Understanding menopause – what happens in the body
Menopause (climacteric) is a natural phase of life accompanied by hormonal changes. For many women, this process begins as early as age 40. In rarer cases, however, it starts even earlier – often gradually and with very different symptoms. Individually tailored medical support can help to specifically alleviate symptoms and support well-being.
In our fertility center in Munich, we support you with medical expertise, modern hormone diagnostics, and a holistic view during this phase of life.
The four phases of menopause
Menopause spans a period of about 10 to 15 years and is divided into several phases in which the hormone balance gradually changes.
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Premenopause (approx. 40–45 years)
In this early phase, fertility changes increasingly. The already declining ovarian reserve leads to the first hormonal changes, and hormonal processes become more irregular. First signs can be shorter cycles or prolonged bleeding, but breast tenderness, palpitations, mood swings, and PMS/PMDD are also frequently reported. Unremarkable hormone levels do not rule out the onset of menopause. -
Perimenopause (approx. 45–51 years)
Hormonal fluctuations increase. Typical symptoms such as hot flashes, sleep disturbances, mood swings, or irregular bleeding occur more frequently and intensely.
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Menopause (average age 51)
Menopause refers to the last natural menstrual period and marks the end of the ovaries’ hormonal activity.
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Postmenopause
Postmenopause begins about twelve months after the last period. The body adjusts to the changed hormonal situation – some symptoms improve, while others, such as sleep problems or hot flashes, may persist.
Typical symptoms of menopause
Many women experience changes during menopause that can manifest in very different ways. Estimates suggest that about three out of four women between the ages of 45 and 60 report corresponding symptoms.
Particularly common are hot flashes and night sweats, sleep disturbances, inner restlessness, or exhaustion. Concentration problems (“brain fog”), physical complaints such as joint or muscle pain, and changes in the cycle can also occur.
These symptoms are closely related to hormonal changes in the body – and in many cases can be specifically treated or significantly alleviated.
Other possible symptoms:
- Weight gain
- Changes in libido
- Skin and hair changes
- Vaginal dryness & pain during sexual intercourse
- Frequent bladder infections
- Urinary incontinence
- Dryness of skin and eyes
These latter symptoms are often a result of falling estrogen levels.
Treating menopausal symptoms – your therapy options
Every woman experiences menopause in her own way. Accordingly, treatment should also be individual. After careful diagnosis and personal consultation, we develop a therapy concept based on your symptoms, your life situation, and your needs – with the goal of supporting you effectively and gently at the same time.
A conscious lifestyle forms the basis of every treatment for menopausal symptoms. Targeted changes in everyday life can already help to balance hormonal fluctuations and improve general well-being. A balanced diet, regular exercise, and a stable sleep routine support the body during this transition phase. Dealing with stress also plays a central role, as persistent strain can intensify many symptoms. Relaxation techniques and mindful breaks in everyday life contribute to reducing inner restlessness and gaining new energy. Depending on the severity of the symptoms, this basic therapy alone may be sufficient or can be sensibly combined with other forms of treatment.
For mild to moderate symptoms, non-hormonal treatment approaches can be a helpful support. These include both herbal preparations and other medication options without hormones.
Herbal preparations can, for example, alleviate hot flashes, inner restlessness, or mood swings. Other non-hormonal medications are used specifically depending on the symptoms.
The effectiveness of herbal preparations is documented to varying degrees depending on the active ingredient. We clarify which treatment may be useful individually in a personal conversation.
Hormone therapy is one of the most effective treatment options for severe menopausal symptoms. It can significantly alleviate hot flashes, night sweats, sleep disturbances, and symptoms such as dryness or pain during sexual intercourse.
According to current medical knowledge, hormone therapy can be used with good tolerability in healthy women under 60 years of age or in the first ten years after menopause, provided there is careful indication and medical supervision.
Before starting treatment, we take the time to discuss possible risks, previous illnesses, and personal concerns in detail. The goal is an individually tailored therapy that is effective and supports you well through this phase.
So-called bioidentical preparations can also be used as part of hormone therapy to treat menopausal symptoms. Their chemical structure corresponds to the body’s own messenger substances and they unfold their effect via the same biological mechanisms. Many women find this form of treatment to be well-tolerated.
The therapy is individually tailored to your levels and symptoms and is regularly monitored. We would be happy to advise you in detail whether such a treatment is suitable for you.
In addition to medical treatment, holistic procedures can represent valuable support. They aim to stabilize both the body and psyche and strengthen personal well-being. Regular exercise as well as relaxation or mindfulness techniques can help to reduce stress, improve sleep, and make it easier to deal with the changes of this phase of life.
These approaches do not replace medical therapy, but can complement it sensibly and be individually adapted.
How we support you during menopause
Symptoms and hormonal changes during menopause can be very different. That is why we look at your personal situation individually and discuss together which diagnostics and treatment make sense for you.
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Initial consultation & diagnostics
In a detailed medical consultation, we discuss your symptoms, your personal situation, and your questions about menopause. Depending on the issue, we supplement the conversation with a vaginal ultrasound examination and a hormone analysis.
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Discussion of findings & treatment plan
Once the hormone results are available, we discuss the findings in detail with you and develop an individual treatment plan on this basis.
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Follow-up checks
We accompany the treatment with regular follow-up checks and adjust it if necessary.
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Fertilization (IVF/ICSI)
Lab step; We update you.
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Egg retrieval (short outpatient)
You rest; We collect oocytes.
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Stimulation & monitoring (10–12 days)
We tailor meds; You attend scans.
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Personalized Support
Continuous support from the first consultation to ongoing therapy by the same doctor.
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Specialized hormone medicine
Many years of experience in gynecological endocrinology (hormone medicine) and the treatment of menopausal symptoms.
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Holistic view
Consideration of hormonal, physical, and emotional aspects of this phase of life, including a look at preventive aspects regarding vascular and bone health.
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Interdisciplinary collaboration
We supplement our gynecological expertise through cooperation with specialists in internal endocrinology, cardiology, and osteology, as well as through offers from nutritional counseling and psychotherapy. This allows us to support you comprehensively and individually.
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Central & flexible
Our practice in Munich is easy to reach and offers appointment times that can be flexibly integrated into your everyday life.
What Our Patients Say
Frequently asked questions about menopause and perimenopause
What are the first signs of menopause?
Typical early signs include irregular menstruation, hot flashes, sleep disturbances, mood swings, irritability, and concentration problems. Weight gain, decreased libido, or vaginal dryness can also sometimes occur during premenopause – i.e., before actual menopause. A medical evaluation can help to categorize the symptoms and identify possible hormonal changes.
Am I already in menopause?
In addition to your symptoms and cycle changes, a hormone analysis can be performed to categorize your phase of life. For example, determining FSH and AMH levels can already provide important clues. Elevated levels can indicate hormonal changes as part of menopause, but are not always clear-cut. Unremarkable levels do not rule out menopause.
The decisive factor is therefore the overall assessment of symptoms, cycle progression, and, if necessary, laboratory values. If required, further examinations are carried out to rule out other causes.
How long does menopause last?
Menopause proceeds in several phases and often lasts several years in total. Many women experience symptoms for about 4–8 years, for some also shorter or longer – individually dependent on the hormone course and symptoms.
In which phase of menopause do most symptoms occur?
For many women, perimenopause is the most stressful phase. This is where the strongest hormonal fluctuations occur, which can intensify physical and emotional symptoms. Symptoms such as hot flashes, sleep disturbances, and depressive moods often reach their peak during this time. However, individual treatment can provide noticeable relief.
When should menopausal symptoms be medically evaluated?
If symptoms are very burdensome (e.g., sleep disturbances, hot flashes, mood swings), occur for the first time, or worsen significantly, a medical evaluation is sensible. Likewise in the case of bleeding disorders (frequent, very heavy, irregular, or after a long break), pain, or if you are unsure whether the symptoms really come from menopause.
Which medications help with menopausal symptoms?
The most effective medicinal treatment for menopause is hormone replacement therapy (HRT), for example with estrogen-progestogen preparations. Alternatives are bioidentical hormones, which are obtained from yam root, for example. Herbal remedies such as chasteberry and St. John’s wort can also help against certain symptoms. The choice depends on symptoms, risks, and individual needs – medical advice is essential.
How does the body change during menopause?
Many women gain weight on the abdomen and waist. Falling estrogen levels affect fat distribution, muscle mass, and metabolism. The body stores fat more easily, while muscle mass decreases.
Can you lose weight again after menopause?
Yes, losing weight is also possible after menopause, although often more difficult. Muscle building, a healthy diet, exercise, and sufficient sleep are also crucial after menopause. Targeted management of stress and hormone fluctuations supports the metabolism. Diets alone are usually not sustainable – a long-term lifestyle change is more effective.
What should be avoided as much as possible during menopause?
A healthy lifestyle can help to positively influence menopausal symptoms. This includes avoiding permanent stress, nicotine, excessive alcohol and coffee consumption, lack of exercise, and extreme diets as much as possible.
Instead, it is worth paying attention to your own body and seeking medical advice for more severe symptoms. Regular exercise, sufficient sleep, and a balanced lifestyle help to get through this phase of life stably.
What does bleeding after menopause mean?
Renewed bleeding after 12 months without a period is considered postmenopausal and should be medically evaluated immediately. Possible causes are harmless changes to the mucous membrane, but also serious illnesses such as uterine cancer.
When does menopause begin?
In Germany, menopause occurs at an average age of about 51. Since it is defined retrospectively, one only speaks of menopause when no menstruation has occurred for twelve months.
