Gynecology
- Annual check-up: annual preventive examination including cervical cytology test (PAP test) and breast examination
- Ultrasound examinations of the uterus and ovaries
- Advice on family planning and contraception, all methods (including IUD insertion)
- Adolescent gynecology
- Counselling and treatment during menopause and post-menopause
- Counselling and evaluation for infertility problems
- Counselling, evaluation and treatment of genital infections
- Counselling, evaluation and treatment of bleeding disorders
- Breast examination and ultrasound
- Screening for cancer diseases and after-cancer care
- Psychosomatic evaluation of gynecological disorders
- Laser treatments in the genital area
Preventive-integrative concepts
Menopausal transition: An opportunity to "cross-over" instead to “collapse”
As a gynecologist with a special interest in menopause and a member of the Swiss Menopause Society, I daily advise women who need to reorient themselves during the menopausal transition. This is not an easy task, as perimenopause can be accompanied by a variety of symptoms, including hot flushes, headaches, sleep disturbances, nervousness, depressive moods, exhaustion, menstrual irregularities, joint pain, decreased libido, and vaginal dryness. These changes are perceived very differently depending on a person’s history, character and cultural background. The consequences of hormonal changes are far-reaching and of great importance for women's health.
Surprisingly, the significance of prevention during the menopausal transition is neither discussed in the media nor adequately supported by the healthcare system. The mandatory health insurance (OKP) informs us that symptomatic perimenopause is considered a "disease" rather than natural – albeit unwanted – consequences of hormone deficiency. To clarify this misconception: No woman is sick here; she only needs education!
Supporting women during menopause is not just about what they lose but also about what they can gain for the rest of their lives. For those who want to remain healthy at 80, it is essential to address the prevention of chronic diseases starting from the age of 40.
What can be prevented during perimenopause?
A common concern in the perimenopause is gradual weight gain. The weight gain occurs due to the loss of muscle mass and reduced energy requirements. In other words, women gain weight without having changed their diet. This increase in abdominal fat is a dangerous factor for later development of diabetes as well as heart and vascular diseases and is by no means just "a little belly fat." The theory that weight gain during menopause is entirely normal has been rejected in recent years: Studies involving several thousand women have clearly shown that women with menopausal hormone therapy gain less weight than those without it. The hypothesis that hormones „would make you fat" has been refuted; in fact, the opposite has been proven.
Although associated with extreme psychosocial stress, hair loss during perimenopause has been trivialized as a "hairdresser's topic" – quite unjustly! Hair loss can have various medical causes: chronic iron deficiency due to heavy and prolonged bleeding, nutrient deficiencies resulting from increasing gastrointestinal issues or food intolerances, as well as a lack of estrogen and progesterone due to anovulatory cycles. With the gradual reduction of female hormones, bone metabolism also decreases. The metabolism of vitamin D and calcium becomes impaired, which can initially lead to osteopenia and later to osteoporosis. In Switzerland, the probability for women over 50 years old to suffer a fracture due to osteoporosis averages 51%. Timely administration of menopausal hormone therapy can effectively reduce, or even prevent this silent but dangerous condition.
A heart attack is very rare in women of reproductive age. With increasing body fat percentage and decreasing levels of estrogen and progesterone, the risk of heart attack rises to male levels. Menopausal, bioidentical hormone therapy plays a protective role, reduces the risk of heart attacks and helps in balancing fat and cholesterol values in the blood.
Should one take hormones and when YES, when?
According to "old" hormone philosophy, the last naturally generated bleeding in a woman's life – the menopause - was the only relevant parameter in the menopausal transition. If at all, menopausal hormone therapy was usually prescribed only after it. By then, some women were already physically and mentally at their lowest point. Today we know that ovarian function declines slowly over several years and that chronic deficiency in estrogen and progesterone can be felt even when bleeding still occurs.
The widespread belief that every menstrual cycle follows ovulation is incorrect. Anovulatory cycles – cycles without ovulation – also end with bleeding. The notion that bleeding guarantees well-being is fundamentally wrong.
The treatment for symptoms should occur when the affected woman demands it – regardless of whether she is still bleeding or not. What remedies should be used - whether plant-derived phyto-hormones, or human bioidentical hormones or bioidentical hormones in Rimkus® protocol or simply supportive hormone yoga and life-style changes -all this should be clarified in direct conversation with the patient. The goal is to promote individual health and minimize risks.
Your Health Remains the Focus
Support during menopausal transition is not a "one size fits all" product. It’s not about offering all women the same thing, but rather, focusing on your situation and needs. Together we can discover which lifestyle choices benefit you, which micronutrients you should be taking, and what habits you should develop to help you during the menopausal transition.
Unlike services covered by OKP (mandatory health insurance), coaching during menopausal transition is a preventive service and therefore paid directly by patient herself. The costs are based on time and effort and do not diverge from standard medical services.
I look forward to supporting you during your perimenopause! For further information, please contact me by phone 044 500 90 95 or email.
