A New Chapter – Not an Ending
Hot flushes that drench you at 3am. Mood swings that rival adolescence. Brain fog that makes you question your competence. Weight gain that appears from nowhere. Joint pain, dry skin, loss of libido, and a body that no longer feels like yours. Menopause is a natural transition, but for many women, it is anything but smooth.
At our practice in Zürich Seefeld, I help women navigate perimenopause and menopause with evidence-based strategies that go beyond “it’s just your age.” This transition deserves proper medical attention and individualised care.
Understanding Perimenopause and Menopause
Menopause is defined as 12 consecutive months without a menstrual period, typically occurring between ages 45 and 55. But perimenopause – the transition phase – can begin up to 10 years earlier and is often the most symptomatic period. During perimenopause, hormone levels fluctuate wildly rather than declining smoothly, which is why symptoms can be so unpredictable.
Common Symptoms
The symptom range extends far beyond hot flushes: vasomotor symptoms (hot flushes, night sweats), sleep disturbance, mood changes (anxiety, irritability, depression), cognitive changes (brain fog, poor memory), joint and muscle pain, weight gain (particularly abdominal), vaginal dryness and urogenital symptoms, decreased libido, skin and hair changes, palpitations, and fatigue. Many women do not connect symptoms like joint pain, anxiety, or brain fog to menopause, leading to multiple specialist visits without resolution.
Why Hormones Matter Beyond Reproduction
Oestrogen and progesterone are not just reproductive hormones. They protect cardiovascular health, maintain bone density, support brain function and mood, regulate metabolism, maintain skin elasticity, and support urogenital health. Their decline affects virtually every system in the body, which is why menopausal symptoms are so diverse.
Our Comprehensive Assessment
I evaluate hormonal status (oestradiol, progesterone, FSH, LH, testosterone, DHEA-S, SHBG), thyroid function (symptoms overlap significantly), bone health markers, cardiovascular risk factors, vitamin D, iron, and metabolic markers. This comprehensive picture guides personalised treatment decisions.
What We Do: Personalised Menopause Management
Hormone Replacement Therapy (HRT): When appropriate and desired, bioidentical HRT can be transformative. I discuss the evidence honestly – the benefits for most women under 60 or within 10 years of menopause significantly outweigh the risks. I use body-identical oestradiol and micronised progesterone, tailored to your symptoms and health profile.
Non-hormonal options: For women who cannot or prefer not to use HRT, evidence-based alternatives include specific SSRIs/SNRIs for vasomotor symptoms, gabapentin, cognitive behavioural therapy, and targeted supplements.
Nutritional optimisation: Phytoestrogens (soy isoflavones, flaxseed), calcium, vitamin D, omega-3 fatty acids, and magnesium to support bone, cardiovascular, and brain health.
Exercise prescription: Resistance training (critical for bone density and metabolism), cardiovascular exercise, and flexibility work tailored to this life stage.
Metabolic support: Addressing the insulin resistance and weight gain that often accompany menopause through dietary strategies and lifestyle modification.
Mental health support: Recognising and treating perimenopausal anxiety and depression, which are driven by hormonal changes and respond to hormonal as well as psychological treatment.
Conclusion
Menopause is a natural transition that deserves informed, compassionate medical care – not dismissal. Whether you choose HRT, natural approaches, or a combination, the key is a personalised plan based on your symptoms, risk factors, and preferences. If menopause symptoms are affecting your quality of life, I invite you to our practice in Zürich Seefeld.
