Menopause care in Munich

The menopause – medically the climacteric – covers the years in which the ovaries gradually stop producing hormones. It often begins in the mid-40s with irregular cycles, because ovulation becomes less frequent and progesterone is the first to fall short. Later, oestrogen falls too. The menopause in the strict sense is the point of the last menstrual period. It can only be determined in hindsight, once twelve months have passed without a period. It usually occurs around the age of 50. The years before are called the perimenopause, the time afterwards the postmenopause. How long the menopause lasts and how severe the symptoms are varies greatly from woman to woman.

Falling oestrogen affects many areas. Hot flushes and night sweats are well known. Sleep problems, heart palpitations, irritability, low mood and difficulty concentrating are often added to these. Joint pain, dry skin and weight gain around the abdomen can also occur. The mucous membranes of the vagina and urinary tract become thinner and drier. This can contribute to burning, pain during sex, a frequent need to urinate and recurrent bladder infections. Specialists speak of genitourinary syndrome of menopause. Unlike hot flushes, these symptoms usually do not improve by themselves over time. Targeted treatment is particularly worthwhile here.

According to current guidelines, hormone therapy is a well-studied treatment for hot flushes and sweating episodes. At our practice, bioidentical hormones are an option for this. For example, oestradiol through the skin, combined with bioidentical progesterone for as long as the uterus is present. The progesterone protects the lining of the uterus. Benefits and risks depend on your age, when therapy starts, your previous illnesses and the form of application. If therapy begins close to the menopause, the balance in healthy women is favourable according to current knowledge. We therefore weigh things up carefully and monitor regularly. You can read more on our natural hormone therapy page.

Not every woman wants to, or is able to, take hormones, for example after breast cancer. In that case there are other approaches. For hot flushes, herbal remedies are used, for example black cohosh. Many women also find exercise, relaxation and acupuncture helpful, or avoid known triggers such as alcohol and spicy food. For vaginal dryness, hormone-free moisturising gels are an option. Prof. Dr. Schulte-Uebbing has looked into what is possible when oestrogens are not an option. His publications include “What can be done about vaginal dryness when oestrogens are forbidden?” (CO MED, 2014; published in German). Another contribution is “Vitamin D in gynaecology” (Menopause Congress, Vienna, 2010; published in German).

Oestrogen keeps bones and blood vessels stable. After the menopause, the body loses bone mass more quickly and the risk of osteoporosis rises. Blood pressure, blood fats and blood sugar also often change. The pelvic floor loses muscle tone, which can contribute to incontinence and prolapse symptoms. The menopause is therefore a good time to take a closer look at your own health: with exercise, strength training, a calcium-rich diet and pelvic floor training. We advise you on preventing osteoporosis. For pelvic floor problems, we offer Neocontrol pelvic floor therapy, among other treatments. You can find more on our osteoporosis and incontinence pages.

Prof. Dr. Schulte-Uebbing regularly speaks at the Menopause Congress of the University of Vienna. His topics range from vitamin D, thyroid and progesterone to hormonally active environmental substances. He has also worked on DHEA. DHEA is a hormone precursor from the adrenal gland whose level falls with age. On this subject he has published, among other things, “What you should know about the ‘anti-ageing hormone’ DHEA” (Your Health, 2018; published in German). This knowledge feeds into our consultations. We discuss individually whether such approaches make sense for you. You can find a selection of his publications on the Publications page.