Balance Hormones

To Foresee Is To Forestall

A third of our life happens post menopause (roughly 33 years if we take the average age for menopause of 51 and as the average life expectancy for women in the EU of 84). Women may also spend up to 10 years dealing with perimenopause symptoms. That is roughly half of our life expectancy spent with a variety of symptoms that decrease our quality of life and productivity.

Patients on HRT (Hormone Replacement Therapy) report “feeling like themselves again”. So discovering the right treatment cadence and dosage is a strategic investment in the next 30-40 years of our life.

A simplified self-diagnosis to know which hormone is low:

Low Progesterone: You may feel anxious, irritated, and wired.
Low Estrogen: You may feel dry, hot, and weepy.
Low Testosterone: You may feel tired, weak, and unmotivated.

Note that different women experience different symptoms at different intensities. There’s overlap or synergetic effect between hormones. Troubleshooting and fixing symptoms is often an iterative process.

A medical graph showing fluctuating estrogen and testosterone levels managed by hormone replacement therapy

A woman meditating cross-legged in a bedroom, highlighting the mental wellness focus of hormone replacement therapy.

Mapping Hormonal Imbalance: Symptoms Throughout Your Body

Sleep: Low Progesterone causes fragmented sleep and nocturnal awakenings (loss of GABA calming effect); Low Estrogen causes night sweats and early-morning awakenings.
Mood: Low Progesterone leads to irritability and anxiety; Low Estrogen is linked to depression and anhedonia; Low Testosterone reduces motivation and assertiveness.
Menstrual Cycle: Low Progesterone causes heavy, irregular bleeding (unopposed estrogen); Low Estrogen results in shorter or skipped cycles.
Vasomotor Symptoms: Low Estrogen is the primary driver of hot flashes and night sweats.
Libido & Sexual Function: Low Estrogen causes vaginal dryness and pain; Low Testosterone is the primary cause of reduced spontaneous desire and weaker orgasms.
Cognitive Symptoms: Low Estrogen causes "brain fog" and memory lapses; Low Testosterone reduces strategic thinking and mental drive.
Metabolism: Low Estrogen promotes central fat (belly fat) and insulin resistance; Low Testosterone causes loss of lean muscle mass, slowing metabolic rate.
Skin & Hair: Low Estrogen reduces collagen and skin elasticity; Low Testosterone can contribute to reduced hair density.
Bone & Muscle: Low Estrogen is a major contributor to osteoporosis and sarcopenia; Low Testosterone reduces physical stamina and muscle strength.
Urogenital Health: Low Estrogen leads to Genitourinary Syndrome of Menopause (atrophy, itching, and frequent UTIs).

What Treatment May Look Like

HRT is a dynamic, iterative process tailored to your unique biology. Unlike a standard prescription, your doctor will adjust dosages and timing based on blood tests and symptom tracking. You’ll typically stabilize one hormone before introducing another, eventually moving to check-ins every 3–6 months.

Progesterone (Oral Micronized): Bioidentical progesterone is plant-derived and easily absorbed. Benefits include protecting the uterine lining, balancing hormones, reducing anxiety, and improving sleep. The protocol is usually 100mg–200mg at night (due to drowsiness). Perimenopausal women often take it during the second half of their cycle (days 14–28); women with irregular cycles and post-menopausal women take it continuously.
Estradiol (Transdermal): Transdermal methods (gels/patches) are safer than oral estrogen. While oral estrogen can quadruple the risk of blood clots, studies (e.g., BMJ 2019) show transdermal use carries no such increased risk as the hormone is absorbed directly through the skin into the bloodstream. Gels are used initially for easy titration, and it typically takes 4–8 weeks of consistent use to see symptom relief.
Transdermal Testosterone: Testosterone helps with libido and energy, but female-specific formulas are rare outside Australia. The dosage is very low (approx. 300mcg/day), as excess can cause acne or hair growth.
Dehydroepiandrosterone (DHEA): Sometimes used as a precursor, but oral results are inconsistent. Note: Vaginal DHEA is specifically for localized atrophy, not systemic replacement.
Medical Supervision: All HRT requires a prescription and professional medical supervision.

A healthcare professional in a white blouse providing expert hormone replacement therapy guidance in a modern office.

Abstract pink and blue swirling textures symbolizing complex biological changes during hormone replacement therapy.

How Long Does It Take For Hormone Replacement Therapy (HRT) To Work?

First Few Weeks You might notice minor symptom relief, such as improvements to your sleep, mood or energy. This depends on the hormone you’re starting with. Progesterone is faster acting while Estradiol takes at least 2 to 4 weeks for minor effects to appear. You find your routine, when, how, where to apply it.
1 to 3 Months You test the dosage as this treatment is tailored around your symptoms. If symptoms come back, you increase the dosage. If you get breast tenderness or migraines, we try to dial down on estrogen. Ideally your mood swings start to stabilize, and your energy levels increase. Symptoms like hot flashes or night sweats should decrease in frequency.
3 to 6 Months This is when most people experience significant relief because transdermal Estradiol and Testosterone take a while to yield effect. Hot flashes, night sweats, and vaginal dryness often improve dramatically, and mood swings become much less frequent.
6 to 12 Months You benefit from the full effect of the treatment and notice an improvement in your quality of life. You understand that there are still changes and can adapt dosage or administration routes.
Month 13 Onwards Additional benefits accumulate in the long run, like stronger bones (reducing the risk for osteoporosis) and better heart health, helping you stay healthy as you age. Note that these work if paired with strength training, a healthy diet and sufficient protein intake.

Next Steps

At The Longevity Practice, we focus on identifying risks before they become health problems through early, precise diagnostics. Instead of reacting to disease, we create clear, personalized plans to maintain long-term health. Our goal is to give every patient a deep understanding of their body along with practical steps they can take today. With prevention and clarity at the core, we help patients build a longer, healthier life.

See if our approach is right for you. Book your consultation online and Schedule an appointment

Evidence-based Longevity

In our practice, we rely exclusively on evidence-based methods and medical diagnostics that have been scientifically proven to make a difference. Our focus is on preventing the “four horsemen” of aging—cardiovascular disease, cancer, metabolic dysfunction, and neurodegeneration—rather than offering trends like epigenetic age tests or wellness drips. Our Prevention strategy addresses tailored exercises, nutrition, sleep, mental health and if necessary support by supplement and medication.

Cost Of A Hormone Replacement Therapy Focus Session

The cost for a Hormone Replacement Therapy Focus Session is based on the German healthcare pricing system (GOÄ – Gebührenordnung für Ärzte). We encourage you not to stop at consultation alone, but to begin your full Longevity Journey with us. Here is what our protocol looks like:

Hormone Replacement Therapy Focus Session

199€

Goal: Conduct a comprehensive hormone panel and risk-benefit analysis to develop a personalized HRT protocol and targeted treatment strategy.

Duration: 45 minutes

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Full Diagnostic Visit

1,399€

Goal: Establish a data-driven biological baseline to unlock personalized peak performance and long-term health optimization.

Duration: 3 hours

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Introduction Session

0€

Schedule a quick video call to learn more about The Longevity Practice services and approach.

Duration: 15 minutes

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Testimonials

What our customers say about us

Julia, 46 – HRT & Strength

When I saw how much muscle mass I had lost, I finally understood why I felt weaker. It took longer than I expected to get my hormone levels properly adjusted, but once they were stable, my sleep and daily energy improved dramatically. Combining this with regular strength training has made me noticeably stronger and more resilient in everyday life.

Anna, 44 – HRT & Sleep

I never realized how much my hormones were affecting my sleep until I have taken progesterone. After adjusting my therapy and tracking my sleep for six weeks, I went from waking up four or five times a night to sleeping through almost every night. It’s such a relief to finally wake up feeling rested and ready for the day.

Pia, 45 – Menopause & Brain Fog

I thought I was losing my mind. I’d forget simple words in the middle of sentences. Realizing it was just the estrogen drop was a huge relief.

Anna, 49 – Menopause & Sleep

The night sweats were brutal—I was waking up drenched and exhausted every single night. I was so irritable with my family. Once I balanced my hormones, I finally got my sleep back.

Anita, 54 – Menopause & Anxiety

Nobody told me about the sudden heart palpitations and anxiety. I felt on edge for no reason. Learning it was hormonal made so much sense.