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Why choose hormone replacement therapy or hormonal treatment (HRT) during menopause (climacteric)?

Hormone replacement therapy is a possibility if it has become difficult for us to enjoy life and we simply don’t feel well any more. This article deals with:

  • Is it possible to compensate a lack of hormones?
  • Does that ease menopausal complaints and symptoms?
  • A short story on human evolution
  • What are possible side effects and risks of HRT – and can they be avoided?
  • When herbal and when hormonal treatment?
  • BE CAREFUL – not all hormones are the same. We’ll explain the difference

We will start off with an introduction on hormonal effects or rather the consequences we experience when our hormone levels drop:

The effect of our hormones – in the entire body

As we grow older, a lot of functions recede. That also applies to producing sex hormones. These hormones do not only control sexual behavior and our genitalia; hormone receptors can be found in almost all our organs.

So sex hormones have an effect almost everywhere. And that does not only apply to purely physiological processes, but it is also relevant for our psyche: estrogen, testosterone and progesterone make us happy, well-balanced, stable, impulsive – energetic, resilient, they improve our drive and our senses – hormones make us “sensual”.

Many people experience this hormonal decline like an attack on their life’s quality and happiness, everything starts playing up, you experience unknown complaints, lots of things no longer work the way they are meant to and you just don’t feel well more and more often, you don’t want to admit it and simply ignore early symptoms.

We will start with what complaints are typical, which hormones (or rather their non-availability) are responsible and why, in our evolution so far, it was less important than today to do something about it.

Typical complaints during menopause include:

  • hot flashes
  • difficulty sleeping
  • less energy
  • degeneration of skin and mucous membranes, dryness of vagina/penis
  • problems concentrating and remembering things: fogginess
  • mood swings / depression / no longer able to enjoy life
  • more and more prone to stress
  • decline in fitness
  • gastrointestinal disorders (“IBS” – irritable bowel syndrome)
  • increasing problems with your joints all the way to chronic pain syndrome (“something is sore all the time, but the doctors can’t find anything wrong”)
  • deterioration of connective tissue
  • increased wrinkling
  • accelerated aging process
  • weakening immune response and reduced cell regeneration
  • more and more prone to becoming ill
  • reduced regeneration…

Typical consequences of a drop in progesterone during menopause

  • often starts with increasing PMS;

then additionally:

  • irregular menstrual cycle, changes in menstruation
  • irritable bowel syndrome (IBS)
  • loss of inner stability and resolve, less energy
  • increased occurrence of ANXIETY
  • increased sensitivity to PAIN
  • increase in INFLAMMATION
  • loss of libido
  • METABILISM slows down, build-up of fluid, tissue slackens
  • higher risk of CELLULAR CHANGES (e.g. carcinomas)
  • and others

Typical consequences of a drop in estrogen during menopause

  • SLEEP: impaired
  • MUCOUS MEMBRANES become drier, rough
  • PSYCHE: unsettled, moods, prone to depressive episodes, low spirits
  • ENERGY: less able to enjoy life
  • LIBIDO: decline of all sensory perception
  • BEAUTY: negative effects on skin, hair, loss of elasticity of connective tissue, beauty fades (“showing age”)
  • CARDIOVASCULAR system: increasingly less vessel elasticity, increase in CVD (cardiovascular disease), higher risk of suffering a stroke
  • and others

Typical consequences of a drop in testosterone during menopause

  • listlessness (adynamia)
  • loss of muscle mass
  • changes in body composition
  • negative effects on prostate (BPH/CA)
  • lower libido
  • increased sensitivity to pain
  • metabolism slows down
  • worsening of lipid profile
  • and others

Why do our hormone levels drop although we go on living for a long time? Here’s the answer:

A short story about evolution – our high life expectancy and hormone levels

If we have a look at our European history just 100 years ago, then women had a life expectancy of 47 years and men only 43 years! So, it was very unusual for someone to turn 50 and live longer than their fertile years…

While losing their ability to reproduce due to the drop in hormones at a certain age, the individual person would become weaker in every way, become ill and finally pass away. Reproduction – and thus the survival of the species – had already been secured by the previously high hormone levels. Seen from an evolutionary point of view, that made perfect sense.

As hardly anyone got older than 45-50 years anyway, the subsequent old-age loss of hormones, involving general decline, increasingly poor health and finally death, no longer had any consequences for the survival of the human species…

This situation, however, has drastically changed within the last one hundred years: the life expectancy of children born today is 85 years for girls and a little less than 80 years for boys (Federal Statistical Office of Germany, 2021). It can therefore come as a bad shock for some people when the above-mentioned symptoms suddenly start appearing. That shows without a doubt: the decline has begun.

The statistic shows the life expectancy of men and women from 1871 to 2020. You can see that it has increased considerably.
hormone replacement therapy, hormonal treatment, hormone deficiency, hormone replacement therapy with plants, side effects hormone replacement therapy
source: life expectancy when born in years, Federal Statistical Office of Germany (Destatis), 2021.

Easing menopausal complaints and symptoms with hormones – is that possible?

When seeing the above-mentioned symptoms and problems, the question arises – Is there anything we can do about it?

There are two options now:

  1. ignore and go on as usual. Often, men choose this way, also because of the fact that with men, hormone levels decrease gradually, over the course of decades, and even physicians often don’t realize that it’s a hormone deficiency which is causing the symptoms. But also some women at first try and ignore the complaints.
  2. suspect hormones as the cause and talk to your personal physician; this, however, requires a certain amount of cooperation from your physician. It is much more common that hormones are suspected as the cause with women, as is the case with men. Now you can look into it and decide:

Compensating the hormone deficiency

If a hormone deficiency is suspected to be the cause of your symptoms, then you can

  1. take hormones


  2. you can learn to somehow live with the complaints resulting from the hormone deficiency. As long as it is only mild symptoms (a third of people affected), most try to somehow cope themselves. But for 2/3 of all women, who experience moderate to severe symptoms, that can be a lot more difficult.

Are there no risks involved with hormone replacement therapy (HRT)?

As it is known today that hormones can be “dangerous” and pose considerable risks, all the way to breast or abdominal cancer, a decision for hormonal therapy (hormone replacement therapy, HRT) should not be made lightly.

Hormonal therapy is however still the most effective treatment method, as it treats the cause of your complaints! Many patients don’t decide in favor of hormone therapy because they are afraid of the risks of HRT.

But not all hormones are the same! Let’s have a closer look:

Because, exactly these risks can be avoided when applying bio-identical/human-identical hormones, as these hormones have NOT been modified compared to natural hormones – unlike conventional HRT (therapy involving hormonoids).

In the case of human-identical hormones, the hormone structure has not been changed, but remains unmodified! So, the structure is exactly as it naturally evolved over the course of hundreds of thousands of years.

And so, in the case of human-identical hormones (“natural hormones”) ALL RISKS CAN BE AVOIDED, WHICH ARE CAUSED BY MODIFYING HORMONE STRUCTURES!

Hormone replacement therapy (“hormonal treatment”) with bioidentical hormones according to Rimkus

By applying the treatment method with bio-identical hormones in individual dosages (Rimkus®Therapy), a hormone deficiency can be refilled – taking the exact amount of hormones that the individual person in fact requires.

Physiological hormones are no health risk – on the contrary! Otherwise, humans would have been extinct a long time ago! The natural UNMODIFIED physiological hormones (we also call them “bioidentical hormones”) give us strength and energy and keep us healthy.

The risks are caused by synthetic modifications performed when producing hormonoids!

So, we have to make a clear distinction as to WHICH hormones are applied.

What are possible side effects of hormone replacement therapy?

Does the risk of developing cancer increase with hormonal therapy?

It is important to distinguish between common HRT (using hormone derivates / hormonoids) and therapy that uses bio-identical hormones in individual dosages (see above).

A) Treatment that involves synthetically modified hormone derivates, i.e. conventional HRT, has undesired effects and most importantly increases the risk of

  • various types of cancer (breast cancer, abdominal cancer, lung cancer, other tumors such as myomas and others…)
  • gall bladder diseases
  • stroke, cardiovascular diseases (heart attack, high blood pressure, thromboses and embolisms),
  • mental changes (mood swings or even depression and increased suicide rates)
  • dementia
  • declining performance, retentiveness
  • changes in libido (loss of libido / impotence / ED = erectile dysfunction)
  • tissue changes, build-up of fluid…

B) If, however, bioidentical hormones are taken, then the undesired effects don’t occur because these hormones have an UNMODIFIED ORIGINAL STRUCTURE, they are NON-MODIFIED physiological hormones.

There can of course be temporary signs or symptoms of an under or overdosage, as the individually suited dose first needs to be established step by step.

Unwanted effects from bio-identical hormones are a result of the physiological (natural) effects of hormones and could be (selection):

  • breast tenderness (also with men)
  • changes in menstruation (breakthrough bleeding, postmenopausal bleeding even at a later stage in life…)
  • mood swings: “I feel like a teenager!”
  • frequently exhausted or overactive (that’s often caused by the thyroid!)

CONCLUSION regarding side effects

The answer regarding side effects can be found in the fact that hormonoids (case A) simply ARE NO HUMAN HORMONES, but have been intentionally modified compared to original human hormones!

And that’s the point: if instead only hormones with human-identical molecular structure (=bioidentical hormones) are taken (case B), all the risks and unwanted effects which are caused by the structural changes of the (unfortunately often prescribed …) hormones can be avoided.

When herbal and when hormonal treatment?

BY THE WAY: when undergoing therapy with the above-mentioned bio-identical hormones according to Rimkus®, you are NOT being treated with PHYTOHORMONES and you are also NOT taking hormones from animal products (e.g. conjugated hormones from mare’s urine).

Therapy using bio-identical hormones is NO therapy with phytohormones! (But rather a treatment method applying UNMODIFIED ORIGINAL bio-identical (=human-identical) hormones – and, as explained above, WITHOUT showing the common side effects of synthetic hormones (=hormonoids).)

A both stimulating and symptom-oriented therapy is, however, POSSIBLE purely herbal WITHOUT HORMONES (but it won’t be able to cure the cause, i.e. the lack of hormones).

When can herbal hormone therapy make sense:

  1. stimulating therapy: As long as you still have reserves left for producing hormones, you can try and stimulate this remaining ability. That often works during PREMENOPAUSE – when hormone levels start shifting from 35 years of age onwards until the symptoms of a complete hormone deficiency show. During this phase it is possible to activate/stimulate the still remaining ability to produce hormones.
  2. symptomatic therapy: If you decide against hormones, then you can try to treat/ease the various symptoms of a hormone deficiency using herbal remedies.

Local hormone application – or generally “systemic”?

We physicians in general distinguish between local dermal therapy – i.e. local application onto the skin – and systemic administration of hormone replacement therapy, so for the entire body.

These two possibilities can be combined by applying something to the skin which then spreads out into the entire body through the skin. That is what we call transdermal, because the substance enters our body via the skin.

One main reason why this transdermal mode of entering our body is problematic, is because our skin acts as an effective protective barrier – a little like a puffer jacket.

So, in general, our skin efficiently protects us from pathogens and external injuries; but when wanting to treat the entire body system, that is of course rather a disadvantage, because only little reaches its destination and large quantities are necessary.

That would also be the reason why no one tries prescribing birth control pills as a transdermal cream!

But, of course, hormones can also be applied topically; e.g. in the form of suppositories in the case of vaginal dryness or as a skin cream to tighten connective tissue or for treating excessive wrinkles.

In general, we start off by “systemically” administering hormones in the form of capsules, taken orally, thus reaching the entire body. After all, the mouth is our central intake organ and is especially well equipped for this purpose.

The actual “systemic” hormone levels are checked in the blood on a regular basis. If the levels are as they should be and you are still suffering from local symptoms, then perhaps they can be treated with local hormone application (hormone cream).

CONCLUSION – DON’T FORGET: not all hormones are the same!
Bioidentical hormones as a natural solution for hormone replacement therapy

Hormonal treatment with bioidentical hormones, systemic, with regular blood checks, will balance out the lack of hormones. We also call this hormone replacement therapy with human-identical hormones.

Undesired side effects can be avoided (unlike when applying conventional HRT); instead you will experience a number of positive effects that will help with menopausal problems.

Read up on the Rimkus Therapy in more detail in the next article: What are bioidentical hormones and their advantages? The Rimkus Therapy

The complete article series:

Menopausal signs and symptoms

Recognizing premature menopause – and what you can do about it

Hormones during menopause

Why choose hormone replacement therapy (HRT) during menopause – pros and cons?

What are bioidentical hormones and their advantages? Rimkus

Bioidentical hormones according to Rimkus – experiences, side effects, application, costs

Bioidentical hormones – preparations, source, physicians