Menopause: more than the end of your period.
Menopause is a turning point, not the end. Much of what is taken for inevitable in these years is treatable, once you know what to look for.
A single point in time, and the phase after it.
Menopause is confirmed in hindsight, once the last period was twelve months ago. The time after that is postmenopause. In Europe, the average age of menopause is 51.
An early menopause before 45 and premature ovarian insufficiency before 40 always warrant a medical assessment and are usually treated, because the hormone deficit acts over many years here. What most women experience as the menopause transition already happens in perimenopause, the phase before it.
What becomes noticeable in menopause and after.
Menopause symptoms touch many organ systems, because oestrogen acts throughout the body.
Five areas that deserve attention after menopause.
After the last period, hormone levels stay low for good. Because oestrogen acts throughout the body, more than the cycle changes over time.
Oestrogen protects the bones. Bone density is lost fastest in the first years after menopause. Hormone therapy slows that loss for as long as the therapy runs.
Oestrogen protects the blood vessels against arteriosclerosis, the main cause of heart attack and stroke. Started early because of symptoms, hormone therapy can maintain that protection for the heart. It does not protect against stroke. Depending on the form, it can slightly increase the risk of stroke and thrombosis. It is not prescribed to prevent cardiovascular disease alone, it is not licensed for that.
With the loss of oestrogen, glucose metabolism changes and the risk of type 2 diabetes rises. Hormone therapy has a protective effect, new-onset diabetes is less common under therapy. It is prescribed because of symptoms, not for prevention.
Vaginal dryness and recurring urinary tract infections are common. Unlike hot flushes, they do not pass on their own. A local therapy relieves the symptoms effectively.
Oestrogen supports neuroplasticity, the brain's ability to form new connections and adapt. Concentration and word-finding problems relate to the hormone swings. Started early, hormone therapy can contribute to protection against dementia.
Important: these developments are not an unavoidable fate. How much they affect you depends on your personal risk profile, and much of it can be influenced: through strength training, nutrition, vitamin D, not smoking and, where medically sensible, hormone therapy.
What is medically possible in menopause, step by step.
It always starts with a medical consultation. What follows depends on your symptoms and your findings.
Intake questionnaire beforehand, then a 1:1 video consultation. Your physician works out which symptoms belong to menopause and which have another cause.
After menopause hormone levels stay low, a single hormone value rarely adds anything. Lab values are used where they change the plan, for example before a therapy or to check tolerability.
A dedicated video consultation: what is treatable, what is watched and which long-term topics matter for you.
Closely guided during the setup phase, then on a quarterly rhythm. Dosage, tolerability and long-term topics stay in view.
Not every patient is suited to every therapy. Treatment decisions are made by your physician, not an algorithm.
To treatmentYour medical consultation
Your consultation brings clarity about your next medical step. Where medically indicated, targeted diagnostics complete the assessment. During treatment you are supported by a physician throughout.
Preparation in your patient area, a review by your physician before the appointment, 30 minutes by video with her, then your assessment and recommendation in writing.
Follow-up with your physician every month, for phases in which effect, tolerability or dosage need to be guided closely. You can stop at any time, and the current monthly period runs to its end.
Follow-up with your physician every three months, once your treatment is well established. You pay for three months in advance. You can cancel at any time, and the quarterly period you have already paid for runs to its end.
Where medically indicated: targeted diagnostics. Your physician discusses the scope and cost with you beforehand.
Your medical consultation
A fixed price for your consultation. Then you decide whether ongoing care makes sense.
Included in both
When your body changes, your next step should be clear.
In your medical consultation, your physician already knows your medical history and any existing results before you speak. You use the 30-minute video call to look ahead, and afterwards you receive your assessment and recommendation in writing.
- Between 38 and 65 years old
- Typical perimenopausal or menopausal symptoms
- Also with hormone therapy already underway
When your body changes, your next step should be clear.
In your medical consultation, your physician already knows your medical history and any existing results before you speak. You use the 30-minute video call to look ahead, and afterwards you receive your assessment and recommendation in writing.
Common questions about menopause.
The most common questions about menopause and postmenopause. Anything further you clarify directly with your physician.
All questions and answersWhat is the difference between peri- and postmenopause?
Perimenopause is the transition phase with periods still present. Menopause is confirmed in hindsight, once the last period was twelve months ago. The time after that is postmenopause.
What is an early menopause, what is POI?
An early menopause is before 45, premature ovarian insufficiency (POI) before 40. Depending on the study, POI affects about 1 to 4 in 100 women, and early menopause is more common. Both warrant a medical assessment, because treatable causes can lie behind them, and are usually treated, because the hormone deficit acts over many years. Ovarian function can return in between, so pregnancy is possible despite POI. Hormone therapy is not a contraceptive.
When is hormone therapy an option?
Hormone therapy is an option when menopausal symptoms are bothering you and there is no medical reason against it. Age alone does not decide. According to the guidelines, the benefits outweigh the risks for many women under 60 or within ten years of menopause. It is not risk-free at any age, though: depending on the form and duration, it can, for example, slightly increase the risk of thrombosis, stroke or breast cancer. Started later, the risks of heart attack, stroke and thrombosis are higher, so it is weighed especially carefully. Your physician assesses this with you.
How long can I take hormone therapy?
There is no fixed upper limit. How long hormone therapy makes sense depends on your symptoms and your risks, and your physician reviews this with you at least once a year. Depending on the type of hormone therapy, the risk of breast cancer can rise slightly with duration, which is part of that decision. After stopping, hot flushes come back in about half of women, in some studies more often, at least for a while and usually milder than before.
Will I automatically be prescribed hormones after the medical consultation?
No. Your physician only recommends a therapy when it is medically indicated and suits your medical history. For some women, options without hormones are the better step. For others it is enough at first to understand the symptoms and keep an eye on them. Whether you start a treatment, and which one, you decide together with your physician.