The menopause – Everything you need to know about the menopause

The menopause is a phase in a woman’s life that is accompanied by many changes. Yet despite the importance of this stage of life, there is often little information about the menopause, menopause and hormone therapy.

The menopause can begin relatively early. The so-called peri-menopause, which marks the start of the menopause, usually occurs from the age of 40. During this phase, less progesterone is produced, which can lead to symptoms such as swelling and mood swings. The actual menopause then occurs with the last menstrual period. This is followed by the post-menopause (twelve months after the last menstrual period), during which not only the luteal hormone (progesterone) but also oestrogen is absent and menopausal symptoms can increase.

What is the menopause?

The menopause is the last menstrual period in a woman’s life and marks the end of her fertility. The phase before and after this is known as the perimenopause. It is only 12 months after the last menstrual period that it can be assumed that this was actually the last menstrual period, meaning that the time of the menopause can only be determined retrospectively. The postmenopause begins one year after the last period. During this period of change, the reduced production of sex hormones can lead to numerous complaints.

What is progesterone?

Progesterone is a hormone that prepares the uterus for pregnancy. Alongside oestrogen, it belongs to the group of female sex hormones. The main function of progesterone is to ensure that a pregnancy occurs and that you remain pregnant. Progesterone also has positive effects on the nervous system. Progesterone has an anxiolytic, sleep-promoting, relaxing and calming effect. When progesterone levels fall during the menopause, many women experience anxiety, sleep disorders and mood swings.

What is oestrogen?

Oestrogen is a female sex hormone. Oestrogens control the female menstrual cycle and the maturation of egg cells. They are also important for maintaining a pregnancy. If oestrogen levels fall during pregnancy, various symptoms can occur. Typical symptoms include hot flushes, dry mucous membranes (vaginal area, eyes), lack of energy and mood swings.

The menopause can bring with it a variety of challenges. Women can suffer from symptoms such as lack of energy, fatigue, reduced performance, weight gain, hot flushes and sleep disturbances. These changes can have an impact on everyday life, family care and job performance. In addition, anxiety and uncertainty can arise as many women do not know exactly what to expect during the menopause.

The menopause is not the first major change that women experience – puberty, pregnancy or breastfeeding are also part of it. Nevertheless, they are often perceived as particularly drastic. This is because women usually live in a phase of relative stability at this time: Career, family and identity are stable. But suddenly the body changes without external circumstances providing a clear explanation.

‘A major challenge of the menopause is that a lot changes physically, although the circumstances of the individual woman’s life do not usually change much.’ (Franziska Shembele, Deputy Head of Sports Science – Lanserhof Tegernsee)

Symptoms such as hot flushes, night sweats, weight gain, brain fog or tiredness can be irritating. There are over 230 possible symptoms, which vary from person to person. Many women feel unprepared and left alone – partly because the topic of the menopause is still a social taboo.

A recurring theme is weight gain, especially in the abdominal area. This change is often due to hormonal fluctuations and reduced muscle mass, which slows down the metabolism. It can also lead to a drop in performance, fatigue and sleep problems. Particularly problematic: many women feel that their complaints are not taken seriously or that they cannot find the right people to talk to.

This is where the Lanserhof concept comes in. Sports scientist Franziska Shelembe and her team at Lanserhof Tegernsee view the menopause as a holistic issue and work on an interdisciplinary basis. Exercise, nutrition, medical care and psychological coaching are individually combined to provide the best possible support for every woman.

Exercise is one of the most effective ways to alleviate the symptoms of the menopause. It is important to tailor the training plan to individual needs and symptoms:

Lack of energy, fatigue and brain fog
Relaxation techniques such as yoga, breathing exercises and stretching help to reduce stress and improve sleep quality.

Muscle loss and weight gain
Strength training is essential to stop muscle loss and boost metabolism. Exercises with resistance, such as squats, also promote the stability of the pelvic floor – an important aspect, as complaints such as incontinence or vaginal dryness are common.

Stamina and well-being
Zone 2 training, i.e. moderate endurance training, improves general fitness and can alleviate symptoms such as tiredness or restlessness.

Shelembe emphasises: ‘Every unit of exercise counts. It’s about trying out what’s good for your body. Even small steps make a big difference.’

One of the key messages is that there is no universal approach. Every woman experiences the menopause differently, so support should also be customised. It is important to integrate exercise into everyday life without overloading the body.

Lanserhof also attaches great importance to taking hormonal changes into account. The drop in oestrogen levels, which is typical during the menopause, not only affects muscle development, but also regeneration and inflammatory processes. A gender-appropriate approach to training and nutrition planning is therefore essential.

The fall in oestrogen levels leads to a loss of bone density. This is why it is so important, especially during the menopause, to maintain a sufficient vitamin D level and keep moving.

During the menopause, women put on weight as their muscle mass continuously decreases. Muscles consume more calories than fat. As muscle mass decreases, the calorie requirement therefore decreases.

On the other hand, the distribution of fat changes during the menopause. In particular, women gain weight on their stomach and hips. Only little oestrogen is produced by the ovaries, which is why abdominal fat cells now also take over the production of oestrogen. This is why the body particularly likes to store fat in the abdominal area.

Sleep disorders can also favour weight gain. When we are sleep-deprived, the hormone ghrelin is increasingly released, which has a particularly appetising effect.

Despite the challenges, there are also positive aspects associated with the menopause. Women have often already achieved a lot by this time, their children are grown up and they are established in their careers. This opens up the opportunity to focus more on themselves and develop a healthy selfishness. The menopause can be a time of personal development and new beginnings.

Hormone replacement therapy is a possible treatment option for women with menopausal symptoms. However, it is important to consider the individual needs and symptoms of each woman. Dr Milz emphasises the importance of a holistic approach, using symptoms, physical changes and laboratory tests to determine hormone levels. Customisation of hormone replacement therapy is crucial to achieve the best possible results and avoid unwanted side effects.

There are different types of hormones that are used for hormone replacement therapy. Natural hormones derived from plants can be an alternative for treating menopausal symptoms. Chemical hormones, such as those in the contraceptive pill, on the other hand, should not be used for preventative hormone replacement therapy as they can have potential risks and side effects.

Bioidentical hormones are obtained from plant substances and converted into a specific molecular structure in the laboratory. The structure of bioidentical hormones corresponds to the structure of our body’s own hormones.

Individualised treatment of menopausal symptoms is crucial. In addition to hormone replacement therapy, lifestyle changes such as a healthy diet, regular exercise and stress management can also help to cope better with the menopause. Good functioning of the liver is also important as it plays a central role in hormone metabolism.

The menopause is a natural phase in a woman’s life that is accompanied by various changes and challenges. An individualised approach to symptoms and holistic treatment can help to better manage the menopause. It is important to educate yourself about the different stages of the menopause and understand that every woman is individual and may have different symptoms and needs.

The menopause should not be seen as something negative, but as a time of transition and personal growth. Many women see this phase as an opportunity to discover themselves and reprioritise. It is an opportunity to focus on your own health and well-being.

Hormone replacement therapy can be an option to alleviate menopausal symptoms, but it is not suitable for every woman. It is important to work with a specialist to find the right treatment method. In addition to medical treatment, natural approaches such as herbal supplements, acupuncture or relaxation techniques can also be supportive.

Lifestyle changes also play an important role in coping with the menopause. A balanced diet, regular physical activity and stress management can help to improve overall wellbeing. It is also important to make sure you get enough sleep and rest.

Ultimately, it is important to treat yourself compassionately and take the time to look after your own needs. The menopause can be a challenging time, but it also provides an opportunity for personal growth and positive change. By becoming fully informed, seeking support and actively working on your wellbeing, you can view the menopause as a phase that brings new opportunities and possibilities.

What are the first signs of the menopause?
Early signs include sleep disorders and insomnia, often caused by falling progesterone levels. Progesterone promotes deep sleep and calms the nervous system. Irregular cycles and spotting can also be early symptoms.

How many women are affected by menopausal symptoms?
Around a third of all women have no symptoms. Another third experience mild symptoms, while a third suffer from severe symptoms that often require medical treatment.

Why do women often suffer from hot flushes during the menopause?
Hot flushes are caused by a dysregulation in the autonomic nervous system, which is due to falling oestrogen levels. The brain misinterprets the body temperature and triggers the release of heat through sweating.

What symptoms affect the urogenital area?
The drop in oestrogen makes the mucous membranes in the vagina thinner and drier, which can lead to pain during sexual intercourse and an increased risk of urinary tract infections. Symptoms such as incontinence or an overactive bladder also occur more frequently.

Why does the metabolism slow down during the menopause?
The decline in muscle mass reduces the basal metabolic rate, which means fewer calories are needed. Regular strength training can counteract the loss of muscle mass and boost the metabolism.

Can the menopause start before the age of 40?
Yes, in the case of premature menopause – often caused by genetic predisposition, autoimmune diseases or the removal of the ovaries – the symptoms appear much earlier. Smoking can also bring the onset of the menopause forward by around two years.

How long do hot flushes last?
On average, hot flushes last around six years. However, they can last longer in some women. They are often particularly distressing at night, as they can significantly impair the quality of sleep.

Is a hormone test useful during the menopause?
In most cases, no. Hormone levels fluctuate greatly and a snapshot taken from a blood test is not very meaningful. However, a test can be helpful if premature menopause is suspected.

Should men in the menopause also be considered?
Although men do not experience a menopause in the classic sense, their testosterone levels drop from the age of 40. This can lead to symptoms such as weight gain, sleep disorders and erectile dysfunction.

How does sexuality change during the menopause?
Vaginal dryness can make sexual intercourse more painful. Local hormone treatments or moisturising creams can provide relief. At the same time, some women report a more intense preoccupation with their sexuality and new perspectives during this phase of life.