HRT & Menopause Care in Marbella

The menopause transition is treatable, and you do not have to "just live with it." At Longevity Marbella, hormone replacement therapy is assessed properly, tailored to you, and monitored by a specialist, so you can feel like yourself again.

Symptoms we help with

Perimenopause and menopause can affect far more than hot flashes. If these sound familiar, an assessment can give you clarity (and if your periods have not stopped yet, read perimenopause: the years before menopause nobody warns you about):

• Hot flushes and night sweats
• Disturbed sleep and fatigue
• Mood changes, anxiety or low mood
• Brain fog and poor concentration
• Low libido and intimate discomfort
• Joint aches and changes in body composition

What proper HRT involves

• Consultation, a careful review of your symptoms, history and goals.
• Blood work where indicated, to inform safe, appropriate treatment.
• A personalized protocol, modern, regulated hormone options chosen to fit you, including body-identical preparations where appropriate.
• Ongoing review, adjusting as your needs change, with safety first.

The assessment, in full

Menopause is, for most women, a clinical diagnosis: your symptoms, your cycle history and your age carry more information than any single blood value. The assessment is built around that, and blood work is added where it genuinely adds information:

• A careful history first. Symptoms, cycle pattern, sleep, mood, and what matters most to you, because that is what treatment success is measured against.
• Hormone levels where the picture is unclear, particularly at a younger age or after a hysterectomy, when the cycle can no longer tell the story.
• The look-alikes checked, thyroid disease first among them, so a treatable mimic is not dressed up as menopause.
• Your personal risk map: blood pressure, cardiovascular and clot history, breast history and family history, because these decide not whether care is possible but which route and preparation fit you best.
• Body composition where useful, since estrogen loss shifts bone, muscle and abdominal fat, and a baseline makes treatment effects visible later.

Why specialist-led care matters

Your care is directed by a doctor double board-certified in Internal Medicine and Endocrinology, expertise in hormones and in your wider health. That means decisions are individualised and your overall wellbeing is considered, not just a single symptom.

The preparations, and how one is chosen

Modern, regulated HRT is a toolkit, and the choice follows your risk map and your preference:

• Transdermal estradiol, a patch, gel or spray, delivers the hormone through the skin, bypassing the liver's first-pass metabolism. That is why patches and gels avoid the small blood clot risk some tablets carry, and why the 2025 European Society of Endocrinology guideline prefers low-dose transdermal therapy when cardiovascular risk factors are present.
• Oral estradiol remains a reasonable choice for many women without those risk factors, and some simply prefer a tablet.
• A progestogen alongside, when you have a uterus, to protect the womb lining; estrogen alone after hysterectomy.
• Vaginal estrogen for dryness and intimate discomfort, locally, with lower or no added systemic risk, alone or alongside the rest.
• Transdermal testosterone where libido remains low on well-adjusted HRT: in a 2025 study of 510 women already on HRT, four months of transdermal testosterone was followed by improvement in libido in 52 percent, mood in 47 percent and cognition in 39 percent. Dose and route decide everything here, and it is prescribed and monitored accordingly.

Body-identical preparations from a regulated pharmacy are part of this toolkit and are used where appropriate. The choice of preparation, dose and route is revisited as your needs change, because the right answer at 51 is not always the right answer at 58.

Is HRT safe?

For most women starting around the menopause, modern HRT is both effective and, with proper supervision, favorable on balance. The right choice depends on your history and is made with your doctor. We've written more here: HRT for menopause: what you should know. Those decisions are weighed against your cardiovascular and clot risk, assessed properly, which is where the internal medicine training earns its place.

Menopause is also a body composition event. Estrogen loss accelerates bone loss and shifts fat toward the abdomen while muscle quietly declines, which is why measurement belongs in menopause care. The Body Composition Assessment maps muscle, visceral fat and thyroid in one session, and a DXA scan can always be ordered in addition, to complete the information: it is the reference standard for bone density, and repeating it later shows exactly what treatment changed.

How treatment is reviewed

An early review after starting, to fine-tune dose and route while your body answers, then regular reviews from there, shaped by your case rather than a fixed template. Blood pressure travels with every review, participation in normal breast screening continues, bone health is reviewed if HRT is ever stopped because its protection fades after stopping, and any unexpected bleeding is investigated properly rather than watched. This is individualized medicine, and the schedule follows you.

The questions worth asking any menopause clinic

When we defer

• Unexpected or unexplained vaginal bleeding, until it is properly investigated.
• A personal history of a hormone-sensitive cancer, until care is coordinated with your oncology team, because that conversation belongs to both specialists.
• A recent blood clot, until route and timing are planned with the clot fully in view, which is where the internal medicine training earns its place.
• Uncontrolled blood pressure, until it is managed, which is usually quick.
• When a look-alike explains the symptoms, because treating thyroid disease as menopause serves nobody.

Deferred is not refused: most of these are a sequence, not a wall, and the assessment tells us which.

Discreet, convenient, in your language

Private telemedicine consultations and discreet concierge home visits across Marbella, Estepona, Puerto Banús and the Costa del Sol. English and Dutch spoken, in full confidence.

Explore our specialist services

• Body Composition Assessment
• Testosterone Replacement Therapy (TRT)
• Men's Health
• Medical Weight Loss (GLP-1)
• Longevity & Preventive Medicine
• Private Prescriptions & Continuity of Care
• Surgical Coordination & Second Opinions

★★★★★ 5.0 on Google from 21 reviews

“Best Endocrinologist for weight loss and improved body composition.”

Lianne Nicole Muller, Google review

Unedited Google reviews from the verified profile I manage. A selection is shown here; all twenty-one are on Google, including the ones in other languages.