Perimenopause & Menopause Consultation In Bonn

Understanding The Hormonal Shift

By 2030, 1.2 billion women will reach menopause, a figure projected to rise to 1.65 billion by 2050. Prior to this, between 60-80% of women from 34 to 51 years of age face perimenopausal symptoms that diminish their quality of life and work productivity. Symptoms can include everything from sleep disturbances and cognitive fog to anxiety and diminished energy levels. Frequently, these symptoms remain without a proper diagnosis or treatment. The consequences affect families and impose a substantial economic burden through missed work, absenteeism, and women exiting their careers.

This transition is triggered by a reduction in hormone levels. Beyond the reproductive system (uterus, ovaries, breast), women possess Estrogen (ER) and androgen (AR) receptors throughout the body, including in the brain, liver, kidneys, fat tissue, bones, and immune cells. These receptors regulate a wide array of functions, spanning from bone density and metabolism to reproduction, cognitive processes, and emotional states.

Consider these hormones as essential “building blocks” for the body. The three primary hormones involved are:

Progesterone, known as "the calm regulator": A decrease in this hormone can lead to disturbed sleep, feelings of anxiety, and heavy menstrual bleeding.
Estrogen, considered "the main character": Its depletion can affect cognitive functions (like memory impairment and poor concentration) or overall quality of life through joint discomfort and vasomotor symptoms (such as night sweats and hot flashes).
Testosterone, often called "the drive booster": A reduction in this hormone influences motivation, sex drive, and muscle tissue.

Smiling woman in black sweater representing perimenopause and menopause care

Distinguishing Between Perimenopause and Menopause

Perimenopause

Commonly referred to as “the second puberty,” this period is the extended phase that precedes the cessation of menstruation.

Age of Onset: Generally begins at 34 years of age or later.
Definition: It is a transitional period initiated by the diminishing function of the ovaries.
Duration: It usually spans a period of 4 to 10 years.
Menstrual Cycle: The cycle grows erratic; periods can become lighter, heavier, shorter, longer, or missed altogether.
Hormone Levels: Progesterone is the initial hormone to decline, while estrogen levels fluctuate unpredictably and testosterone shows a gradual reduction. A diagnosis is typically made based on symptoms, not bloodwork.
Fertility: Pregnancy is still possible; continuing with a chosen method of birth control is advised.
Key Symptoms: Common signs include sleep disturbances, exhaustion, hot flashes, night sweats, emotional shifts, anxiety, cognitive fog, joint pain or stiffness, muscle soreness, vaginal dryness, reduced libido, and symptoms of depression.

Menopause

Menopause refers to a distinct moment in time that signals the conclusion of a woman's reproductive phase.

Age of Onset: It most often happens around the age of 51 (with a typical range of 45–55).
Definition: This is a definitive milestone identified after experiencing 12 straight months without a menstrual period.
Duration: It is a single event in time. The stage that comes after this point is called Postmenopause.
Menstrual Cycle: Menstruation has permanently stopped.
Hormone Levels: Hormonal levels stabilize at a consistently low state.
Fertility: Conception is no longer possible.
Key Symptoms & Risks: Certain symptoms like hot flashes and dryness can continue. There is a heightened risk of bone density loss (osteoporosis), along with an increased risk of dementia and Alzheimer’s disease for individuals not using Hormone Replacement Therapy (HRT).

Symptoms And Hormonal Shifts In Perimenopause And Menopause

Sleep Problems (50–55%): This encompasses insomnia, waking often during the night (WASO), and unrefreshing sleep. It is caused by fluctuating progesterone (impacting GABA receptors) and low estrogen levels leading to night sweats. A decrease in melatonin after 40 also contributes to the problem.
Low Energy and Fatigue (~80%): Estrogen helps manage cortisol and aids mitochondrial activity. A reduction in estrogen results in metabolic stress and a decrease in cellular energy, frequently appearing in conjunction with sleep issues.
Joint & Muscle Pain (65%): A decrease in estrogen elevates pro-inflammatory cytokines, causing body-wide inflammation and diminished joint lubrication, which can manifest as stiffness or a "frozen shoulder".
Brain Fog (60%): Neurons depend on estrogen to utilize glucose for energy. Falling estrogen levels induce a "hypometabolic" condition in the brain's memory areas (the hippocampus), which compromises concentration.
Hot Flashes & Night Sweats (50–55%): The hypothalamus, the body's internal thermostat, is regulated by estrogen. When estrogen levels fall, the brain may wrongly perceive the body as too hot, initiating abrupt cooling mechanisms.
Anxiety & Irritability (50–60%): Falling estrogen levels decrease the production of serotonin ("happiness hormone"), and lower progesterone diminishes the brain's natural calming effect, resulting in heightened reactivity and fluctuating moods.
Abdominal Weight Gain (50%): The loss of estrogen heightens insulin resistance. The body intentionally accumulates visceral fat around the abdomen in an effort to generate estrone (an estrogen type) from these fat cells.
Vaginal Dryness & Pain (40%): Reduced estrogen levels diminish blood circulation, collagen, and elasticity in the pelvic tissues, which results in atrophy and pain during sexual intercourse (dyspareunia).
Low Libido (40–45%): This is primarily caused by a significant drop in testosterone between the ages of 45–55, compounded by the physical discomfort and exhaustion associated with low estrogen.
Depressive Symptoms (40–45%): The likelihood of developing new depression rises by 2–4 times during perimenopause because of estrogen's effect on the density of serotonin receptors in the brain.
Dry Skin & Urinary Problems (35–45%): These issues stem from the same reduction in collagen, moisture retention, and tissue elasticity that impacts the vaginal tissues.

Woman in her 40s experiencing perimenopause or menopause symptoms, wearing turquoise sweater in natural light

Modern menopause and perimenopause clinic, The Longevity Practise, with patient consultation space and wellness equipment

Our Philosophy and Your Next Steps

At The Longevity Practice, we are dedicated to detecting health risks before they develop into problems by using early and accurate diagnostics. Rather than responding to illness, our method involves developing straightforward, individualized strategies for preserving health over the long term. We aim to provide each patient with profound insight into their own body and actionable steps they can implement immediately. By prioritizing prevention and clarity, we guide patients in constructing a longer, more healthful life.

Our Core Principles

Our primary objective is to assist individuals in feeling optimal at every stage of life and to support their pursuit of a longer, healthier existence. To accomplish this, our work is centered around a number of key principles:

Scientific Accuracy
Customized Plans
Preventive Focus
Guidance and Clarity
Sustained Healthspan
Transparency and Trust

Note: Our methodology is built around sustainable and non-invasive solutions. We adhere to these guiding principles to facilitate enduring physiological improvements and effective long-term health strategies.

Next Steps

Discover if our methodology is a good fit for your needs. Reserve your consultation online and Schedule an appointment

Evidence-based Longevity In Bonn

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 Perimenopause And Menopause Focus Session In Bonn

The cost for a Perimenopause and Menopause 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:

Perimenopause and Menopause Focus Session

199€

Goal: Assess menopausal stage and symptom profile to evaluate disease risk associated with hormonal decline and determine optimal clinical interventions.

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

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.

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.

Anne, 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.