Archive by Author | Dr. Swica

Look, It’s Probably Perimenopause

Dr. Swica in an interview on

The following is an excerpt of the interview.
Click here to see the entire piece on

by Karen Russo

“Aside from the ‘classic’ symptoms of hot flashes and night sweats, many women experience increased anxiety, depression, poorer sleep, worsening migraine headaches, difficulties with executive functioning and concentration, worsening PMS symptoms, hair loss, increasing bladder irritability or more frequent urinary tract infections, low libido, vulvar irritation, and dryness or pain with vaginal sex. These symptoms can build gradually or be intermittent, and can begin while a woman is still having regular menstrual cycles — which can be very confusing for women and also for their doctors,” says Dr. Swica. “How can these symptoms be due to menopause if a woman is still having regular cycles? The symptoms must be due to something else, like a thyroid, adrenal, autoimmune, or psychiatric disorder.  However, menopause, like puberty, is a multi-year process. During that process, women can experience many unpleasant and even disabling symptoms. The transition to, and away from, fertility does not happen overnight.  Fortunately, we now know more and have effective options for treating the problems women face as they move through the perimenopausal transition.”

This was an excerpt of the interview.
Click here to see the entire piece on

This entry was posted on September 16, 2021.

5 Questions Every Woman Over 40 Should Be Asking Her Doctor

A Q&A with Dr. Yael Swica and Tiffany White, Features Editor at First For Women:


Although entering your 40s is an important milestone full of new chapters and experiences, for many women, aging is the start of health changes. Women over 40 are typically more at risk for heart disease, osteoporosis, and cancer, and so it’s important to be more cognizant of these areas of your health going forward. Fortunately, you can easily do that by being prepared with the right questions to ask the doctor when you go in for your annual check-up or gynecological exam. We asked Dr. Yael Swica, a women’s health doctor and Assistant Clinical Professor of Family Medicine at Columbia University, what questions you should be asking your doctor:

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This entry was posted on March 14, 2018.

Treating Osteoporosis

See published letter to New York Times, Sept. 4, 2012:

NY Times - Letter to the Editor, September 3, 2012

Published: September 3, 2012

To the Editor:

Too Many Bone Tests for Some, and Too Few for Others” (The Consumer. Aug. 28) neglects to mention one effective and well-tolerated treatment for postmenopausal women under 65 who are at high risk for osteoporosis: hormone replacement therapy. The reduction in fracture risk associated with use of hormone therapy is comparable to that from bisphosphonate drugs, and its use addresses the most salient cause of this disease that so disproportionately affects older women: loss of estrogen.

Yael Swica, M.D.



This entry was posted on September 4, 2012.


A scientific article that questioned the existence of PMS created a stir. The Atlantic Monthly published an article based on the article’s findings. These are my thoughts about the study:


Twenty six out of the 47 articles in Roman et al.’s meta-analysis had sample sizes of 50 or fewer, only three used a random sample, very few used a comparison group (i.e. non-cycling women such as those using the pill or other anovulatory agent), none included in their methodology an a priori quantification of what is a meaningful increase in symptoms of PMS, the list goes on. The authors themselves expressed their regret over how flawed or inadequate the studies were. The most reasonable conclusion for the authors to have drawn is not that the research to date fails to provide evidence of PMS and therefore it must be a cultural construct, but rather that the research to date has been of such poor quality that it is unable to answer the question of whether or not menstrual cycles significantly affect mood and quality of life. The adage “garbage in, garbage out” applies.

This entry was posted on July 19, 2012.