Menopause & Hormone Therapy

The menopause transition is a woman's natural phase of hormonal change, usually between the ages of 45 and 55. Complaints such as hot flushes, sleep problems and mood swings can often be treated effectively. In a video consultation, doctors advise on hormone replacement therapy (HRT) and, based on their medical assessment, can issue follow-up prescriptions for an existing therapy.

Medically reviewed by Adi Zoabi, Approbation als Arzt.
Last reviewed on August 31, 2026. Updated as clinical guidelines change.

Overview

The menopause transition (climacteric) is the natural phase of hormonal change in a woman's life, usually occurring between the ages of 45 and 55. During this time the body gradually reduces its production of the sex hormones oestrogen and progesterone until menstrual periods stop permanently (menopause). Many women experience complaints such as hot flushes, night sweats, sleep problems or mood swings during this phase; for a considerable proportion, the symptoms are severe enough to noticeably affect everyday life, work and quality of life. Menopausal symptoms are very treatable. Based on a medical assessment, hormone replacement therapy (HRT) may be an option; non-hormonal and herbal approaches as well as lifestyle measures are also available. In a video consultation, doctors can assess your symptoms, discuss the benefits and risks of hormone therapy with you and, where medically justifiable, issue follow-up prescriptions for an existing, well-adjusted therapy. Billing is carried out as a private service according to the German GOÄ fee schedule; patients with statutory insurance can use the service on a self-pay basis.

Common causes

Menopausal symptoms are caused by the declining hormone production of the ovaries. Falling oestrogen levels affect, among other things, temperature regulation in the brain, the sleep-wake rhythm, the mucous membranes, bone metabolism and mood. The transition does not proceed evenly: during perimenopause, the years before the final menstrual period, hormone levels fluctuate strongly, which explains irregular cycles and symptoms that vary in intensity. How strongly symptoms are experienced depends on genetic predisposition, lifestyle, body weight, stress levels and accompanying illnesses. Smoking and premature loss of ovarian function, for example after surgery or certain cancer treatments, can bring the onset of menopause forward and intensify complaints. Other conditions, such as thyroid disorders or depression, can cause similar symptoms and should be taken into account in the medical assessment.

When to see a doctor

Seek medical advice if hot flushes, sleep problems or mood swings noticeably impair your quality of life, if you would like to start, adjust or continue hormone replacement therapy, or if you are unsure whether your complaints are actually explained by the menopause. Certain warning signs require prompt in-person assessment: any bleeding that recurs after more than twelve months without a menstrual period, unusually heavy or persistent bleeding, newly palpable lumps in the breast, and unexplained weight loss. If you are on hormone therapy, you should also watch for signs of thrombosis, for example a calf that is swollen, painful or warm on one side. In case of sudden shortness of breath, severe chest pain, signs of paralysis, speech disturbances or sudden loss of vision, call the emergency number 112 immediately – these signs may indicate a pulmonary embolism or a stroke.

Symptoms & Indications

Hot flushes and sudden episodes of sweating Night sweats Sleep problems Mood swings and irritability Irregular or absent menstrual periods Vaginal dryness and discomfort during intercourse Joint and muscle complaints Difficulties with concentration and memory

Treatment Options

In-depth medical advice on the benefits and risks of hormone replacement therapy (HRT)
Hormone replacement therapy with oestrogens and progestogens (for example as gel, patch or tablet), subject to medical assessment
Local (vaginal) oestrogen treatment for vaginal dryness
Non-hormonal treatment options, for example certain classes of antidepressants for severe hot flushes
Herbal preparations, for example black cohosh extracts, after medical advice
Lifestyle measures such as regular exercise, relaxation techniques, sleep hygiene and a balanced diet
Follow-up prescriptions for an existing, well-adjusted hormone therapy after medical review

Important Notes

A video consultation does not replace a gynaecological examination. Regular check-ups, including breast and cancer screening, should continue to take place in person.
Any bleeding that recurs after more than twelve months without a menstrual period must be assessed promptly by a gynaecologist in person.
Hormone replacement therapy is not suitable for every woman, for example after certain cancers or thromboses. Suitability is decided by medical assessment in each individual case.
In case of sudden shortness of breath, chest pain, painful swelling of one leg, signs of paralysis or speech disturbances, call the emergency number 112 immediately.

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Medical notice: Not a substitute for an in-person medical examination. The information on this page is intended for general guidance only. In an emergency, please call 112.

Frequently Asked Questions

Can I get a follow-up prescription for my hormone therapy via OpenClinic24?

Yes, in many cases this is possible. If you are already on a well-adjusted hormone replacement therapy, the doctor can issue a private prescription in the video consultation based on their medical assessment. It helps to have the name of your current preparation and recent findings at hand. There is no entitlement to a prescription; the decision always rests with the treating doctor.

What does the consultation cost and will my insurance cover it?

Billing is carried out as a private medical service according to the German fee schedule for physicians (GOÄ). Privately insured patients can usually submit the invoice to their private health insurer; reimbursement depends on the individual tariff. Self-paying patients receive a transparent invoice based on the GOÄ. The cost of medication on a private prescription is paid additionally at the pharmacy.

Is hormone replacement therapy dangerous?

Like any effective treatment, hormone replacement therapy has benefits and risks. According to current knowledge, for healthy women with troublesome symptoms who start therapy close to the time of menopause, the benefits often outweigh the risks. Risks, for example of thrombosis or certain cancers, depend on the active substance, route of administration, duration and individual medical history. A careful medical benefit-risk assessment is therefore part of every treatment decision.

Can hormone therapy also be prescribed for the first time via video?

An initial consultation is well suited to video. Whether a first-time prescription is medically justifiable via telemedicine depends on the individual case: your medical history, current findings and the status of your gynaecological check-ups are important. If necessary, the doctor will first recommend an in-person examination or blood pressure check before hormone therapy is started.

Are there effective treatments without hormones?

Yes, there are alternatives for women who do not wish to use hormones or are not able to. These include certain non-hormonal drug classes for hot flushes, herbal preparations and lifestyle measures such as exercise, relaxation techniques and sleep hygiene. Which option is suitable is discussed individually during the medical consultation.