Tishrei 5783 / October 2022

Oct 23, 2022 | new newsletters | 0 comments

Dear Friends, 

As we begin an auspicious new year, we look forward to even more growth, connection, and progress together with you. 

Once again, we thank you, our readers and partners, for your encouragement and participation. 

We wish you a healthy and happy winter – and a year of fulfilled dreams!

Rabbi Yitzchok Melber


We are pleased to announce that Rabbi Melber will be visiting the Los Angeles area next week for the upcoming ASRM conference, and looks forward as well to counseling couples struggling with infertility, pregnancy loss, and/or genetic issues. To take advantage of this opportunity, please click here or call 888 565 3628.

Updates will be shared following the trip.


Last week, Rabbi Melber attended the NAMS (North American Menopause Society) conference in Atlanta. This annual meeting of US/Canadian medical experts is the leading association in the field of perimenopause and menopause – in both the research and licensing arenas. Menopause is now an official subspecialty, as is befitting this complex and often difficult stage of life. In most countries this subspecialty is not defined and many people will simply visit their ordinary gynecologist; however, it is advisable to visit a subspecialist because this has become a very advanced field.

Overview: Perimenopause and Menopause

Everyone in the women’s health field knows of the potential challenges of menopause, which affect approximately 50% of women. Although there are over 25 symptoms related to menopause, the vast majority of women are suffering in silence. Over 40% of women don’t reach out for help, and of the 60% who do reach out, only about 35% are actually getting the proper medical help available; they are using largely ineffective alternative methods. 

There is a dearth of awareness and proactivity in this area, particularly in our community.

This is something we need to focus on – as leaders and laymen. 

The most common menopause-related issues are:

  • Hot flashes/VMS (Vasomotor symptoms)
  • Sleep disturbance
  • Emotional challenges
  • GSM (Genitourinary syndrome of menopause)
  • AUB (Abnormal uterine bleeding)

Updated for 2022: NAMS Position Statement for Hormone Therapy

Hormonal therapy is still a controversial treatment option for menopause symptoms, but this well-researched paper provides reassurance for women to rely on when exploring this path. At Tahareinu, we highly recommend this treatment, because it is based on a concept of benefits outweighing risks. Shared decision making is key here, because each case is so individual. 

Read the entire paper here.

Here we share several conclusions culled from this paper:

  • Hormone therapy is the most effective treatment for VMS and GSM, and has been shown to prevent bone loss and fractures associated with menopause/perimenopause.
  • HT has an antidepressant effect for perimenopausal women, and enhances mood and improves well-being in non-depressed perimenopausal women.
  • For women with POI (Primary Ovarian Insufficiency) who have either lost their cycle young or have irregular cycles below age 40, the health risks are well-documented and include serious conditions such as heart disease, hypertension, and stroke. This is a condition that requires medical intervention; it’s not simply a matter of quality of life.

When a woman begins having an irregular cycle at a young age, even if she doesn’t have Tahara challenges, she must address the issue. 

Hormone therapy is recommended at least until the average age of menopause, approximately 52 years.

Oral contraceptives may be an alternative form of hormone therapy with contraceptive benefits, because spontaneous pregnancy may occur in about 5% of women with POI.

Hormone therapy is FDA approved for four indications: moderate to severe VMS; prevention of osteoporosis in postmenopausal women; treatment of hypoestrogenism caused by hypogonadism, BO, or POI; and treatment of moderate to severe vulvovaginal symptoms. 

Another treatment option is Compounded Bioidentical Hormones. It is important to know that these have minimal government regulation, and should not be confused with FDA-approved hormonal treatment. Patients should be aware that these are actually medications, not vitamins, and should be employed with caution. From the perspective of NAMS there is no benefit to this option, but if you and/or your doctor prefer it for an individual reason, it can be used

Laser and technology for GSM (dryness in the vaginal area)

This condition can be helped with a low dose of Estrogen (as per NAMS). Some people don’t want to take medication, or hormones specifically, and want to utilize this option. 

There are multiple kinds of laser treatment available, and they are constantly evolving, so patients should be aware of their options. Also, the expectation of success should not be unreasonably high, as its efficacy is still in debate.

Alternative solutions for menopause symptoms:

Patients often want to explore alternative options as opposed to a purely medical route. NAMS divides these routes into three categories, as displayed below:


(proven effective)
CBT (Cognitive Behavioral Therapy), Clinical Hypnosis. 
Recommended with caution: 
(efficacy debatable)
Mindfulness and relaxation
Not recommended: 
(no proof of efficacy)
Paced breathing, exercise, and yoga

Breast cancer: Turn off the faucet

NAMS also featured lectures on breast cancer, the main takeaway being that 30-40% of cancers that kill women can be prevented. How? 

Dr. Dawn M. Mussallem of Mayo Clinic presented astounding information on the role of weight loss and physical activity in prevention of breast cancer: 

There are, unfortunately, 43,250 breast cancer deaths annually in the US.

Of those, 33% are preventable. 

11% of cancers in women are attributed to excess body weight.

Obesity puts women at a 20% greater risk of cancer, and it is crucial to lose extra weight specifically in this age bracket. Because it is difficult to lose weight at this age, options for weight-loss treatment should be explored. 

Currently, there are about 20 pharmaceutical weight-loss medications. The injections are popular, and a preferred effective option. It should be noted that hormonal changes in the body lead to changes in fat destruction and eating. When a woman is over the age of 40, even at the same level of food intake the body will retain more fat; therefore, these options should be considered when appropriate.

As Dr. Mussallem says, “Instead of mopping the floor by treating the various outcomes, we need to turn off the faucet by managing weight first.”

The AICR (American Institute For Cancer) guidelines include limiting meat, added sugar, and highly processed foods. Eggs and dairy items are in the questionable bracket, and fruit, vegetables, nuts, and seeds are highly beneficial. 

A note on menopause: 

These are the golden years for most women. Any effect on quality of life impacts not only themselves but their spouses, children, and career. 

Our perspective is that better quality of life is key, and with the right treatment it can be enhanced tremendously. Take the first step – and reach out.

Update: Record-breaking visit to tri-state visit a resounding success!

With an incredible 52 meetings in one week, Rabbi Melber’s recent visit to New York and New Jersey concluded with both missions successfully executed: He conducted in-person meetings with 33 couples, and met with many in the medical field together with Rabbi Dovid Bartfeld to cement relationships and initiate vital connections. 

While in Monsey, Rabbi Melber visited Refuah Health Center and met Mrs. Sternberg, the CEO, as well as many doctors in myriad departments. already enjoy an established collaboration with this eminent medical center, and were pleased to forge further ties with their expert team.

In Manhattan, they met Dr. Baruch Abittan, Reproductive Endocrinologist at Extend Fertility, under the leadership of

Dr. Joshua Klein. Dr. Abittan is a welcome new member to this eminent team, and we look forward to collaborating with him further.

In Lakewood, they were excited to visit Dr. Isaac Glatstein in his new infertility clinic, Conceive NJ. This stellar new facility has already established itself as a rising star on the New Jersey fertility horizon.

Rabbi Melber, Rabbi Bartfeld, and Tzvi Goldman also met with Dr. Allen Morgan and his  team at Morgan Fertility – an established clinic in Lakewood trusted by Rabbanim and community leaders. Dr. Morgan and the entire team were very welcoming and are open to working with the Rabbanim and our community.

They also had a chance to meet the TRU Birth Center team to get an inside view of the infrastructure and their valuable services. 

Rabbi Melber was privileged to meet with Rabbi Yaakov Forcheimer Shlita and Rabbi Shmuel Meir Katz Shlita, leading Rabbanim in Lakewood, to discuss issues that couples in our community are facing. He also presented several Shailos. and received their Bracha for the vital work of Tahareinu in enhancing Tahara and growth in our community. 

Rabbi Melber was privileged to meet with Rabbi Yaakov Forcheimer Shlita and Rabbi Shmuel Meir Katz Shlita, leading Rabbanim in Lakewood, to discuss issues that couples in our community are facing. He also presented several Shailos. and received their Bracha for the vital work of Tahareinu in enhancing Tahara and growth in our community. 

Rabbis Melber and Bartfeld also met Dr. Esther Hirschhorn in Queens at her women-only center, Women for Women. She is a compassionate frum doctor who is beloved by so many women in our community.


Tahareinu is proud to announce the assembly of the Tahareinu Online Marketing Team. We are particularly excited to have added this new division that will help us have a stronger reach and impact, and a closer connection to those that seek our services. We are pleased to report that in just a short period of time our two active accounts have begun to grow, and with your help we’ll B”EH reach all those that may benefit from our services. This objectives of this team are to disseminate important innovations and concepts related to reproductive health and Tahara, highlight new and exciting Tahareinu events and happenings around the globe, and to achieve our goal in serving as the premier organization providind medical solutions for couples.

Please join us in welcoming our newest additions to the Tahareinu family and community. Be sure to follow and share with friends and family the
Tahareinu USA and the Tahareinu Jerusalem accounts!

(Keep an eye out for additional accounts tailored to your location, and be sure to contact us with any questions, concerns and/or thoughts).

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Call the Tahareinu Hotline!

Got a question about relieving tahara problems, infertility, reproductive health, pain or other related issues?

call the Tahareinu hotline

For ongoing infertility, recurrent pregnancy loss, or reproductive genetic issues,
you and your spouse are warmly invited to schedule an in-person, phone or Zoom consultation with our founder and president, Rabbi Yitzchok Melber.

Please send an email to rabbimelber@tahareinu.com Include your first name and location, and briefly describe your issue.

Personal consultations are for more involved reproductive issues. Note the Israel
office has reopened for in-person consultations,
in line with the country’s coronavirus status.

Most Tahareinu issues are addressed by our hotline advisors, 13 hours a day, 5 days a week. If you are unsure whether to schedule a consultation, call the hotline first.