Perimenopause & Menopause Consultation In Stuttgart

Understanding the Menopausal Transition

By 2030, 1.2 billion women will reach menopause, a figure set to rise to 1.65 billion by 2050. Before this stage, 60-80% of women between the ages of 34 and 51 experience perimenopause symptoms that negatively influence their quality of life and productivity. These can include everything from sleep issues and brain fog to anxiety and diminished energy. In many cases, these conditions remain undiagnosed and unaddressed. This affects families and carries a substantial economic cost from lost productivity, absenteeism, and women leaving their careers.

The underlying cause is a decline in hormones. Women possess Estrogen (ER) and androgen (AR) receptors not only in reproductive organs (like the uterus, ovaries, and breast) but also in the brain, liver, kidney, adipose tissue, bone, and immune cells. These receptors regulate functions ranging from bone density and metabolism to reproduction, cognition, and mood.

Consider them essential “building blocks.” The three most significant are:

Progesterone, known as "the calm regulator": A reduction in this hormone can lead to sleep disturbances, anxiety, and heavy menstrual bleeding.
Estrogen, considered "the main character": Its reduction may affect brain function (such as memory impairment or difficulty concentrating) or diminish quality of life through joint pain and vasomotor symptoms (like night sweats and hot flashes).
Testosterone, often called the "the drive booster": Its decline can impact motivation, libido, 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 is the transitional period of several years that precedes the final menstrual period.

Age of Onset: Usually begins at age 34 or later.
Definition: A transitional phase initiated by the diminishing function of the ovaries.
Duration: It typically spans a period of 4 to 10 years.
Menstrual Cycle: Becomes irregular; periods can be lighter, heavier, shorter, longer, or missed altogether.
Hormone Levels: Progesterone is the first to drop, while estrogen levels fluctuate erratically and testosterone gradually declines. Diagnosis is typically made based on symptoms, not blood work.
Fertility: Pregnancy is still possible; it is advised to continue with a preferred method of birth control.
Key Symptoms: Includes sleep disturbances, fatigue, hot flashes, night sweats, mood fluctuations, anxiety, brain fog, joint pain or stiffness, muscle soreness, vaginal dryness, reduced libido, and depressive symptoms.

Menopause

Menopause refers to a precise moment in time that signifies 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 distinct point in time confirmed after experiencing 12 straight months with no menstrual period.
Duration: A singular event. The period that comes after this point is known as Postmenopause.
Menstrual Cycle: Periods have stopped entirely.
Hormone Levels: Hormones stabilize at a consistently low level.
Fertility: It is no longer possible to become pregnant.
Key Symptoms & Risks: Symptoms like hot flashes and vaginal dryness might continue. The risk for bone density loss (osteoporosis) is elevated, as is the risk for dementia and Alzheimer’s disease in individuals not using Hormone Replacement Therapy (HRT).

Perimenopause and Menopause: Hormones and Symptoms

Sleep Problems (50–55%): Encompasses insomnia, waking often during the night (WASO), and non-refreshing sleep. This is caused by progesterone fluctuations (which impact GABA receptors) and low estrogen that leads to night sweats. A decrease in melatonin after age 40 also exacerbates the issue.
Low Energy and Fatigue (~80%): Estrogen helps regulate cortisol and supports mitochondrial function. A drop in estrogen causes metabolic stress and a reduction in cellular energy, which frequently occurs alongside sleep issues.
Joint & Muscle Pain (65%): A decrease in estrogen elevates pro-inflammatory cytokines, resulting in systemic inflammation and less joint lubrication (which can cause stiffness or "frozen shoulder").
Brain Fog (60%): Neurons require estrogen to metabolize glucose. Falling levels result in a "hypometabolic" condition in the brain's memory areas (hippocampus), which impairs concentration.
Hot Flashes & Night Sweats (50–55%): Estrogen helps regulate the hypothalamus (the body’s internal thermostat). When levels decline, the brain may incorrectly sense overheating, setting off sudden cooling reactions.
Anxiety & Irritability (50–60%): Falling estrogen levels lower serotonin (the "happiness hormone") production, while a decrease in progesterone lessens the brain's "calming" effect, resulting in high reactivity and mood fluctuations.
Abdominal Weight Gain (50%): A loss of estrogen elevates insulin resistance. The body then intentionally accumulates visceral fat in the abdominal region to try and produce estrone (a type of estrogen) from fat cells.
Vaginal Dryness & Pain (40%): Reduced estrogen levels cause a decrease in blood flow, collagen, and elasticity within the pelvic tissues, resulting in atrophy and discomfort during intercourse (dyspareunia).
Low Libido (40–45%): This is primarily caused by a significant drop in testosterone for those between 45 and 55, compounded by the physical discomfort and tiredness resulting from low estrogen.
Depressive Symptoms (40–45%): The likelihood of new-onset depression rises 2–4 times during perimenopause, stemming from estrogen's influence on serotonin receptor density in the brain.
Dry Skin & Urinary Problems (35–45%): These issues are caused by 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 Philosophy and Your Next Steps

At The Longevity Practice, our emphasis is on using early and accurate diagnostics to identify health risks before they develop into problems. Instead of responding to illness, we develop clear, individualized strategies for sustaining long-term wellness. Our aim is to provide each patient with a profound insight into their body, complete with actionable steps they can implement immediately. With prevention and clarity as our foundation, we guide patients toward building a longer, more healthful life.

Our Core Principles

Our primary objective is to help individuals feel optimal at every stage of life and to support them in achieving longer, healthier lifespans. To accomplish this, we adhere to several fundamental principles:

Scientific Accuracy
Individualized Care
A Proactive Approach
Clarity & Guidance
Extended Healthspan
Trust & Transparency

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

Next Steps

Discover if our approach is a good fit for you. Arrange your consultation online and book an appointment

Evidence-based Longevity In Stuttgart

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 Stuttgart

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.