Internal Medicine Doctors of
Mill Basin & Bergen Beach, Brooklyn

6301 Mill Lane (Corner of East 63rd) in Mill Basin (11234)


Dr. Bella Zimilevich

Dr. Bella Zimilevich, MD
Primary Care Doctor

Dr. Bella Zimilevich

Dr. Anatoly Pisman, M.D
Physical Medicine & Rehabilitation

Considering Medical Treatment For Menopause Symptoms?

Posted by on July 23rd, 2013

Dr. Bella Zimilevich, MD

“Menopause is called ‘the change’ for good reason. While some women breeze through menopause without any problems, some women experience all of the menopause symptoms- hot flashes, depression, interrupted sleep, weight gain…Menopause is a great time to take stock of your health with a view to thwarting any conditions that may be a problem in the future. If you think you are in menopause, whether you are just starting the process or are nearing the end, come in and see me so that we can discuss what changes you can expect and plan for your healthy future”.

-Dr. Zimilevich, MD

What is menopause?

Medically speaking, a woman is said to be in menopause when she has not has a period for one full year. At this point, ovulation no longer occurs and a women can no longer become pregnant. Perimenopause is the period before menopause when estrogen levels begin to decline. Perimenopause can last several years. When women talk about menopause symptoms, they may be in the perimenopause period or may already be menopausal. It is the absence of the menstrual period for a period of one year that defines menopause. Women may have very irregular periods leading up to menopause.

What are the symptoms of menopause?

Symptoms of menopause can affect virtually every system of the body and can vary between women. No woman will experience menopause in exactly the same way as another. If you are nearing menopause you may experience:

  • irregular menstrual periods– periods may be very irregular and you may even skip several months between periods; they may also be heavier or lighter than normal
  • infertility– older women (women in their 40s) may have difficulty becoming pregnant as estrogen levels drop
  • vaginal discomfort and dryness- as estrogen levels decline, natural lubrication of the vagina also diminishes, which may result in vaginal dryness. Some women experience discomfort during intercourse. Vaginal atrophy refers to thinning and shrinking of the vaginal tissues, which can cause inflammation.
  • hot flashes– hot flashes are the most notorious of all menopause symptoms. Hot flashes involves a sensation of heat in the head, face and chest. These sensations occur suddenly and without warning and may be accompanied by palpitations or a  racing heart. Hot flashes may last for a few seconds to a minute or more. They may leave you feeling weak and clammy.
  • night sweats– if you wake up drenched in sweat even when the room is cool, you may have had a night sweat. These are similar to hot flashes but occur at night, often interrupting sleep
  • disturbed sleeping patterns– night sweats may keep you awake, but you may also be kept awake by anxiety or have difficulty falling asleep or staying asleep
  • mood swings– irritability is common in menopause and may be due to lack of sleep if sleep is interrupted. Rapid mood swings may also occur in women who are not sleep deprived. You may find yourself see-sawing between tears, laughter and every emotion in between
  •  urinary issues– lack of estrogen can contribute to weakened pelvic floor muscles, resulting in incontinence. Urinary tract infections are more common. Urinary frequency may occur.
  • joint pain– some women experience more frequent joint pain, or a worsening of preexisting joint pain.
  • headaches– some women experience more frequent headaches, while other women find that their headaches improve.
  • cognitive difficulties– difficulty in remembering and processing information may occur; forgetfulness is a frequent complaint
  • weight gain– muscle is replaced by fat, especially around the abdomen, and you may find it harder to lose weight
  • breast changes– breasts may atrophy (become smaller) due to lack of estrogen, and nipples may become smaller and flatter than before
  • hair changes– scalp hair may thin and become weaker and more brittle
  • bones– bones lose mass and become weaker in some women, leading to osteoporosis
  • skin changes– the skin becomes drier and less elastic after menopause
  • depression– some women experience depression before, during or after menopause. This is often due to fluctuating hormones and may be transient

How is menopause diagnosed?

If you have not had a period in a year or longer, it is safe to say you are in menopause! Otherwise, there is no sure way to diagnose menopause. Measuring FSH (follicle stimulating hormone) levels can give us an idea that you may be approaching menopause because FSH levels tend to rise as estrogen levels decrease; however, this is a far from perfect science as FSH levels can fluctuate wildly. The symptoms you are experiencing will provide many clues- if you have many of the symptoms you are likely approaching menopause.

What can I expect when I come to see you?

When you come in to see me and you suspect you may be in menopause, I’ll start by asking you about your periods: How often are you having periods? If your periods have stopped, when did they stop? I’ll ask you about any menopause symptoms you are experiencing and whether they are particularly bothersome. Most symptoms will pass with time; if they are impacting on your life, we can talk about how to manage them.

We’ll also discuss your risk factors for certain conditions, such as osteoporosis and heart disease. Menopause can raise your risk for certain health problems, so from now on it will be important that I see you regularly for checkups.

Menopause is the ending of one phase or your life and the beginning of another. Many women are glad to say goodbye to their periods, while others feel sad that their childbearing years are over, even if they did not plan on adding to their family. If you are feeling conflicted, this is perfectly normal. If you feel blue for a while that’s okay too- but if you feel depressed for longer than a few weeks and your symptoms are not improving, it’s time to do something about them.

If you are experiencing symptoms of menopause, come in and talk to me. Together we can determine where you are in your menopause journey and discuss ways to manage menopause symptoms. Make your appointment today.


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6301 Mill Lane, Brooklyn, NY 11234.

(718) 942-4600


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