Although the word “men” is part of menopause, men don’t typically figure into conversations about the subject. Dr. Frank Bonura, who recently became director of menopausal health at St. Catherine of Siena Medical Center in Smithtown, proves the exception to the rule.
And not just because he’s a man, but because Bonura spent the bulk of his 50-year medical career delivering babies — nearly 10,000 of them.
“It’s been my dream for the past 10 years,” Bonura said of the new position. As he began to see the need for menopausal medicine in the community and that women’s needs in this area were not being addressed, Bonura said he started including its treatment in his practice in the late 1990s.
Med school: Italian-style
Bonura doesn’t like to talk about his own age, but when pressed he’ll say, “I’m menopausal.”
He got his medical degree from the University of Rome, Bonura said, because graduating from college with a B-average made it difficult to get into U.S. medical schools at the time.
With an uncle working for the U.S. State Department in Rome, Bonura decided to study medicine there.
There was one catch: He didn’t speak Italian. To learn, Bonura studied Italian with a professor six days a week for four months before setting off for medical school from his home in Ridgewood, Queens.
“By the time I went to Europe, I was fluent in Italian,” he said.
During his medical studies, Bonura recalled getting a taste of each branch of medicine during three-month rotations.
“I loved ob,” he said referring to obstetrics and gynecology, “because I was able to do deliveries, which I always loved.
“I was able to operate. I was able to take care of babies. I was able to do internal medicine, taking care of the medical problems of obstetrical patients and also the gynecological patients that I operated on,” he said.
When he started teaching obstetrics and gynecology at Stony Brook in 1978, Bonura observed that of the 20 percent to 30 percent of students in the class who went into obstetrics, practically all were men. In the 1990s, he further observed, the ratio was divided evenly between the sexes, and today very few men go into the field each year.
Statistics from the Association of American Medical Colleges bear him out: In 2013-14, according to the AAMC, women made up 85 percent of gynecology residents in the United States. Men don’t want to spend 14 hours with a woman in labor, he explained. “They don’t want to be up all night doing ob.”
The lifestyle never deterred Bonura, though he eventually gave up delivering babies in 2004.
“It’s such a wonderful specialty. My only regret is that I’m at the end of my career, and I had to give up ob,” he said, noting that the number of deliveries he was doing toward the end of his private practice didn’t cover the exorbitant cost of malpractice insurance. “Otherwise, I would have never given it up.”
Bonura and his wife, Leni, live in St. James and have two sons who are both in their 40s.
“Unfortunately, although I’ve delivered over 10,000 babies, I don’t have one grandchild,” he mused.
Long-term career goals
Directing St. Catherine’s menopausal health program is the culmination of his most recent long-term goals, Bonura said. His earlier aspirations had been met: a 35-year private practice in obstetrics and gynecology; serving for 38 years as director of obstetrics and gynecology at St. John’s Episcopal Hospital (renamed St. Catherine’s); teaching as an associate clinical professor of obstetrics and gynecology at Stony Brook University; and establishing the osteoporosis program at St. Catherine’s in 1998.
When he started the osteoporosis program, Bonura observed there was no one specialized in menopause, so he became an active member of the North American Menopause Society. Citing census data, Bonura estimates that there are about 380,000 women in menopausal transition or menopause in Suffolk County.
He became more knowledgeable on the subject, going to national meetings, reading every journal he could find on the subject, and writing articles and a chapter in a textbook on menopause. His motivation, he said, was simple: He was seeing more and more women who had issues that weren’t being addressed and he felt that there wasn’t anybody else who had a high level of expertise.
Lorraine Black, of Smithtown, said she’s been under Bonura’s care for her premature osteoporosis for the past several years.
“Sometimes we don’t think about when we’re starting to hit menopause that there are other issues, not just gynecological ones, but other issues systemically,” said Black, who is in her 50s. “It really is something to shed light on.”
Bonura stresses the importance of determining the cause of the osteoporosis. Patients fill out a two-page questionnaire, which helps identify the cause of the osteoporosis. If the osteoporosis stems from an underlying condition, that condition may be treated.
“In some cases, doctors can treat the underlying medical condition or adjust your medication rather than putting you on a drug to treat the osteoporosis,” he explained.
For the 80 percent to 85 percent of menopausal women who have hot flashes, night sweats and insomnia, Bonura recommends medication only if the quality of their life is adversely affected.
All medication has side effects, some can be somewhat serious, and have contraindications for people with a history of breast cancer, heart disease and stroke so it’s best to avoid them whenever possible, he noted. Other issues menopausal women experience, including bladder infections, lower sex drive and overactive bladder, often are treated with medication.
A 38-year patient of Bonura’s, Lorraine Salvato, 65, of Montauk, is undergoing hormonal therapy.
“Now that I’m in my 60s, he really treats multiple parts of my body, not just the reproductive system,” Salvato said.
‘I love what I do’
Bonura attributes an active lifestyle — taking regular spinning classes, lifting weights, playing singles tennis, doing yoga and other exercise — as a factor in the longevity of his career.
Contentment, he maintains, is also key.
“I lead a very happy life,” he said. “I love what I do. My wife takes good care of me. I love my patients. I love my practice.
“It’s the old corny thing: if you love what you do, you don’t really go to work in the morning,” he said.
A good measure of discipline, apparently, also keeps him in good stead.
Bonura said he typically wakes between 4:30 and 5 a.m. — a carry-over from his years of medical residency — feeds the two feral cats his wife adopted, then indulges his favorite hobby: learning. Whether at home or on vacation, he said, each day starts with a perusal of medical journals. He also attends National Osteoporosis Foundation and North American Medical Society annual meetings.
“I’m dealing with your life,” he remarked about how he sees his patients. “How can I say with good conscience that I don’t know the latest information in my field?”
Dorothy Tuttle, Bonura’s first — and current — patient, recalled that he delivered each of her five children, even when he had a broken hand.
“He is interested in the whole person, not just the particular pregnancy or problem or whatever it may be,” said Tuttle, 70, of Coram, who now sees him in his menopause practice.
A community need
John Pohlman, chief operating officer for St. Catherine’s, said Bonura helped him see the need for menopausal medicine.
“From a health care hospital perspective, one of our goals should be what do we feel the community needs,” Pohlman said. “This is absolutely a community need. I know we’re focused in Suffolk County, but I think it’s probably a need throughout Long Island.”
“He is very passionate about the menopausal program and supporting that need for the patient population in the community,” Pohlman said, adding, “Passion is probably the best word I can think of to describe Dr. Bonura.”
Pohlman hopes other hospitals will follow suit and establish menopause programs.
Now that he’s achieved five major life goals, Bonura said there’s yet one more on his wish list: Preparing the program to continue for the long term. Ultimately, he would like to train someone to take over the program.
“That’s going to take a little while for me to do, and that’s my major focus right now,” he said.
Dr. Bonura on surviving menopause
Noting that women spend about one third of their lives in menopause, Dr. Frank Bonura says he makes the following recommendations to his patients:
For hot flashes and night sweats, avoid exercise, spicy foods, smoking and alcohol before bed;
Take vitamin D (800 to 1,000 IU) with the largest meal of the day because it’s fat soluble;
Have bone density scans every two to three years;
Exercise seven days a week for a at least a total of 150 minutes per week, including daily walks, weight-bearing exercise and high-intensity workouts.