One-to-one consultations for peri/menopause

Your peri/menopause is personal, so your care plan should be too. I find the root causes of your symptoms and build your plan from your own test results, online by video.

First consultation
£36590 minutes
Follow-ups
£16545 minutes
Book a free strategy call What’s included
Sandra Ishkanes smiling on a consultation at her desk
Online by video, wherever you live

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Free strategy call30 minutes, free

We talk on the phone about your symptoms and what you most want help with. You get my first read on what is driving them, and we see if my approach suits you. No commitment, no pressure.

Hot flushes. Brain fog. Anxiety. Exhaustion. Joint pain that won't quit. Restoring your health begins with a one-to-one consultation.

What your first consultation includes

£365 for 1.5 hours by video, and the work starts before we meet. Check-ins between consultations are included in your fees.

  1. You join my online portal and fill in four forms, including an extensive health assessment with a body systems metabolic check. You also keep a 3-day food and lifestyle diary and complete a peri/menopause symptoms assessment. I review it all with your previous lab tests (up to 10 pages), your diet and supplements, and draft your protocol.

  2. We go through your health history and work through my analysis of the root causes of your symptoms, then talk through the draft protocol. I order your 54-marker blood test and tell you whether you need any specialised tests.

  3. After we talk I finalise your personal protocol: nutrition, supplements and lifestyle, with step-by-step directions so you can start making progress straight away.

  4. Most plans begin with a 7 Day Detox to bring down pain and inflammation, balance your blood sugar, stop sugar cravings and give your liver and gut a break.

Fees, follow up, and testing

Follow-ups are every 4 to 5 weeks. I may send you forms to fill in beforehand so we can track your progress, then we review your tests and adjust your protocol to keep you on track. There are no fixed packages, and payment plans are available.

First consultation

£365

1.5 hours · video call

  • Pre-consultation forms and a draft protocol before we meet
  • Your health history and the root causes of your symptoms
  • Your 80-marker blood test ordered
  • Your Health Optimisation Plan, usually starting with a 7 Day Detox
  • Check-ins between consultations
Start with a free call

Follow-up consultation

£165

45 minutes · video call · every 4 weeks

  • A review of your symptoms and progress
  • Your blood tests reviewed and your plan updated
  • Analysis of standard blood tests included
  • Brief check-ins through the client portal
  • Analysis of specialised tests is charged separately
Ask me about the process

The tests I use

I need standard blood test results to guide your plan. Lab costs are paid directly to the lab.

Standard blood tests80 markers analysed to personalise your protocol

Red blood cells

  • Haematocrit
  • Haemoglobin
  • MCH
  • MCHC
  • MCV
  • RDW-CV
  • Red blood cells (RBC)

White blood cells

  • White blood cells (WBC)
  • Neutrophils (count)
  • Neutrophils (%)
  • Lymphocytes (count)
  • Lymphocytes (%)
  • Monocytes (count)
  • Monocytes (%)
  • Eosinophils (count)
  • Eosinophils (%)
  • Basophils (count)
  • Basophils (%)
  • Neutrophil to lymphocyte ratio
  • Monocyte to lymphocyte ratio

Platelets

  • Platelets
  • Mean platelet volume (MPV)
  • Platelet to lymphocyte ratio

Sex hormones

  • Oestradiol (E2)
  • Progesterone
  • Testosterone
  • FSH
  • LH
  • Prolactin
  • SHBG
  • Free androgen index
  • DHEA-S

Stress hormone

  • Cortisol

Thyroid

  • TSH
  • Free T4
  • Free T3
  • Total T4
  • Free T3 to free T4 ratio
  • TPO antibodies
  • Thyroglobulin antibodies

Inflammation

  • CRP
  • hs-CRP
  • LDL to HDL ratio
  • Monocyte to HDL ratio

Iron

  • Iron
  • Ferritin
  • Total iron binding capacity
  • Transferrin saturation

Lipids

  • Total cholesterol
  • HDL cholesterol
  • LDL cholesterol
  • Non-HDL cholesterol
  • VLDL cholesterol
  • Triglycerides
  • Total cholesterol to HDL ratio
  • Triglyceride to HDL ratio

Blood sugar

  • Glucose
  • HbA1c
  • Estimated average glucose
  • Triglyceride-glucose index

Liver

  • ALT
  • ALP
  • GGT
  • Total bilirubin

Kidneys

  • Creatinine
  • eGFR
  • Urea
  • Urea to creatinine ratio

Proteins

  • Total protein
  • Albumin
  • Globulin
  • Albumin to globulin ratio

Vitamins

  • Vitamin D
  • Vitamin B12
  • Active B12
  • Folate

Minerals

  • Magnesium

Metabolic

  • Creatine kinase (CK)
  • Uric acid

Enzymes

  • Alpha-amylase

Advanced tests

  • DUTCH
  • Mitochondrial (OAT)
  • Gut microbiome
  • Vaginal microbiome
  • Adrenal function

Complex history? This is where I can help most

Many of the women I see have endometriosis, adenomyosis, PCOS or fibroids, or an autoimmune condition. They’ve been through years of appointments, and been told there’s nothing more to be done. By the time they find me, I’m often their last resort.

  • Endometriosis
  • Adenomyosis
  • PCOS
  • Fibroids
  • Lupus
  • Hashimoto’s
  • Psoriasis
  • Rheumatoid arthritis

For ten years I’ve supported women like this, looking for the root causes behind their symptoms. These conditions shape how your hormones, immune system and metabolism behave. They need a deeper look at your history, your tests and how it all connects.

That’s what my 1-2-1 consultations are for:

  • A full review of your history and symptoms
  • Functional testing where it helps
  • A plan built around you, adjusted as you go
Book a free strategy call

No complex conditions? My six-week course may be all you need

Endometriosis
“I had been to see many doctors and was prescribed lots of different drugs and treatments, including painkillers, pills, hormone treatments and surgery. But nothing seemed to improve it and I was in crippling pain every month. … I have had a drastic improvement since following the plan. My pain and nausea has massively reduced. … I really believe that seeing Sandra has changed my life.”
PG, Brighton
Psoriasis and arthritis
“It took about four months to see really substantial improvements, but it’s been worth it, as my scalp has not been this clear since the psoriasis started, and the arthritis (which turned out to be unrelated to the psoriasis) has eased significantly.”
DF, Brighton
Menopause with a history of PCOS
“Following her advice has resulted in a very marked improvement in almost all of the symptoms I was experiencing – menopausal symptoms with a history of PCOS. I feel about 15 years younger, with far greater energy, far less pain and a sense of health that’s been missing for some time now.”
1-2-1 client

With every consultation: everything you need, with care and support

I take the time to understand how your life works, so every recommendation is realistic and specific to you: nutrition, supplements and lifestyle changes built around your biology, your stage and your circumstances. You get a complete protocol and can start straight away, and I will be with every step of the way

A plate of grilled meat and salad on a white table

A precise dietary framework built to support your metabolic state, your symptoms and the shifts your body is going through right now.

Supplement capsules and tablets on a pale blue background

Only what your biology needs, at the right doses and in the right forms. I tie every supplement to a specific finding in your results.

A woman resting on a sofa with her eyes closed

Light, sleep, movement and social connection can all be optimised to bring you health and vitality.

A smiling woman in an armchair using her laptop

Partnership, compassion and care

A safe and supportive environment means you can discuss your concerns and receive personalised care that meets your unique needs.

I suffered with menstrual migraines all my adult life, sometimes 2 a month, wiped out for 2 days at a time. In perimenopause they got worse, longer, and came with exhaustion, an aching body and weight gain. Then I met Sandra, who is a functional nutritional genius. I have lost 2 stone, and haven't had a migraine for 3 months! That has not happened since I was 15.

Anna L
Anna L
  • 2 stonelost
  • 3 monthswithout a migraine
H.B.
  • Symptoms gone within4 weeks

I took the plunge and booked Sandra to work with her 1:1 to get me back on track. Sandra provided a detailed health review, testing and a healthy eating guide. I found it inspiring to work with her, I felt better almost within a week and 4 weeks later symptoms almost gone! My vitality is back!

H.B.

Why this works

Not a generic list of lifestyle tips. A plan built on your own results, with support while your body adapts.

  1. You stop guessing

    Generic advice treats all women alike. Your plan comes from your history, your symptom pattern and you own blood results, so you only change what you need to change.

  2. Turn off the gas, not just the fire

    If you only treat only the symptoms they'll keep coming back. Your plan works on what's driving your symptoms, such as blood sugar and how your liver clears hormones.

  3. Support as your body adapts

    Your body is programmed to adapt to a new life stage. As your health improves we adjust your nutrition and supplements session by session and 98% of women see results within 4 weeks.

Your questions
about working with me

Peri/menopause is not one event but four overlapping shifts in the body's biology — Progesterone shift (progesterone crashing causing oestrogen dominance), Energy (fuel switching), Oestrogen (intracrine production), and Emotional (HPA axis and nervous system). Most women have a combination. I work out the drivers, so your plan targets the root, not the surface.

There is a real gap in the UK menopause landscape. The functional medicine doctors who specialise in menopause are GPs who prescribe HRT alongside their functional protocols. The non-prescribing menopause specialists - nutritionists, dietitians, nutritional therapists - are not functional medicine practitioners. As far as I am aware, I am the only practitioner in the UK who is trained as a functional medicine practitioner, who works exclusively in menopause, and who works non-hormonally, with the clinical framework I have developed over a decade of focused, non-prescribing work in this space.

Generic menopause nutrition is written for the average woman. Your plan is written for your biology - your shifts, your labs, your history, your constraints. The principles may overlap with what you have read, but the sequencing, the emphasis, and the detail are specific to you.

Supplements are matched to what your blood test results show you actually need - nutrient gaps, metabolic markers, gut findings, inflammatory signals. The aim is the smallest effective protocol, reviewed and adjusted as your body changes. The supplements I recommend are professional- grade and are usually sourced from professional online dispensaries.

A detailed written plan delivered through the client portal, combining personalised nutrition, therapeutic-grade nutrient restoration and system support, and realistic stress-axis regulation tailored strictly to your markers.

You work with your plan, and track what changes - sleep, energy, symptoms, cycle if you still have one. I am available through the client portal for questions that come up between sessions. Follow-up - optimise -consultations are where we review what is working, refine what isn't, and decide what to adjust.

Most women complete the core arc within 3 months - the initial consultation, then 2-3 optimise sessions spaced four weeks apart. Some women stay longer for more complex histories or because they want continued refinement. We work together until you achieve your goals.

Yes, if that is what you want. Coming off HRT safely means preparing you for the taper first - supporting intracrine oestrogen production, metabolic resilience, and adrenal capacity - then tapering in a sequence your body can hold. I do not pressure women off HRT. I support the women who have decided they want to come off.

All consultations are online, by video, so you can work with me from anywhere in the UK or internationally. Booking is via my online calendar.

Ready for a clear roadmap?

Book a free peri/menopause strategy call. In 30 minutes you can:

  • Understand why you have your symptom pattern
  • See what testing and support could look like for you
  • Ask anything, with no commitment and no pressure
  • Leave with clear next steps

Calls Tuesday to Thursday, 8 to 10am and 2 to 5pm (UK time). 30 minutes, free, by phone.

Book a free strategy call
Sandra Ishkanes smiling on a phone call at her desk