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Internal Medicine Doctors of
Mill Basin & Bergen Beach, Brooklyn

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

718-942-4600

Dr. Bella Zimilevich

Dr. Bella Zimilevich, MD
Primary Care Doctor

Dr. Bella Zimilevich

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

Dr. Bella Zimilevich

Dr. Alexander Shapsis, M.D
Gastroenterologist

Women’s Health

 

Medical Treatment For Vaginal Yeast Infections (Candida infection)

Posted by on August 28th, 2013

Dr. Bella Zimilevich, MD

“Most women will experience a yeast infection at some point in their life. Yeast infections are very common and are not a sexually transmitted disease. They can be easily treated. If you have symptoms of a vaginal yeast infection and aren’t sure about your symptoms, come in and see me.” 

-Dr. Bella Zimilevich, MD

What is a vaginal yeast infection?

Vaginal yeast infections cause irritation of the vagina and vulva (the tissue surrounding the vagina). It is a very common infection- almost all women will experience at least one yeast infection in their life. For some women, yeast infections may occur more than once.

What causes vaginal yeast infections?

Yeast infections are caused by an overgrowth of Candida albicans. Candida is always present in the vagina, but sometimes an overgrowth of this yeast occurs, resulting in the symptoms of yeast infection. Overgowth can occur when the pH of the vagina is altered. Many factors can influence the internal conditions of the vagina, including:

  • hormonal changes– some women may experience a yeast infection around the time of their period due to hormonal changes; pregnancy also increases the risk of developing a yeast infection
  • illness
  • medications– steroids and birth control pill may increase your risk of infection; antibiotics are the worst offenders because they kill of the normal flora (healthy bacteria that reside in the vagina) that normally keep yeast in check
  • altered immunity– conditions such as HIV and diabetes can make your body more prone to yeast infections
  • lifestyle factors– stress, lack of sleep and a poor diet have all been implicated in yeast infections

What are the symptoms of a yeast infection?

Symptoms of a yeast infection may include:

  •  redness and swelling of the vagina and vulva
  • soreness/itchiness of the affected area
  • pain during intercourse or when urinating
  • a rash in the vaginal area
  • thick, white discharge the consistency of cottage cheese but without an odor

Symptoms can be mild or very severe. If your symptoms are very severe, you will be unlikely to be able to ignore them.

Do I need to see you if I think I have a yeast infection?

It depends. If you have never had a yeast infection before, you should come in and see me. Yeast infection symptoms can be similar to the symptoms of certain sexually transmitted infections. It is best to be sure you actually have a yeast infection.

If you have had a yeast infection before and you are in a monogamous sexual relationship (meaning that you are fairly certain that both you and your partner have not been with anyone else), you might try an over-the-counter remedy recommended by your pharmacist.

If you treat yourself and your symptoms do not improve or they reoccur, you need to come in and see me.

What can I expect when I come in to see you?

When you come in and see me, I’ll ask you about any health problems you might have. I will also ask about any allergies you have. I’ll ask when your symptoms started and whether you have had similar symptoms before (and if so, how were you treated?)

In order to make the correct diagnosis, I will need to examine you. You will be asked to change into a gown and provided with a sheet for comfort and modesty while I examine you.  The entire procedure is over in minutes and is not painful; although it may be mildly uncomfortable if you are inflamed in the vaginal area. I’ll explain everything I am doing before I do it, and if you are feeling nervous, or if you have never been examined before, please feel free to ask questions or let me know. I’ll tell you what to expect every step of the way.

If I think you have a vaginal yeast infection, I may prescribe an antifungal cream or suppository. I may also prescribe an oral antifungal medication. What I prescribe will be dependent on whether this is your first yeast infection and your overall health.

If you have had frequent yeast infections, I may suggest treating your partner as well. Although a yeast infection is not a sexually transmitted disease, men can also get a yeast infection and it is possible that you and your partner may pass the infection back and forth to each other. In addition, I may do some testing to make sure that your immune system is functioning the way it should.

Can yeast infections be prevented?

 There are several things that you can do to avoid a yeast infection. Yeast thrives in a warm and moist environment, so bearing that in mind:

  • avoid douching (this may kill off the normal flora of your vagina, allowing yeast to overgrow)
  • avoid tight clothing or underwear made of nylon or synthetic fibers that don’t “breathe”
  • shower instead of bathe, and avoid hot tubs
  • get out of your wet bathing suit as soon as possible
  • avoid bubble baths and other scented products that come in contact with the vaginal area

If you think you have a yeast infection but aren’t sure, or you are experiencing frequent yeast infection, make an appointment to come in and see me. We’ll soon have you feeling back to normal.

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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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Menstrual Problems (Long Periods, Heavy Periods, Irregular Periods, Painful Periods, etc.)

Posted by on July 6th, 2013

Dr. Bella Zimilevich, MD

“Menstrual problems are very common. While some women sail through their periods without ever experiencing any issues, other women experience heavy, prolonged, irregular or painful periods that can impact their life greatly. Menstrual problems can be caused by a wide variety of issues, from structural to functional to hormonal problems. If your periods are ruling your life, causing you to dread their appearance, it’s time you did something about them. Most menstrual problems can be treated effectively”.

-Dr. Bella Zimilevich, MD

Skipping periods (irregular or absent periods)

Many women will occasionally miss their period for good reason. This may occur if you are pregnant, breastfeeding or have reached menopause. Young women often have irregular periods in the first year or two after first starting their period. If none of these apply to you, the cause may be:

  • problems with the pituitary, thalamus or the thyroid gland-these glands secrete hormones which influence the menstrual cycle
  • prolonged strenuous exercise
  • very low body weight- excess exercise and low body weight (gymnasts are a prime example) may result in absent or irregular periods
  • anatomical problems of the cervix, vagina or uterus
  • chronic illness- if you have been unwell, you may stop ovulating
  • hormonal imbalances
  • stress- severe and prolonged stress may actually cause your periods to stop for awhile
  • premature menopause- occasionally, women will go into menopause earlier than expected
  • ovarian problems- large cysts on ovaries and other problems may influence hormone levels
  • certain medications- chemotherapy, antipsychotic drugs and hormones may affect your periods

Absent periods (known as amenorrhea) means that your periods are totally absent. In primary amenorrhea, a young woman reaches the age of 16 without starting her period. In secondary amenorrhea, a woman who has previously had a period misses her period for six months or longer. The cause of amenorrhea may be any of the problems listed above.

Painful Periods (Dysmenorrhea)

Painful periods are common menstrual problems. Many women experience cramps and lower back discomfort in the first day or two of their period, but for some the pain can be severe enough that normal activities become difficult. Abdominal cramping and back pain may be accompanied by nausea, headache and sometimes vomiting.

Primary dysmenorrhea is caused by contractions of the uterus. It is estimated that almost half of all menstruating women have primary dysmenorrhea. Symptoms are often at their worst in the first day or two of their period.

Secondary dysmenorrhea is caused by an underlying problem such as:

  • IUDs (intrauterine devices)
  • uterine abnormalities such as fibroids (abnormal growths in the uterus)
  • endometriosis (a condition in which uterine tissue is present outside the uterus)
  • PID (pelvic inflammatory disease) caused by infection of the uterus, fallopian tubes and/or ovaries)

Heavy or Prolonged Periods (Menorrhagia)

When periods are abnormally long (lasting more than a week) or very heavy, with large clots and episodes of flooding, anemia can occur. There are many problems that can cause menorrhagia, such as:

  • uterine fibroids or polyps
  • a bleeding tendency or disorder
  • cancer (rarely)
  • infection
  • thyroid disease
  • kidney or liver disease
  • hormonal imbalances
  • certain medications (aspirin, anticoagulants)
  • IUDs

What can I expect when I come to the clinic with menstrual problems?

If you come to see me complaining of irregular, prolonged, heavy and/or painful periods, I will first ask about your past gynecological history, including the age you first began menstruating, length and duration of normal menstrual cycles, when the problem started and whether you have been pregnant and/or given birth before. I’ll ask about medications you are taking. I will also perform a physical exam, which may include a vaginal exam and pap smear if necessary. I may order blood work or other diagnostic tests, depending on what I think the problem may be.

What treatment is available for menstrual problems?

The treatment I prescribe will be dependent upon what is causing your menstrual problem. Because there are so many possibilities, I can’t list them all here. Suffice it to say that most menstrual problems can be treated.

If you are experiencing heavy, painful, irregular or prolonged periods, make an appointment to come and see me. Your period should not make you feel miserable. Treatment is available, but in order to help you with your menstrual problems I first need to see you, so make your appointment today.

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Women’s Health

Posted by on May 24th, 2013

Dr. Bella Zimilevich, MDAs a female and a physician, I know how easy it is to put your health on the back burner. Women’s health is about taking care of you. I try to make uncomfortable exams as comfortable as possible and provide you with the information you need to make decisions regarding your personal health”.

– Dr. Bella Zimilevich, MD

As a woman, you know the importance of regular internal exams. Regular exams can detect problems such as cervical cancer while they are still easily treated. In addition, seeing your physician regularly provides you the opportunity to discuss any women’s health issues such as breast health, menstruation problems, urinary health problems or sexual health issues.

Understandably, women often prefer to see a female physician for women’s health care, particularly if they have experienced an impersonal or uncaring gynecological exam. It is far easier to discuss women’s health issues with someone who understands the female body from a personal perspective.

I want you to feel comfortable coming to me for your health care. I provide personal, discreet and compassionate care for a variety of women’s health needs, including:

Routine medical care can prevent many women’s health conditions, such as cervical, uterine and breast cancer, and allow you to function at your best. If it has been too long since your last female health exam, make an appointment today- you’ll be glad you did.

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Urinary Tract Infection (Bladder Infection)

Posted by on May 15th, 2013

Dr. Bella Zimilevich, MD“Urinary tract infection, or bladder infection, is a common problem. If you have a urinary tract infection, ignoring the symptoms will not make it go away and may lead to complications. It is best to come in and see me as soon as possible if you think you may have one”.

– Dr. Bella Zimilevich, MD

What causes urinary tract infection?

Bladder infections (urinary tract infections) are very common, especially in women. Why? It’s basic anatomy 101- the urethra, the tube that carries urine from the bladder to the outside of the body, is much shorter in women and the rectum, vagina and urethra are close together, making it easy for bacteria to spread from one area to another. Women are more prone to bladder infection during pregnancy because the weight of the growing baby places a lot of pressure on the bladder. In men, the urethra is much longer, which means that bacteria must travel a greater distance to reach the bladder. However, as men age the prostate gland often enlarges, which can make it difficult to completely empty the bladder.

Untreated bladder infections may lead to pyelonephritis (kidney infection), which is far more serious and can make you very sick. A kidney infection can be life-threatening if it spreads to the bloodstream. For this reason, it is best to treat simple bladder infections before they cause serious illness.

What are the symptoms?

If you have a bladder infection, you may notice:

  • burning pain with urination (this is usually the symptom that will make you run to pick up the phone and call for an appointment!)
  • hematuria (blood in the urine which may be visible or microscopic)
  • lower belly discomfort
  • urinary frequency (feeling as though you need to run to the washroom constantly)
  • urgent need to urinate (“I have to go NOW”)
  • cloudy or foul-smelling urine

If you have a kidney infection, you will feel very ill. You may experience flu-like symptoms, including fever, chills, headache and flank pain (pain in your back just below your ribs). You may feel nauseated and lose your appetite. Older adults may become confused or even delirious. Sometimes confusion is the only symptom of urinary tract infection in older individuals.

What can I expect at my appointment?

To diagnose a urinary tract infection, I’ll ask you about your symptoms. I may examine your belly to rule out any other causes of your symptoms and press on (palpate) your kidneys to see if you have any pain that might indicate kidney involvement. You will be asked to provide a urine sample. If we determine that bacteria in your urine is the likely culprit for your symptoms, I will prescribe an antibiotic. Your specimen will be sent for culture to determine the type of bacteria that is causing your infection.

What is the treatment?

If we determine that you have a bladder infection, I will prescribe an antibiotic. Remember, it is very important that you finish all of your medication. Do not stop taking the antibiotics even if you feel better after a day or two- stopping the antibiotics too early may result in reinfection and may make it harder to treat. If you have a urinary tract infection, you should drink plenty of fluids. This will help to keep you well hydrated and also helps to wash the bacteria out of your urinary tract.

If you have symptoms of a bladder infection, don’t delay. Make an appointment to come in to see me- I’ll have you on your way to feeling better in no time at all.

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Pap Smear

Posted by on May 13th, 2013

Dr. Bella Zimilevich, MD“As a female doctor, I have a keen interest in women’s health issues. I understand what women worry about and what women should worry about. I offer gentle, discreet and professional medical care to women from puberty to menopause and every stage in between.”

– Dr. Bella Zimilevich, MD

Pap smears are an essential part of women’s health maintenance. If you’d rather have a root canal than a Pap smear, you’re in good company! However, although most women dread them, a Pap smear appointment is actually the ideal time to discuss any unusual symptoms or ask a question that you may have been wondering about, including questions about sexuality, breast health issues, menstrual issues or any other subject related to female health and/or reproduction. There is no question that you can’t ask me and, being a female doctor, I will understand if you have had a “bad experience” with Pap smears in the past. I’m here to ensure that your Pap smear experience is a positive one going forward.

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Our Location

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6301 Mill Lane, Brooklyn, NY 11234.

718-942-4600

We are not a hospital/urgent care facility. Our urgent care services are offered during normal business hours only.
Mill Basin Clinic Location

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