Georgia Hormones
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  • Dr. Robert P. Goldman
  • Donna Smyth, PA-C
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    • Abnormal Bleeding, Weight Gain
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404.814.9808 • fax: 404.814.6086 • admin@centrespringmd.com
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FAQ

Appointments

Are you accepting new patients?
Yes. Call 770.475.0077, email drbob@georgiahormones.com or fill out a contact form. 

Does Georgia Hormones treat men with hormone problems?
Absolutely. In addition to treating female patients with hormone concerns and office gynecology, Dr. Goldman and his staff also treat men who experience hormone, aging and thyroid issues.

Is Dr. Goldman licensed as a standard gynecologist?
Since 1975, Dr. Goldman has been practicing obstetrics and gynecology. He has delivered thousands of babies and has performed many gynecologic surgeries (laparoscopic and laser). In 2005, Dr. Goldman stopped practicing obstetrics, limiting his practice to office gynecology, male and female hormone management, holistic medicine, menopausal management and minor in-office procedures.

I live out of state. Can I receive care by email or phone?
To provide proper individualized care, Dr. Goldman requires the initial consultation to be done in person. He will be happy to conduct follow-up visits over the phone. 

Bioidentical Hormones

Are bioidentical hormones made from plants?
Yes. All U.S. manufacturers of the bioidentical ovary and adrenal hormones are made from soy or wild yam.

Are bioidentical hormones FDA approved?
Yes. These hormones are manufactured at FDA approved facilities and shipped to individual compounding pharmacies.

Where do I buy bioidentical hormones?
There are many compounding pharmacies available around the U.S. To obtain a list of mail order pharmacies and Georgia area locations, click here. 

Are bioidentical hormones expensive?
Costs are comparable or even less than many commercial medications.

Will my insurance pay for compounded medications?
Each insurance company is different. It is advisable to check with your carrier to determine eligibility. Some insurance companies have their own mail-order compounding pharmacies.

Read more about Bioidentical Hormones.

Holistic Medicine

Is a holistic doctor a regular medical doctor?
Many alternative practitioners use the term “Holistic Physician,” but in the U.S. an MD must be trained at an approved medical school and be licensed to practice medicine. Dr. Goldman also received specialty training and board certification in Obstetrics and Gynecology.

Is there a term for a regular medical doctor?
Standard medicine taught in medical school in the U.S. and other western countries is called allopathic medicine. Allopathic means “against disease.” It is no coincidence that many medications begin with the word “Anti-” (e.g., antihistamine, antibiotic, antifungal,
anti-inflammatory, anti-cancer, antidepressants, antihypertensive, etc.). Treatment is aimed at countering symptoms and fighting diseases. This type of medical model declares war on a particular disease. Many have heard terms like the War on Cancer, the War on Drugs, the War on Heart Disease, the War on Diabetes and, more recently, the War on Obesity.

How is holistic medicine different?
Holistic physicians seek to correct the cause of disease. It is a peacemaker’s approach. War tends to produce casualties. Many powerful drugs have potent side effects. If possible, changing our lifestyle and seeking balance are much safer.

How did Dr. Goldman become a holistic physician?
Dr. Goldman has done extensive study in many complementary and alternative medical practices. He has taken coursework through the American Holistic Medical Association (now known as Academy of Integrative Health and Medicine) and was certified by the American Board of Holistic Medicine in 2004.

How is holistic medicine different from complementary and alternative medicine?
Many children and adult physicians focus on a single type of therapy. Some reject modern American, allopathic medicine altogether. As a holistic physician, Dr. Goldman is aware of the strengths and weaknesses of the allopathic system along with many complementary and alternative therapies. All therapy recommendations are made precisely for the individual patient and their specific needs. Holistic medicine is inclusionary, not exclusionary.

Menopausal Practice

How did Dr. Goldman become a menopause specialist?
Dr. Goldman always had a great interest in hormone balance. A Baby Boomer himself, shifting from delivering babies to menopause management was a natural progression. He joined the North American Menopause Society (NAMS) and became a Certified Menopause Practitioner.

I have looked at the NAMS website. They don’t seem to be in favor of bioidentical hormones. Why? 
Unfortunately, most leaders of the society are purely allopathic physicians and are financially connected to major pharmaceutical companies. They are not aware of the benefits of properly dispensed bioidentical hormones. Rather than separating himself from the allopathic community, Dr. Goldman feels it is better to stay connected to mainstream medicine and try to affect change from the inside.

Menopause Symptoms

How do I know if I am going through menopause?
Symptoms can vary from woman to woman. By testing hormone levels, Dr. Goldman can determine your menopause status.

I had a hysterectomy years ago but kept my ovaries.  Now I am having symptoms. Am I menopausal?
Without having periods to use as a guideline, hormone testing is especially important to determine your exact hormone status and needs.

I had an endometrial ablation procedure and stopped getting periods, but now I am having symptoms. Am I menopausal?
Without having periods to use as a guideline, hormone testing is especially important to determine your exact hormone status and needs.

Read more about Why Women Take Hormone Replacement Therapy, HRT Issues and Methods, and Unopposed Estrogen.

Male Hormones and Andropause

How did Dr. Goldman become an andropause specialist?
Many physicians who utilize bioidentical hormones are general practitioners, and most physicians’ coursework will include hormone therapy instruction for both men and women. Dr. Goldman has always been interested in maintaining his own health and vitality, following closely the advances made in male hormone therapy. Many of his female patients requested treatment for their husbands or companions, using the same techniques that he has applied to women. After significant study, Dr. Goldman has also been treating men for several years.
 
Does a man have to be middle-aged or older to be considered for male hormone supplementation?
There is no specific age. As men age, healthy levels of testosterone and DHEA gradually diminish. A man in his 30s or 40s usually produces higher levels than older men but may have lower levels that are inconsistent with his age. In holistic medicine, therapy needs to fit the individual patient needs. Hormone testing can be done to determine if a man’s symptoms are due to hormone deficiency. If so, treatment is available.

Are there other treatments for men with problems?
As in all holistic medicine, diet, exercise, lifestyle, stress and habits all have to be considered. It is possible that improvement can be achieved without needing additional hormones.

Hormone Testing

What kind of hormone testing do you do?
Georgia Hormones usually runs blood tests.

Will my insurance cover the tests?
Blood work is usually covered by most insurance companies.

How often will I need to be retested?
After a change in medication, form or dosage, testing is usually repeated in two to three months. Once stable and doing well, reevaluation a couple of times a year is usually sufficient.

I read that running tests through the saliva is best. Should I do that, too?
It is Dr. Goldman’s experience that blood tests are more accurate than saliva, especially when testing for estrogen, progesterone, testosterone and thyroid. Pituitary hormones are not available in saliva, and they play an important role when running tests. Additionally, insurance companies rarely pay for salivary tests, as salivary testing is not done by most large commercial laboratories.

Does Dr. Goldman ever test saliva?
Salivary testing is more practical in evaluating cortisol and adrenal gland function. Cortisol testing is accurate in both blood and saliva but must be done multiple times a day.

What about urine tests?
24-hour urine collection tests have the advantage of averaging results from various times of the day. The disadvantage is that they measure only what is excreted by the kidneys, which may not reflect hormone balance in the blood. They are still used for some special situations.

Hormone Replacement Therapy

Does every woman need Hormone Replacement Therapy (HRT)?
Each patient must decide for herself. Dr. Goldman does not try to push anyone into unwanted therapies or those with which they may not be comfortable. Become educated about your body and what the various hormones do, and decide for yourself.

Why should women take hormone therapy?
Relieving hot flashes and regulating bleeding are immediate benefits. Hormone support of bone, heart, skin, brain and vagina reduces many of the long-term, harmful effects of aging.

When should I start on hormones?
As women age, their hormones do not decline all at once. Progesterone is usually the first to go and may be needed to be boosted a decade or more prior to menopause. Estrogen is the next hormone to go. Testosterone is the last to decline; for some women testosterone can stay high into old age. HRT means just that — we replace only what is needed.

Is it OK to wait until my symptoms become worse?
Waiting to start taking hormones ten, twenty or thirty years after menopause begins may be too late to reap the benefits and may increase the risk of heart attack and stroke. Estrogen’s benefits to bone, heart, skin, brain and vagina are mostly preventative. Hormones cannot fix or restore what has already been lost or damaged.

How long will I be on the hormones?
As Americans age, many continue to become part of an ongoing study. Women and men are living longer, more active, functioning at a higher sexual level and enjoying increased vitality. Each year, Georgia Hormones will assess lifestyle and current medications to determine any modification or other course of treatment.

Will the prescription always remain the same?
In general, older women can be maintained at lower hormone levels than younger women. It depends on individual comfort and need.

Additional reading materials:
  • Hormone Replacement Therapy (HRT)
  • HRT Issues and Methods
  • Bone Health
  • Weight Control
  • The Women's Health Initiative
  • Holistic Male Health
  • Why Should Men Take Hormone Supplementation

Fibroids of the Uterus

Will hormone balance help my fibroids?
Fibroid growth is frequently related to estrogen excess. Progesterone and other therapies can frequently control excess bleeding and reduce further growth.

Will my fibroids shrink?
Slightly, but fibroids don’t usually shrink until menopause. Bleeding and pain can usually be controlled and further growth prevented. 

Bleeding Problems


Can Georgia Hormones regulate my cycle? 
Most irregular bleeding is due to hormone imbalance and can usually be corrected without surgery.

Can Georgia Hormones help diminish heavy periods and clots?
Most heavy bleeding and clots are due to hormone imbalance and can usually be corrected without surgery.

I am scheduled for a hysterectomy. Should I have the surgery first and then make an appointment? 
Please see us first; we can probably correct the problem without surgery. If you still have a uterus, maintaining hormone balance is easier than having a surgical procedure. 

I am scheduled for an Endometrial Ablation. Should I have the surgery and then see you?
Please see us first; we can probably correct the problem without surgery. If you still have a uterus, maintaining hormone balance is easier than having a surgical procedure. 

Read more about Unopposed Estrogen and Progesterone Use for Cycle Regulation.

PMS

Can you help my PMS?
PMS responds well to bioidentical progesterone given at the proper point in the cycle. There are several ways to administer progesterone. 

Migraines

I have started getting migraines. Could it be my hormones?
Some young girls and many women over 35 complain about getting migraines. We have found that with proper hormone balance, 25% of women will notice their migraines are permanently gone, while another 50% of women will see a significant reduction. The remaining 25% usually have non-hormone related migraines and should be treated symptomatically with other medications.

Weight Gain

I exercise and try to eat right, but lately my weight is shifting to my stomach. What can I do?
Hormone imbalance, especially unopposed estrogen, leads to fat deposits around the waist. Proper hormone balance reduces carbohydrate craving, enhances thyroid function and makes weight control easier. For more information about weight control, click here.
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Dr. Robert P. Goldman

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10220 Medlock Bridge Road  • Johns Creek, GA 30022
phone: 404.814.9808  •  fax: 404.814.6086  •  admin@centrespringmd.com