Woman smiling in natural sunlight representing wellness during perimenopause and menopause

Perimenopause & Menopause Consultation In Duisburg

Fast appointments (self payers or privately insured patients only)

Online doctor consultations and testing at our office in Berlin Prenzlauer Berg

On-demand coaching from doctors for your current problems, needs and healthspan goals.

Understanding the Transition Ahead

By 2030, 1.2 billion women are projected to reach menopause, a figure set to rise to 1.65 billion by 2050. Preceding this stage, between 60% and 80% of women from ages 34 to 51 encounter perimenopausal symptoms that diminish their quality of life and work performance. Symptoms can include everything from sleep disturbances to brain fog, anxiety, and diminished energy. These conditions often remain undiagnosed and unmanaged. The consequences affect families and create a substantial economic burden through missed work, absenteeism, and women exiting their careers.

The root cause is a decrease in hormones. In addition to reproductive organs like the uterus, ovaries, and breast, women possess Estrogen (ER) and androgen (AR) receptors throughout the body, including the brain, liver, kidneys, fat tissue, bones, and immune cells. These receptors play a role in regulating functions ranging from bone density and metabolic rate to reproductive health, cognitive processes, and emotional state.

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

  • Progesterone, known as "the calm regulator": A reduction in this hormone can lead to disturbed sleep, feelings of anxiety, and excessive menstrual bleeding.
  • Estrogen, considered "the main character": A deficiency can affect cognitive functions such as memory and concentration, and diminish quality of life through joint discomfort and vasomotor symptoms like night sweats and hot flashes.
  • Testosterone, or "the drive booster": A decrease in this hormone impacts motivation, sex drive, and lean muscle.
Smiling woman in black sweater representing perimenopause and menopause care
Chart showing estrogen, progesterone, testosterone and FSH hormone changes across perimenopause stages to menopause

Comparing Perimenopause and Menopause: The Core Differences

Perimenopause

Frequently referred to as “the second puberty,” this transitional period spans multiple years before the cessation of menstrual cycles.

  • 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: Loses its regularity; periods can become lighter, heavier, briefer, more prolonged, or 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 a chosen method of birth control is advisable.
  • Key Symptoms: Includes disturbed sleep, tiredness, hot flashes, night sweats, mood fluctuations, anxiety, cognitive fog, joint pain or stiffness, muscle soreness, vaginal dryness, reduced libido, and symptoms of depression.

Menopause

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

  • Age of Onset: Generally happens at approximately age 51 (with a common range of 45–55).
  • Definition: A specific landmark confirmed following 12 straight months of no menstrual periods.
  • Duration: It is a singular event. The stage that comes after this point is known as Postmenopause.
  • Menstrual Cycle: Entirely ceases.
  • Hormone Levels: Hormonal levels stabilize at a new, consistently low baseline.
  • Fertility: Conception is no longer possible.
  • Key Symptoms & Risks: Symptoms like hot flashes and vaginal dryness can continue. There is an elevated risk of bone density reduction (osteoporosis) and a higher risk of dementia and Alzheimer’s disease for individuals not undergoing Hormone Replacement Therapy (HRT).

Perimenopause and Menopause: Hormones and Related Symptoms

  • Sleep Problems (50–55%): Encompasses insomnia, waking often during the night (WASO), and unrefreshing sleep. This is caused by fluctuating progesterone (impacting GABA receptors) and low estrogen leading to night sweats. A decrease in melatonin after 40 exacerbates 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 co-occurring with sleep issues.
  • Joint & Muscle Pain (65%): A decrease in estrogen elevates pro-inflammatory cytokines, which causes body-wide 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 within 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. Decreasing levels make the brain mistakenly perceive the body as too hot, initiating abrupt cooling mechanisms.
  • Anxiety & Irritability (50–60%): Falling estrogen levels diminish the production of serotonin (the "happiness hormone"), and lower progesterone lessens the brain's "calming" influence, resulting in heightened reactivity and mood shifts.
  • Abdominal Weight Gain (50%): The loss of estrogen leads to greater 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%): Reduced estrogen diminishes blood flow, collagen, and elasticity in the pelvic tissues, which can cause atrophy and painful intercourse (dyspareunia).
  • Low Libido (40–45%): Caused by a significant drop in testosterone from ages 45 to 55, along with the physical discomfort and tiredness resulting from low estrogen levels.
  • Depressive Symptoms (40–45%): During perimenopause, the likelihood of developing depression for the first time rises by a factor of 2–4, 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 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

The Longevity Practice Approach and How to Proceed

The Longevity Practice is dedicated to detecting potential risks ere they develop into health issues by using early and accurate diagnostics. Rather than responding to illness after it occurs, we design straightforward, customized strategies for preserving health over the long term. We aim to provide each patient with profound insight into their own body and actionable measures they can implement immediately. By focusing on prevention and providing clarity, we guide patients toward constructing a longer, healthier existence.

Our Foundational Principles

Our primary objective is to assist individuals in feeling optimal at every stage of life and to help them lead longer, more healthful lives. To accomplish this, our work is centered on several key principles:

  • Scientific Accuracy
  • Individualized Care
  • A Proactive Approach
  • Clear Direction
  • Extended Wellness
  • Honesty & Reliability

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

Taking the Next Step

Discover if our methodology aligns with your needs. Reserve your consultation through our online system and Schedule an appointment

Evidence-based Longevity In Duisburg

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.

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Cost Of Perimenopause And Menopause Focus Session In Duisburg

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
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
Introduction Session
0€
Schedule a quick video call to learn more about The Longevity Practice services and approach.
Duration: 15 minutes

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.