Perimenopause and Menopause Support in Freiburg

Gaining an Edge Through Insight

By 2030, 1.2 billion women are projected to reach menopause, a figure that will rise to 1.65 billion by 2050. Prior to this, between 60-80% of women from 34 to 51 years of age endure perimenopausal symptoms that diminish their life quality and work performance. These can include anything from sleep difficulties and brain fog to anxiety and diminished energy levels. Frequently, these conditions remain undiagnosed and without treatment. The consequences affect families and impose a substantial economic burden through missed work, absenteeism, and women exiting their careers.

A decline in hormones is the underlying cause. In addition to reproductive organs like the uterus, ovaries, and 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 play a role in regulating functions that span from bone density and metabolic processes to reproduction, cognitive abilities, and emotional state.

Consider these hormones as fundamental "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 heavy menstrual bleeding.
Estrogen, often called "the main character": A decrease in estrogen can affect cognitive function, causing memory issues and trouble concentrating, or reduce quality of life through joint discomfort and vasomotor symptoms like night sweats and hot flashes.
Testosterone, or "the drive booster": A drop in testosterone levels can impact motivation, sex drive, and muscle tissue.

Smiling woman in black sweater representing perimenopause and menopause care

Perimenopause and Menopause: Defining the Key Stages

Perimenopause

Frequently described as a “second puberty,” this represents the transitional period of several years that precedes the final menstrual period.

Age of Onset: Usually begins at 34 years of age or later.
Definition: A transitional phase initiated by the diminishing function of the ovaries.
Duration: It commonly persists for a period of 4 to 10 years.
Menstrual Cycle: Periods become unpredictable; they can be lighter, heavier, shorter, or longer, and some may be missed altogether.
Hormone Levels: Progesterone levels are the first to drop, followed by unpredictable fluctuations in estrogen and a gradual decline in testosterone. A diagnosis is typically made based on symptoms, not blood work.
Fertility: Pregnancy is still possible, and continuing with a preferred method of birth control is advised.
Key Symptoms: Includes sleep disturbances, tiredness, hot flashes, night sweats, mood 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 generally happens at approximately 51 years of age (with a common range of 45–55).
Definition: An established event confirmed after a full 12 months have passed without a menstrual period.
Duration: A singular event in time. 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 level.
Fertility: Conception is no longer possible.
Key Symptoms & Risks: Issues like hot flashes and vaginal dryness can continue. There is a heightened risk for bone density loss (osteoporosis), as well as for dementia and Alzheimer’s disease in individuals not undergoing Hormone Replacement Therapy (HRT).

Symptoms and Hormonal Shifts of Perimenopause and Menopause

Sleep Problems (50–55%): Encompasses insomnia, waking often during the night (WASO), and sleep that is not refreshing. This is caused by fluctuating progesterone levels (which influence GABA receptors) and low estrogen that leads to night sweats. A decrease in melatonin after 40 also contributes to the problem.
Low Energy and Fatigue (~80%): Estrogen plays a role in cortisol regulation and mitochondrial support. A reduction in estrogen results in metabolic stress and a decrease in cellular energy, which frequently happens in conjunction with poor sleep.
Joint & Muscle Pain (65%): A decrease in estrogen elevates pro-inflammatory cytokines, which causes body-wide inflammation and diminished joint lubrication, resulting in stiffness or conditions like "frozen shoulder".
Brain Fog (60%): Neurons need 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 responses to cool down.
Anxiety & Irritability (50–60%): Decreasing estrogen levels lower the production of serotonin ("happiness hormone"), and a drop in progesterone lessens the brain's natural calming effect, resulting in heightened reactivity and emotional fluctuations.
Abdominal Weight Gain (50%): The loss of estrogen promotes insulin resistance. Consequently, 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 diminishes blood flow, collagen, and elasticity within the pelvic tissues, which can cause atrophy and painful intercourse (dyspareunia).
Low Libido (40–45%): This is caused by a significant drop in testosterone for those between 45 and 55, which is compounded by the physical discomfort and tiredness resulting from low estrogen levels.
Depressive Symptoms (40–45%): The likelihood of developing depression for the first time rises by 2–4x during the perimenopausal period 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 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: Our Approach and Getting Started

The Longevity Practice is dedicated to detecting health risks before they develop into problems by using early and accurate diagnostics. Rather than taking a reactive approach to illness, we develop straightforward, customized strategies for preserving health over the long term. Our aim is to provide each patient with profound insight into their own body and actionable steps for immediate implementation. By centering our practice on prevention and clarity, we guide patients in constructing a longer and healthier life.

Our Core Principles

Our primary commitment is to assist individuals in feeling their best regardless of age and to support them in achieving longer, healthier lives. 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 focused on sustainable and non-invasive solutions. We adhere to these core principles to facilitate enduring physiological adjustments and effective long-term health stewardship.

Next Steps

Discover if our methodology aligns with your needs. Book your consultation online and Schedule an appointment

Evidence-based Longevity In Freiburg

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 Freiburg

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.