Hormone Balancing in Cologne

Anticipating and Addressing Menopause

A third of a woman’s life occurs after menopause, which amounts to about 33 years based on an average menopause age of 51 and an average female life expectancy of 84 in the EU. Additionally, women can spend as long as a decade managing perimenopause symptoms. This means that roughly half of a woman's life expectancy is spent dealing with a range of symptoms that can reduce quality of life and productivity.

Patients undergoing HRT (Hormone Replacement Therapy) frequently report that they “feel like themselves again.” For this reason, finding the correct treatment rhythm and dosage represents a significant investment in the next 30 to 40 years of your life.

A basic guide to self-diagnose which hormone might be deficient:

Low Progesterone: You might feel anxious, irritable, and overstimulated.
Low Estrogen: You might experience dryness, heat, and tearfulness.
Low Testosterone: You might feel fatigued, weak, and unmotivated.

It is important to note that each woman can experience different symptoms with varying levels of intensity. There can also be an overlap or a synergistic effect among hormones. Addressing and resolving symptoms is therefore 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.

Systemic Symptoms of Hormonal Imbalance

Sleep: Low Progesterone leads to interrupted sleep and waking during the night (from the loss of GABA's calming effect); Low Estrogen is responsible for night sweats and waking up in the early morning.
Mood: Insufficient Progesterone contributes to irritability and anxiety; low Estrogen is associated with depression and anhedonia; inadequate Testosterone diminishes motivation and assertiveness.
Menstrual Cycle: A lack of Progesterone results in heavy, erratic bleeding (due to unopposed estrogen); deficient Estrogen leads to shorter or missed cycles.
Vasomotor Symptoms: An Estrogen deficiency is the main cause of hot flashes and night sweats.
Libido & Sexual Function: Insufficient Estrogen leads to vaginal dryness and discomfort; low Testosterone is the main reason for a decrease in spontaneous desire and weaker orgasms.
Cognitive Symptoms: Low Estrogen is a cause of "brain fog" and memory difficulties; deficient Testosterone impairs strategic thinking and mental motivation.
Metabolism: A lack of Estrogen encourages central fat storage (belly fat) and insulin resistance; insufficient Testosterone leads to a reduction in lean muscle mass, which slows the metabolic rate.
Skin & Hair: Low Estrogen decreases collagen and the elasticity of the skin; inadequate Testosterone may play a role in thinning hair.
Bone & Muscle: Insufficient Estrogen is a significant factor in the development of osteoporosis and sarcopenia; low Testosterone weakens physical stamina and muscle power.
Urogenital Health: An Estrogen deficiency results in the Genitourinary Syndrome of Menopause (which includes atrophy, itching, and recurrent UTIs).

Understanding the HRT Treatment Process

HRT is a personalized and iterative journey that is adapted to your individual biology. Unlike a fixed prescription, your physician will modify dosages and schedules based on blood work and symptom monitoring. The typical approach involves stabilizing one hormone at a time before adding another, with check-ins eventually occurring every 3–6 months.

Progesterone (Oral Micronized): Derived from plants, bioidentical progesterone is readily absorbed. Its benefits encompass protecting the uterine lining, balancing hormones, diminishing anxiety, and enhancing sleep. The standard protocol is 100mg–200mg taken at night (as it can induce drowsiness). Perimenopausal women typically use it in the latter half of their cycle (days 14–28), whereas women with irregular cycles and those who are post-menopausal take it on a continuous basis.
Estradiol (Transdermal): Applying estrogen through the skin with gels or patches is safer than taking it orally. While oral estrogen can increase the risk of blood clots by a factor of four, research (like the BMJ 2019 study) demonstrates that transdermal application does not carry this elevated risk since the hormone enters the bloodstream directly. Gels are often used initially to allow for easy dose titration, with symptom relief typically appearing after 4–8 weeks of consistent application.
Transdermal Testosterone: Testosterone is effective for improving libido and energy, though formulas made for women are uncommon outside of Australia. The dose is kept very small (approximately 300mcg/day), because higher amounts can lead to acne or hair growth.
Dehydroepiandrosterone (DHEA): This is occasionally used as a precursor hormone, but oral supplementation yields inconsistent results. Note that vaginal DHEA is formulated for localized atrophy and is not a systemic replacement.
Medical Supervision: Any form of HRT necessitates a prescription and ongoing supervision from a medical professional.

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.

Expected Timeline for HRT Efficacy

First Few Weeks You may start to feel minor relief from symptoms, like enhancements in your sleep, mood, or energy. This will vary depending on the initial hormone used. Progesterone tends to act more quickly, whereas Estradiol needs at least 2 to 4 weeks for initial effects to become noticeable. You will establish a routine for when, how, and where to apply it.
1 to 3 Months The dosage is fine-tuned during this period because the therapy is customized to your symptoms. If symptoms reappear, the dose is raised. If you experience issues like breast tenderness or migraines, we typically lower the estrogen. Ideally, your mood swings start to even out, and your energy levels rise. Symptoms such as hot flashes or night sweats should occur less often.
3 to 6 Months This is the period when most individuals report significant relief, as transdermal Estradiol and Testosterone need time to take full effect. Hot flashes, night sweats, and vaginal dryness frequently improve substantially, and mood swings happen much less often.
6 to 12 Months You now receive the full impact of the therapy and observe an enhanced quality of life. You also recognize that changes can still occur and are able to adapt the dosage or method of administration.
Month 13 Onwards In the long term, additional advantages accumulate, such as stronger bones (which lowers the risk for osteoporosis) and improved heart health, contributing to your well-being as you age. It's important to know that these outcomes are most effective when paired with strength training, a healthy diet, and sufficient protein.

Next Steps

At The Longevity Practice, our approach is to identify health risks before they develop into problems by using early and precise diagnostics. We focus on creating clear, individualized plans to sustain long-term health rather than just reacting to illness. Our objective is to provide each patient with a thorough understanding of their own body, complete with actionable steps they can implement immediately. By prioritizing prevention and clarity, we empower patients to build a longer, healthier existence.

Determine if our approach is the right fit for you. Book your consultation through our website and Schedule an appointment

Evidence-based Longevity In Cologne

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 In Cologne

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.