Perimenopause & Menopause Consultation In Dortmund

A Proactive Approach to Menopause

By 2030, 1.2 billion women will reach menopause, a figure projected to rise to 1.65 billion by 2050. Prior to menopause, 60-80% of women between the ages of 34 and 51 encounter perimenopausal symptoms that diminish their quality of life and work productivity. These symptoms can include anything from sleep disturbances and brain fog to anxiety and diminished energy levels. Frequently, these conditions are not diagnosed or addressed. The consequences affect families and create a substantial economic burden through missed workdays, absenteeism, and women exiting their careers.

The underlying 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, adipose tissue, bones, and immune cells. These receptors play a role in various bodily functions, including bone density, metabolism, reproduction, cognitive processes, and mood regulation.

Consider them fundamental “building blocks” of the body. The three primary hormones are:

Progesterone, known as "the calm regulator": A decrease in this hormone can lead to sleep disturbances, anxiety, and heavy menstrual bleeding.
Estrogen, considered "the main character": The reduction of estrogen can affect brain function, causing memory issues and concentration difficulties, or diminish quality of life through joint pain and vasomotor symptoms like night sweats and hot flashes.
Testosterone, or "the drive booster": A fall in testosterone levels can impact motivation, sex drive, and muscle mass.

Smiling woman in black sweater representing perimenopause and menopause care

Distinguishing Perimenopause From Menopause

Perimenopause

Frequently referred to as “the second puberty,” this transitional period spans several years before menstruation ceases entirely.

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: Typically persists for a period of 4 to 10 years.
Menstrual Cycle: Periods become unpredictable; they can vary in flow (lighter or heavier), length (shorter or longer), or may be missed altogether.
Hormone Levels: Progesterone levels are the first to drop, estrogen fluctuates erratically, and testosterone shows a gradual decline. A diagnosis is typically made based on symptoms, not bloodwork.
Fertility: Pregnancy is still possible; continuing with your chosen method of birth control is advised.
Key Symptoms: Common indicators include disrupted sleep, exhaustion, hot flashes, night sweats, mood shifts, 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 signals the conclusion of a woman's reproductive phase.

Age of Onset: Occurs on average at age 51, with a common range of 45–55.
Definition: A precise milestone confirmed after 12 straight months have passed with no menstrual period.
Duration: It is a singular event. The period that follows this point is known as Postmenopause.
Menstrual Cycle: Menstruation has permanently stopped.
Hormone Levels: Hormone production stabilizes at a consistently low level.
Fertility: Natural conception is no longer possible.
Key Symptoms & Risks: Symptoms like hot flashes and vaginal 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 undergoing Hormone Replacement Therapy (HRT).

Hormone Shifts and Their Associated Symptoms

Sleep Problems (50–55%): Encompasses insomnia, waking often during the night (WASO), and unrefreshing sleep. This is prompted by fluctuating progesterone (impacting GABA receptors) and reduced estrogen that leads to night sweats. A decrease in melatonin after 40 also contributes.
Low Energy and Fatigue (~80%): Estrogen helps manage cortisol and aids mitochondrial function. When it declines, it can cause metabolic stress and a decrease in cellular energy, frequently co-occurring with sleep issues.
Joint & Muscle Pain (65%): A reduction in estrogen boosts pro-inflammatory cytokines, resulting in widespread inflammation and less joint lubrication, which can cause stiffness or "frozen shoulder".
Brain Fog (60%): Neurons need estrogen to utilize glucose for energy. Falling estrogen levels can induce a "hypometabolic" condition in the brain's memory regions (hippocampus), which hinders concentration.
Hot Flashes & Night Sweats (50–55%): The hypothalamus, the body's internal thermostat, is regulated by estrogen. Decreasing levels can make the brain wrongly perceive the body is too hot, setting off abrupt cooling mechanisms.
Anxiety & Irritability (50–60%): Falling estrogen levels lower the production of serotonin (the "happiness hormone"), and declining progesterone diminishes the brain's calming effect, resulting in heightened reactivity and mood fluctuations.
Abdominal Weight Gain (50%): The loss of estrogen heightens insulin resistance. In response, the body intentionally accumulates visceral fat around the abdomen to try and generate estrone (an estrogen type) from these fat cells.
Vaginal Dryness & Pain (40%): Reduced estrogen diminishes blood flow, collagen, and elasticity in the pelvic tissues, which can cause atrophy and painful intercourse (dyspareunia).
Low Libido (40–45%): Primarily caused by a significant drop in testosterone between the ages of 45 and 55, this is worsened by the physical discomfort and fatigue from low estrogen.
Depressive Symptoms (40–45%): During perimenopause, the likelihood of developing new-onset depression rises by a factor of 2 to 4, owing to estrogen's effect on the density of serotonin receptors in the brain.
Dry Skin & Urinary Problems (35–45%): These issues stem from the same decrease 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

The Longevity Practice Approach And Getting Started

The Longevity Practice is dedicated to identifying potential risks before they develop into health issues by using early and accurate diagnostics. Rather than responding to illness after it appears, we design straightforward, customized plans aimed at preserving health over the long term. Our aim is to provide each patient with profound insight into their own body, complemented by actionable steps they can implement immediately. By centering our approach on prevention and clarity, we guide patients in constructing a longer and healthier life.

Our Core Principles

Our primary commitment is to help individuals feel optimal at every stage of life and to support their pursuit of a longer, healthier existence. To accomplish this, our work is centered on several key principles:

Scientific Precision
Personalization
Prevention First
Clarity & Guidance
Long-Term Healthspan
Trust & Transparency

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

Next Steps

Discover if our approach is suitable for you. Reserve your consultation online and Schedule an appointment

Evidence-based Longevity In Dortmund

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 Dortmund

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.