prescribes,”says Dr. Berkman, “even if you are feeling better.”

How Can I Avoid UTIs?
“About 1 in 5 women who get UTIs will get another one,” says Dr. Berkman. “There are steps you can take to prevent a UTI, but if you still have symptoms, you should see your doctor.”

“UTIs can be painful,” says Dr. Berkman, “but they are manageable and with antibiotics we can generally avoid serious health risk. Listen to your body. There’s no need to live in pain and discomfort, so call your doctor when you think you have a UTI.”

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On November 15th, 2011, posted in: News by

Built for Life

Osteoporosis, which means “porous bones,” causes bones to become weak and brittle. In some cases, a fall or even mild stresses like coughing or bending can cause a fracture. Most fractures occur in the spine, hip or wrist. Although it’s often thought of as a women’s disease, men can have osteoporosis too. It’s never too late or too early to take steps to keep bones strong and healthy.

Calcium is important to help build strong, dense bones early in life and to keep bones healthy later in life. About 99 percent of the calcium in our bodies is in our bones and teeth yet calcium also helps blood clot, nerves send messages, and muscles contract. Every day we lose calcium and our bodies cannot produce enough calcium to meet our needs. Calcium supplements are helpful for people who cannot get enough calcium through their diets. Good nutritional sources of calcium are low-fat milk, yogurt and cheese and leafy green vegetables. Some products such as juice and breakfast cereal are fortified with additional calcium.

According to OB/GYN Eumena Divino, M.D., FACOG, three simple steps can help you build a foundation for life-long strong bones. “Calcium, Vitamin D and exercise are key,” says Dr. Divino. “Aim for adequate calcium intake – 1500 milligrams per day. Remember that your body can’t absorb more than 500 mg. of calcium at any one time so it’s important to space your calcium intake out during the day, either through supplements or diet.” Dr. Divino also recommends 800 to 1000 units of Vitamin D per day. “Weight bearing exercise is also important,” says Dr. Divino. “Aim for about 35 minutes of the kind of exercise that causes your lower extremities to bear the weight of your upper body.” She suggests walking, running and using a stair machine, or participating in sports like basketball or tennis. “Follow this simple regimen throughout your life and you can help avoid the risk of osteoporosis later in life,” suggests Dr. Divino.

Risk factors for osteoporosis include aging; ethnicity, especially white or Southeast Asian women and African-American and Hispanic men and women; a personal history of fractures after age 40; a parental history of osteoporosis or fractures; low body weight; or using medications that can cause bone loss, especially steroids.

Why Have a Bone Density Test?

“A bone density test is a painless, non-invasive procedure that takes just a few minutes,” says Dr. Divino. “The results will let you know if you are at risk or not. If you are, then you can work with your physician to create a plan of care.”


• You’re a woman age 65 or older.

• You’re a postmenopausal woman under age 65 with one or more risk factors for osteoporosis.

• You’re a man age 70 or older.

• You’re a man between age 50 and 70 with one or more risk factors for osteoporosis.

• You’re older than age 50 and you’ve experienced a broken bone.

• You’re a postmenopausal woman and you’ve stopped taking estrogen therapy or hormone therapy.

To schedule a bone density test, call The Centers for Women at Raritan Bay Medical Center, with two convenient locations in Old Bridge and Perth Amboy, at 732.324.5270.

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On August 19th, 2011, posted in: News by