Perimenopause & Menopause Consultation In Cologne

The Importance Of Early Awareness

By 2030, 1.2 billion women will reach menopause, and this figure will rise to 1.65 billion by 2050. Before this stage, a significant 60-80% of women between 34 and 51 experience perimenopausal symptoms that diminish their quality of life and work productivity. Symptoms can include everything from sleep issues to brain fog, anxiety, and diminished energy. Often, these conditions are not properly diagnosed or managed. This situation affects families and creates a substantial economic burden through missed workdays, absenteeism, and women exiting their careers.

The root cause is a decline in hormones. In addition to reproductive organs like the uterus, ovaries, and breast, women possess Estrogen (ER) and androgen (AR) receptors in the brain, liver, kidneys, fat tissue, bones, and immune cells. These receptors play a role in various bodily functions, including bone density, metabolism, reproduction, cognitive abilities, and mood.

Consider these hormones as essential "building blocks." The three primary ones are:

Progesterone, also known as "the calm regulator": A reduction in this hormone can lead to sleep disturbances, anxiety, and excessive menstrual bleeding.
Estrogen, often called "the main character" Its depletion can affect brain function, causing memory problems and concentration difficulties, and can also reduce quality of life through joint pain and vasomotor symptoms like night sweats and hot flashes.
Testosterone, referred to as "the drive booster." A decrease in this hormone impacts motivation, sex drive, and muscle mass.

Smiling woman in black sweater representing perimenopause and menopause care

Distinguishing Between Perimenopause And Menopause

Perimenopause

Frequently referred to as “the second puberty,” this term describes the transitional period of several years that precedes the final menstrual period.

Age of Onset: Generally begins at 34 years of age or later.
Definition: A transitional phase initiated by the diminishing function of the ovaries.
Duration: Usually persists for a period of 4 to 10 years.
Menstrual Cycle: Becomes erratic; periods might become lighter, heavier, shorter, longer, or missed altogether.
Hormone Levels: Progesterone is the initial hormone to decline, estrogen levels fluctuate erratically, and testosterone levels fall slowly. A diagnosis is typically made based on symptoms, not blood work.
Fertility: Pregnancy remains possible; continuing to use a preferred method of contraception is advised.
Key Symptoms: Includes disturbed sleep, fatigue, hot flashes, night sweats, mood fluctuations, anxiety, brain 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 signifies the conclusion of a woman's reproductive phase.

Age of Onset: Commonly happens at approximately 51 years of age (the typical range is 45–55).
Definition: A precise milestone that is confirmed after 12 straight months have passed without a menstrual period.
Duration: It is a single event. The period that comes after this point is known as Postmenopause.
Menstrual Cycle: Has ceased entirely.
Hormone Levels: Hormone levels stabilize at a consistently low baseline.
Fertility: It is no longer possible to become pregnant.
Key Symptoms & Risks: Symptoms like hot flashes and vaginal dryness can continue. There is an elevated risk of bone density loss (osteoporosis), along with a higher risk for dementia and Alzheimer’s disease in individuals who do not use Hormone Replacement Therapy (HRT).

Understanding Symptoms Tied To Hormonal Shifts

Sleep Problems (50–55%): Encompasses insomnia, waking often during the night (WASO), and sleep that is not refreshing. This is caused by fluctuating progesterone (which impacts GABA receptors) and reduced estrogen leading to night sweats. A drop in melatonin after age 40 also contributes to the problem.
Low Energy and Fatigue (~80%): Estrogen helps manage cortisol and aids mitochondrial function. When it decreases, it results in metabolic stress and a reduction in cellular energy, which frequently happens in conjunction with sleep issues.
Joint & Muscle Pain (65%): A decrease in estrogen elevates pro-inflammatory cytokines, which causes systemic inflammation and less joint lubrication, resulting in stiffness or conditions like "frozen shoulder."
Brain Fog (60%): Neurons need estrogen to utilize glucose for energy. Falling estrogen levels result in a "hypometabolic" condition in the brain's memory areas (hippocampus), which hinders concentration.
Hot Flashes & Night Sweats (50–55%): The hypothalamus, the body's internal thermostat, is regulated by estrogen. A drop in this hormone can make the brain incorrectly perceive the body as too hot, which sets off abrupt cooling mechanisms.
Anxiety & Irritability (50–60%): A fall in estrogen diminishes the production of serotonin ("happiness hormone"), and lower progesterone lessens the brain's calming effect, resulting in heightened reactivity and mood fluctuations.
Abdominal Weight Gain (50%): The loss of estrogen elevates insulin resistance. The body intentionally accumulates visceral fat around the abdomen in an effort to generate estrone (a type of estrogen) from these fat cells.
Vaginal Dryness & Pain (40%): A reduction in estrogen decreases blood circulation, collagen, and elasticity within the pelvic tissues, which can cause atrophy and painful intercourse (dyspareunia).
Low Libido (40–45%): Caused by a significant drop in testosterone levels between the ages of 45 and 55, along with the physical discomfort and tiredness resulting from low estrogen.
Depressive Symptoms (40–45%): During perimenopause, the risk of developing depression for the first time rises by 2–4x 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 walls.

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 Approach And How To Begin

The Longevity Practice is dedicated to detecting health risks before they develop into problems by using early and accurate diagnostics. Rather than simply responding to illness, our method involves developing straightforward, individualized strategies for sustaining long-term wellness. We aim to provide each patient with profound insight into their own body and actionable measures they can implement immediately. By prioritizing prevention and clarity, we assist our patients in constructing a longer, healthier life.

Our Core Principles

Our main objective is to help individuals feel optimal at every stage of life and to assist them in achieving longer, healthier lifespans. To accomplish this, our work is centered around a number of key principles:

Scientific Accuracy
Individualized Care
Proactive Prevention
Clear Guidance
Extended Healthspan
Trust and Openness

Note: Our methodology is built around sustainable and non-invasive solutions. We concentrate on these fundamental principles to facilitate enduring physiological adjustments and effective long-term health management.

Next Steps

Find out if our methodology is a good fit for you. Reserve your consultation online 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 Perimenopause And Menopause Focus Session In Cologne

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.