Steven R Goldstein, MD

02/15/2026

02/15/2026

02/06/2026

There’s been a lot of buzz about progesterone being “great for sleep.” Yes, natural progesterone can make some women sleepy, but that’s not the whole story. For others, it does nothing. And for many, it causes fatigue, mood swings, irritability, breast tenderness, and even acne. Around 10% can’t tolerate it at all. Progesterone absolutely has medical uses, and when you need it, we prescribe it at night, but it should not be used as a sleep aid. Women deserve the whole picture, not half the story.

01/28/2026

Let’s talk about side effects.

Patients often ask me, “What are the side effects of this medication?” And my answer is usually this: the most common side effect is the reason you’re taking it.

If I prescribe medication for severe osteoporosis, the most common side effect is fewer fractures. If I prescribe menopausal hormone therapy for night sweats that wake you up three times a night, the most common side effect is sleeping through the night.

Too often, we focus on very small percentages listed on drug labels. Many of those appear simply because they occurred slightly more often than placebo, sometimes in just over 2% of people.

That’s why you’ll see labels listing things like weight gain and weight loss, increased hair and decreased hair.

It’s important to understand risks, but it’s just as important to remember the intended benefit. The main side effect is usually the help you were looking for.

01/13/2026

Most people think of a fracture as a short-term problem. But as we get older, it can affect much more than just the bone.

There’s a surprising statistic: after a hip fracture, about 1 in 5 women don’t make it through the following year, often because of loss of mobility, independence, or medical complications, not the fracture itself.

That’s why bone health matters so much.

Strong bones support independence, movement, and quality of life as we age, and that’s something worth protecting.

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01/03/2026

📸 Let’s talk about the hidden downside of modern imaging.

Today’s MRIs, ultrasounds, and scans are so sensitive that they often find things we were never meant to see, what I call “incidental-omas.”

These are incidental, benign findings discovered when we weren’t even looking for a problem.

👉 1 in 8 menopausal women has a uterine polyp that never causes symptoms and the risk of cancer is less than 1 in 1,000.
👉 1 in 7 menopausal women has a simple ovarian cyst, benign and not precancerous.

Yet the complication rate from removing these can be as high as 4%, making the treatment riskier than the finding.

Imaging saves lives, but it can also lead to unnecessary anxiety, testing, and even surgery if we don’t put results in context. 🧠🩺

12/29/2025

When we think about bone health, most of us immediately jump to calcium, vitamin D, or bone density scans. But what often gets overlooked is the incredible role of muscle. 💪🦴 There’s a medical term you may not have heard before: sarcopenia. It refers to the natural, age-related loss of muscle mass that accelerates with age. And here’s why this matters—especially for women:

➡️ Even a modest degree of muscle loss can triple to quadruple the risk of falls and fractures.

➡️ This elevated risk exists regardless of bone density. Meaning, even if you don’t technically have “low bone mass,” the loss of muscle still makes you more vulnerable.

➡️ Falls are one of the biggest
contributors to fractures later in life, which can be life-changing events for women’s independence and long-term health.

Muscle is not just about strength or aesthetics. It’s an organ of longevity. The more we protect it through resistance training, adequate protein intake, and movement, the more we protect our bones and our quality of life.

12/22/2025

So what’s the key to healthy aging? It really comes down to lifestyle choices. Your weight, blood sugar, smoking status, exercise, and nutrition all matter more than any quick fix. We don’t like hearing this; we want a pill or supplement to do the work for us, but the reality is that the basics truly drive long-term health. If you want to take a deeper dive, check out my website linked in my bio.

12/22/2025

There’s no such thing as anti-aging. People have been searching for the fountain of youth for centuries, and it still doesn’t exist. What does matter is healthy aging, focused on longevity, prevention, and evidence-based care.