Welcome to the EU’s first digital Hormone Online Clinic specializing in menopause care!
When I wrote my second book, “Woman on Fire”, I was already aware that many women feel left alone with their needs and issues during menopause. It has therefore always been my hope to reach and help as many women as possible. This Hormone Online Clinic now makes that hope a reality!
Menopause is an extremely important time in a woman’s life, which requires particular, specialized medical care so that women will have the freedom to live life to the fullest. The most successful way of achieving that is regular care in the context of a strong, ongoing doctor-patient relationship. That’s also the purpose of our Hormone Online Clinic – to help you right now and together develop a highly personalized therapy plan to make your life so much better – and maybe even better than ever! To fulfill my heartfelt wish of helping as many women as possible I have selected a unique team of experts who all share in the same vision of becoming your trusted personal advisor, guide and companion through all aspects of menopause to help you make the years to come happy, healthy and amazing.
It’s easy to register and make an appointment on our user-friendly VCita online portal. Take your time to find a specialist and appointment time that are right for you. Then please fill out our questionnaire regarding your specific medical data. If you have any useful medical data – like blood values, preliminary finding, or other relevant material – it’s easy to upload items using the My Documents function. These will then be available to us during your consultation. Payment is also easy using either PayPal or your credit card.
The initial consultation takes about 50 minutes and can take place either via Zoom or telephone. During this conversation, we will take the time to learn exactly what you need, and in many cases we will already be able to determine a personalized course of therapy. If you require hormone therapy treatment or other medication, we will prescribe it and order it for you, and it will be delivered to your door. You will of course also receive a written summary of our consultation and a personalized treatment plan specific to your individual needs.
You’ll begin your personalized therapy routine from home. Starting with your first consultation, we will ensure that you have all the necessary and detailed comprehensive information you need to confidently begin your therapy. We’re with you every step of the way, so if questions arise, we’re always only just a few clicks away!
The first follow-up consultation usually takes 6-8 weeks from the onset of therapy. During this follow-up conversation, we’ll see how you’re doing and determine your progress over the past weeks. After that, we’ll get into the “fine tuning”. Sometimes we may require new blood values or other documentation, which you can easily upload to your account.
Before the first consultation, you should have your hormone levels determined (see FAQs) and upload them to your Vcita customer portal.
Additional follow-up consultations usually take place 8-12 weeks later. If your hormone levels are balanced and your symptoms have improved, it’s often enough to only have follow-up consultations once every six months. Please be aware, however, that everyone has unique needs, and many women prefer follow-up appointments at three- month intervals. Most importantly, though, know that we are always there for you, we’re easy to reach and always ready to provide quick help with any questions or issues you may have, so contact us whenever you need us.
There are actually more than 70 medically documented symptoms of menopause!
Here’s a list of a few of the “usual suspects”:
Our patient portal offers additional digital services.
Please let us briefly introduce some of its various functions.
Not too long ago, people still believed that menopause didn’t begin until a woman’s menstrual cycle became irregular. Fortunately, we are today much smarter and have learned that is not the case! Our first hormonal changes actually tend to start taking place in our late thirties, when we begin to experience the first changes in our monthly cycles. This phase, which can sometimes last for ten years, is referred to as “pre-menopause”. The next phase, which we associate with classical symptoms of menopause, is called “perimenopause”. At the onset of perimenopause, many women experience various symptoms that at first glance may not seem like they are caused by a massive shift in hormone levels. These often include, for example, dizziness, headaches, circulatory issues and arrythmia, or joint and muscle pain. These symptoms often propel women on a “medical marathon” going from doctor to doctor, but which seldom provides any relief because the treating physicians may not be aware of the real organic causes. This is actually the exact moment when women should be made aware that all of these symptoms may actually be symptoms of menopause. Perimenopause is actually a potpourri of different, highly individual symptoms and is not always confined to classical menopause symptoms like irregular periods, hot flashes, weight gain or insomnia. If treated properly, the menopause years can be some of the most amazing years in a woman’s life, but unfortunately for far too long this phase has received insufficient medical recognition and, as a result, too many women have suffered unnecessarily. This is why we have made it our mission to help, advise and support women during this important time.
Just as every woman, every woman’s life, and every woman’s menstrual cycle is each uniquely individual, so is the beginning of menopause. As a general rule, though, the first hormonal changes (pre-menopause) begin to take place in our late thirties and continue into our mid-forties. Around that time, we begin to seamlessly transition into perimenopause, the “actual menopause” phase. Many women therefore can expect to enter into this new and exciting phase of life in their mid-forties.
Just as the onset of menopause is highly individual so is its duration. There is a wide range which can stretch from 3 years to 10 years. When perimenopause ends, we enter a phase called “post-menopause”, but what officially is referred to as “menopause” is actually the date of a woman’s last menstrual cycle that usually takes place around the age of 52.
The purpose of bioidentical hormone replacement therapy is to repair hormone deficiency and/or balance any hormone imbalance. Its foremost goal is to restore a woman’s health and wellbeing. Today, it is completely unacceptable that women must continue to suffer hot flashes, insomnia or severe mood swings simply because they have reached a certain age. Women suffering should not be considered “natural”, and it shouldn’t be “normal”. Women in peri- and post-menopause are actually in the prime of their lives. They have earned the right to be joyful, vivacious, energetic and emotionally and sexually happy. Besides supporting these important aspects of female wellbeing, bioidentical hormones also help protect against serious medical conditions like arteriosclerosis, osteoporosis, dementia and certain cancers such as, for example, colon cancer.
Many women in peri- and post-menopause often report having pain during sex. Many women also report vaginal burning and itching alongside frequent vaginal and urinary tract infections. The cause of this is often estrogen deficiency, which renders the vaginal membrane thinner, dryer and more susceptible to infection. This occurs most frequently at the entry to the vagina, which is already a highly sensitive area, but which becomes even more sensitive and painful with increasing estrogen depletion. Often, the skin in this area will tear and bleed. Sex therefore becomes highly painful and sometimes impossible. To prevent this condition called “vaginal atrophy”, it is therefore extremely important to treat the vagina with a specifically designed hormone cream containing estriol, which is a type of estrogen. Estriol is also available in the form of vaginal suppositories for women who would rather not apply cream. It’s extremely important to note that in this regard prophylactics and preventive measures are critical. It is much better to begin with early prophylactic treatment than to wait for your vagina to become affected. Moreover, localized estriol therapy works best in combination with systematic hormone replacement therapy.
Hot flashes can be very different. Some arrive seemingly out of nowhere, can be very intense, but will only last a few minutes. In those cases, you might find your head, breasts and arm pits immediately drenched in sweat. Your face may turn bright red, and your heart may start to race. Other hot flashes may be less intense, but they can last much longer, with some lasting even up to half an hour. Unfortunately, hot flashes may also be accompanied by a feeling of general malaise, including nausea, circulatory issues and dizziness. Some women experience significantly more symptoms during the day, while other experience them primarily at night, and therefore wake up drenched in sweat.
Insomnia is highly common among women in peri- und post-menopause. This is caused by progesterone deficiency, as progesterone is the hormone tasked, among others, with helping us relax and fall asleep. When progesterone is depleted, it becomes significantly more difficult for women to become relaxed and fall or stay asleep. Women therefore sleep less, sleep worse and wake up too often. Of course, hormone-related sleep deprivation naturally affects your entire organism and daily life. Natural progesterone replacement therapy can help significantly by simply taking a single capsule in the right dosage half an hour before going to bed. Women who do so overwhelmingly report that shortly after beginning therapy they are able to fall asleep much more quickly, easily and soundly.
Hair loss during peri- and post-menopause often results from hormone depletion and can especially be traced to a deficiency in estradiol, which as a form of estrogen is tasked with ensuring that hair roots remain strong and healthy. If estradiol is missing, this commonly leads to hair loss in women and, more unfortunately, to the demise of hair roots. One treatment method is applying compounds containing estradiol, whereby we recommend that before beginning this therapy one also certainly consult a dermatologist and remember – when it comes to hair loss, the quicker, the better.
Certain natural remedies like cimcifuga, black cohosh, blue cohosh, evening primrose or St. John’s wort extracts may have some limited use in regard to certain menopause symptoms. However, these remedies might, if anything at all, only reduce symptoms, but they do not address or solve any of the fundamental medical problems caused by hormone depletion or serious medical conditions relating, among others, to the body’s circulatory, nervous and osteopathic systems.
For many years, hormone replacement therapy was attacked and tarnished in the media. It was therefore only ever prescribed with great reservations. The reason for this was one single US-American study from 2002 that initially sought to claim that HRT could be responsible for a heightened risk of cancer, as well as a heightened risk of thrombosis, embolisms, strokes and heart attacks. At least that was how that single study was originally interpreted, which caused hormone replacement therapy to be shunned but, more importantly, caused billions of women worldwide unnecessary suffering. However, upon review, the scientific community has located increasingly grave weaknesses in that study; a fact which was however largely ignored by the media (perhaps because actual science might be less eye-catching than causing alarm and panic). Leaving aside the many questionable aspects of that study, the fact is that the results of that initial study are today largely irrelevant because today’s hormone replacement therapy relies on modern bioidentical hormones rather than on the older, non-bioidentical hormones (estrogen gained from horse urine and synthetic gestagen), which were the subject of the original study. Today’s bioidentical estrogen and natural gestagen compounds do not cause cancer. In fact, more recent studies show they can reduce the risk for certain cancers. They also do not increase the risk of thromboses, embolisms, strokes or heart attacks. Of course, as with every pharmaceutical therapy, there will always be certain exceptions to the rule, and there are certain women who should not take bioidentical hormones, such as those who have or who have had breast cancer. If you have more questions on this topic, please contact us. Our team of experts are always ready to help!
As each therapy is highly individualized, so too are our individual therapy package offers. We thereby make every effort to find solutions that are right for everyone’s needs.
Both your initial consultation and follow-up consultations will take place via Zoom conferencing. Consultations that take place in the form of second opinions where there is already an existing course of therapy in place will also take place via Zoom. We also offer our existing patients the opportunity to make telephone appointments for quick inquiries, updates or for short “assessments”.
Dr. med. Sheila de Liz (50 min.): EUR 595,-
Initial consultation: EUR 390
Follow-up (up to 30 min.): EUR 200,-
Telephone appt. (max. 10 min): EUR 79,-
Second opinions in the case of already ongoing therapy (15 min.): EUR 120,-
In order to be ideally prepared for your initial consultation with one of our team of experts, we kindly ask that you first have your hormone levels measured and then upload these values to your Vcita patient portal prior to your initial consultation. This allows us to optimize and begin your personalized course of therapy as quickly and soundly as possible. Please pay special attention to which blood values are being taken and to the time of your cycle during which they are taken. If your menstrual cycle has already stopped entirely or only takes place highly sporadically with long intermissions, you can have your blood values determined at any time.
In case of a regular or nearly regular cycle, please take as follows:
1st Week: FSH, Estradiol, Testosterone 20th – 25th Day of Cycle: Progesterone
In case menstruation has ceased:
Estradiol, Testosterone, Progesterone
Your period may start occurring irregularly, then regularly again, and then even go completely “crazy”. During menopause, any constellation is possible. What many people don’t know (including even many doctors) is that menopause actually begins when you are still having regular periods!
Hot flashes occur when your estrogen levels plummet and the portion of your brain that regulates body temperature is affected. You don’t need to experience hot flashes to be going through menopause – in fact, many women never experience them at all. Yet, those of us who do suffer from them have sometimes had to endure “advice” like “don’t be so sensitive”, “just wear lighter clothing” or even “just put some cooling pads in your bed” (!!!). This completely misses the point that, from a medical perspective, “hot flashes” are serious alarm signals that your body is sending out, and not simply some minor symptom that can be “managed”. If they are not treated properly, your body will at some point turn off its alarm system, causing the hot flashes to gradually decrease. That does not mean, however, that everything has gone “back to normal” – to the contrary, the complete opposite is the case, and the changes that have taken place in the meantime are usually neither positive nor healthy. As you can tell, this is a topic I’m extremely passionate about because women have received wrong information or even been misled about this issue for years. Not only can hot flashes be medically prevented, they should be medically prevented because they are a serious signal that your body is suffering. As medical menopause specialists, it is one of our most important duties to provide you with vital, true information so that together we can find and implement the right solutions for you.
Nearly 20 % of all women experience only one serious symptom during menopause – joint pain. This fact often leads women on a misguided medical odyssey – going from their general practitioner to an orthopedist and then to a rheumatologist – none of whom are then unable to help. The truth is that many women experience joint pain because their hormones are depleted. This is another critical area that requires correct treatment and information, as women with menopause-related joint pain have a far greater risk of developing rheumatoid arthritis if their hormone deficiency isn’t treated.
Sex is one of the most important aspects of our lives and an important means of communicating in relationships. When libido declines, this can lead to our most precious relationships deteriorating over time. Even those of us who have understanding partners can often miss the feeling of being a complete sexual being. Many women may find themselves thinking “I was never like this before!” Please know that we can help make you feel as good as you used to (and sometimes even better!), so please contact us if you need help. No one is ever “too old” for sex!
One of the most irritating symptoms of menopause is weight gain, especially around the belly, caused among others by decreasing hormone levels. Many women unfortunately shy away from hormone replacement therapy because they have been misinformed that it will cause them to gain even more weight, when in fact the exact opposite is often the case! We look forward to advising you in this regard so you can know the real facts.
Sometimes, it’s all just too much to take, right? We fluctuate between episodes of sadness, outbursts of anger, and even moments of despair when we wonder if we haven’t made all the wrong choices in life. Many women with these symptoms are then sent to therapists or even prescribed antidepressant pharmaceuticals. Yet the real cause is often overlooked: hormone depletion! Many women begin to feel like themselves again after beginning a personalized hormone therapy. So speak with us because the solution is sometimes simpler than we imagined.
What many don’t know is that our bladders can react extremely sensitively to hormone deficiency, leading to recurring UTI’s. Over time, this can lead to chronic bladder irritation and incontinence if the underlying hormonal causes are not properly treated.
Painful episodes during sex simply shouldn’t be happening – even when major companies and the media are still trying to sell the myth that all women need is just more lubricant. It’s important to know that the vagina is often not merely “dry”, but that hormone depletion actually causes the vaginal skin to become thin and brittle. Without precise, targeted treatment, vaginal thinning will continue to worsen, and no lubricant in the world will be able to prevent the resulting pain. We can provide a safe, lasting solution to help make your vagina healthy and pain-free again.
Have you also joined the 3:00 AM Club? Lying in bed awake every night and only barely falling asleep right when the alarm goes off is a terrible reality for many women. The cause for this is often hormone deficiency, which can be alleviated safely and relatively quickly. We’re here to help!
Do you experience heavy exhaustion, a need to lay down and sleep during the day, low energy levels or lack of drive? This lesser known but common symptom of menopause can have severe life consequences, such as a lack of stamina at work, a lack of desire to meet and share with friends, losing interest in your relationship or an increasing desire to “check-out” of life and all it has to offer. Your nervous system may feel overextended, and you may feel a need to withdraw. Extremely often these are signs of testosterone deficiency, which can be (and which should be!) alleviated so that you can feel good again. We are experts in managing testosterone for females, so let us know, and we can help!
One of the most emotionally devastating and problematic symptoms of menopause is increased hair loss. If you are experiencing these symptoms, it’s important not to sit and wait while things get worse but to act quickly to stop it. Remember: time is hair!
If you feel that you might just “lose it” when coughing, laughing or sneezing, please know that many women suffer in silence with this problem. Nobody wants to be incontinent – after all, the myth is that this only happens to infants or the very old. There is so much false information about this topic floating around on the internet, especially that incontinence can be cured by simply doing regular pelvic floor exercises. This usually doesn’t work because most often the problem is not located in the pelvic floor but actually stems from weakening of the urethra caused by hormone depletion. The earlier you start treating this issue the easier it will be to achieve an effective, lasting solution. You don’t need to suffer from incontinence!