Womens Health & Longevity
The EAU (Peri)Menopause
Protocol
Thanks to modern medicine, menopause no longer has to be a turning point in a woman's life. We have entered an era where this transition can be actively managed and navigated with control.
By combining targeted interventions with pharmaceutical options, we can protect women’s health and well being for the decades to come, ensuring they feel like themselves again and successfully extend their prime.
Led by the joint expertise of Dr. Maria Luis and Nathan Gutz, this 4-consult program provides a fully guided, multi-angled baseline assessment, establishing a strong foundation for informed decision-making and the long-term preservation of health, performance, and quality of life.
The Menopause timeline
Menopause marks the end of a woman's reproductive years, typically occurring around age 51.
Yet, the biological transition leading up to it—perimenopause—can begin as early as a woman's late 30s or early 40s. This phase is characterized by prolonged and unpredictable hormonal fluctuations.
Including postmenopause, roughly half of a woman's life is spent dealing with a wide range of symptoms that can significantly impact her day-to-day quality of life.
Managing symptoms
& Optimize risk profiles
With today’s advanced medical options, we can powerfully relieve (peri)menopausal symptoms, with the massive added benefit of lowering your long-term risk for chronic diseases.
Acute symptoms
Recognizing potential hormone deficiencies generally comes down to identifying specific symptoms:*
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Low Progesterone: Often causes anxiety, irritability, and a restless, jittery feeling as well as initial insomnia and an inability to wind down for sleep.
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Low Estrogen: Typically leads to hot flashes, mood swings, and feeling unusually tearful or emotional as well as night sweats and vaginal dryness.
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Low Testosterone: Frequently manifests as fatigue, brain fog, and a distinct lack of drive or motivation as well as physical weakness and reduced libido.
*Symptoms and their severity vary widely from person to person; hormones have complex, overlapping, and interconnected effects.
Long-term protection
When initiated within the critical Window of Opportunity—typically under the age of 60 [1] or close to the onset of menopause [2,3,4,6]
Menopausal Hormone Therapy has proven to improve women’s risk profiles with respect to:
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All-Cause Mortality: reducing total mortality rates for younger postmenopausal women [1,2].
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Cardiovascular Health: slowing the progression of atherosclerosis [3] and decreasing the risk of heart failure and myocardial infarction [2,4].
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Bone Density: preventing bone loss, osteoporosis, and related fractures [5].
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Brain Health: maintaining brain energy metabolism and offering potential protection against early neurodegenerative changes associated with Alzheimer’s disease [6].
PHASE 01
YOUR BASELINE
Combining industry-leading technology and key biomarkers, we gather a wealth of information, allowing us to make high-impact decisions regarding menopause treatment while detecting the earliest, often unnoticed, abnormalities that could compromise your quality of life over time.
Symptom Profile
Since each individual experiences different symptoms at different hormonal profiles, your lived experience of (peri)menopausal changes is essential. We pay close attention to how shifts in energy, sleep, cognition, mood, recovery, and physical performance affect your daily function. These signals are interpreted alongside clinical markers.
Blood Panels
We analyze your comprehensive hormone profile to map your status through the menopausal transition. Alongside this, we evaluate your lipid profiles and early signs of metabolic dysfunction, allowing us to aggressively outsmart the risk of chronic conditions decades before they impact your healthspan.
Body Composition
The hormonal shifts of (peri)menopause accelerate biological aging, driving rapid changes in body composition and increasing the risk of chronic diseases. To protect your healthspan, we use a high-resolution DEXA scan to evaluate essentials of longevity:
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Visceral fat: Deep abdominal fat to manage long-term health risks.
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Bone mineral density: Skeletal strength to proactively protect against bone loss.
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Muscle mass: Muscle reserves to safeguard physical performance and independence.
Proactive Women’s Screenings
Your safety and long-term health are our priority. We strictly follow national guidelines for preventive women’s health screenings and early detection, ensuring a maximally favorable risk profile before and during any hormonal optimization.
PHASE 02
THE STRATEGY
We synthesize all insights to compose your personalized plan. This may consist of targeted pharmaceutical follow-up combined with evidence-based longevity interventions to extend your healthspan.
Menopausal Hormone Therapy
The intense hormonal fluctuations and symptoms of perimenopause can be effectively managed with Menopausal Hormone Therapy. This approach offers a wide range of options to safely restore your hormone levels to an optimal range.
We prioritize the use of transdermal estradiol (gels or patches) combined with oral micronized progesterone. Derived from natural plant sources, these hormones are molecularly identical to the ones your body produces naturally.
Women’s Longevity
The remarkable relief from menopausal symptoms and its protective benefits opens up the opportunity to broaden your health horizon even further.
Our goal is to detect potential chronic disease risks and performance declines at the earliest possible stage—decades before clinical symptoms appear. Once a disease manifests, the window for true prevention has often already closed.
To maximize both your lifespan (how long you live) and healthspan (how well you live), we dive into a neglected part of medicine: evidence-based longevity.
Nutrition: Optimizing nutrient intake to preserve lean muscle mass and support long-term health.
Exercise: Balancing resistance training (to fight bone and muscle loss) with cardiorespiratory fitness.
Sleep: Prioritizing sleep architecture to maximize physical recovery and cognitive health.
Supplementation: Using a targeted, data-driven approach to fill specific nutritional gaps.
FAQ
At what age is it best to start managing (peri)menopause?
There is no defined age at which perimenopause should be managed, as the onset and progression of the transition vary between individuals.
The goal is to identify the right time for intervention. This begins with recognising early signs such as changes in menstrual cycles, sleep, mood, energy levels, cognitive function, or skin health.
Early action is important to avoid missing the window of opportunity for optimal support and intervention. A structured, personalised evaluation with a qualified specialist helps determine whether and when treatment or support is appropriate.
Does Menopausal Hormone Therapy cause breast cancer and thrombosis?
The widespread anxiety surrounding Menopausal Hormone Therapy originates from a 2002 study that was later misinterpreted and has since been re-evaluated in light of more recent medical evidence.
This misunderstanding has unfortunately led to a significant setback in the appropriate use and perception of MHT for many years.
For a more detailed analysis of the clinical data, read our comprehensive review here.
What makes this protocol different from standard care?
This protocol is built on a vision of Women’s Longevity: early detection and prevention. It goes far beyond symptom management, using the perimenopausal transition as an opportunity to optimise long-term health and reduce the future risk of chronic diseases through evidence-based interventions.
We use advanced assessments to create a multidimensional health profile. From this, we develop a clear, personalised action plan.
This integrated, proactive approach is what makes the protocol unique in Lisbon, and potentially in Portugal, as it combines medical expertise with a longevity-focused strategy that is rarely found in conventional care settings.
What is metabolic health, and why does it matter?
In simple terms, metabolic health means your body can efficiently process and utilize the energy you consume without causing internal damage. It is not just about being thin or having a stable weight; it is about how well your cells manage glucose, insulin, and lipids (fats).
Think of your metabolism as your body’s engine. When you are metabolically healthy, your blood sugar stays stable, your body is highly sensitive to insulin, and systemic inflammation is low.
From a longevity standpoint, poor metabolic health—such as insulin resistance—is the ultimate driver of the chronic diseases responsible for 80% of all deaths: cardiovascular disease, cancer, type 2 diabetes, and Alzheimer's disease. If you want to maximize your healthspan, optimizing your metabolic health through nutrition, sleep, and exercise is the most powerful tool you have.
References
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Salpeter, S. R., Walsh, J. M., Greyber, E., Ormiston, T. M., & Salpeter, E. E. (2004). Mortality associated with hormone replacement therapy in younger and older women: a meta-analysis. Journal of General Internal Medicine (JGIM), 19(7), 791–804. (Evidence for: the definitive age threshold; hormone therapy significantly reduces all-cause mortality specifically in women under the age of 60).
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Schierbeck, L. L., Rejnmark, L., Tofteng, C. L., Stilgren, L., Eiken, P., Mosekilde, L., Køber, L., & Jensen, J. E. (2012). Effect of hormone replacement therapy on cardiovascular outcomes in recently postmenopausal women: randomised trial. BMJ (British Medical Journal), 345, e6409. (Evidence for: a significant reduction in total mortality and heart failure following 10 years of randomized treatment initiated early after menopause).
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Hodis, H. N., Mack, W. J., Henderson, V. W., Shoupe, D., Budoff, M. J., Hwang-Levine, J., Li, Y., Feng, M., Dustin, L., Knight-Saddler, L., Azen, S. P., & ELITE Research Group. (2016). Vascular effects of early versus late postmenopausal treatment with estradiol (ELITE). The New England Journal of Medicine (NEJM), 374(13), 1221–1231. (Evidence for: the underlying biological mechanism; early initiation significantly slows the progression of atherosclerosis, whereas late initiation shows no vascular benefit).
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Multi-Ethnic Study of Atherosclerosis (MESA). (2026). Timing hypothesis of hormone replacement therapy and cardiovascular disease risk across diverse populations. American College of Cardiology (ACC) Journal Scan. (Evidence for: contemporary validation of the 'timing hypothesis' and its cardiovascular protective benefits across diverse patient populations).
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The 2022 Hormone Therapy Position Statement of The North American Menopause Society. (2022). Menopause: The Journal of The North American Menopause Society, 29(7), 767-794. (Evidence for: the official clinical consensus statement confirming that the benefit-risk ratio within the 'window of opportunity' is highly favorable for the prevention of bone loss).
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Mosconi, L., Berti, V., Dyke, J., et al. (2021). Menopause impacts human brain structure, connectivity, energy metabolism, and amyloid-beta deposition. Scientific Reports, 11(1), 10867. doi:10.1038/s41598-021-90084-y. (Evidence for: neuroimaging data confirming the critical midlife transition where oestrogen decline alters brain energy metabolism and accelerates amyloid-β deposition, particularly in APOE-4 carriers).