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!