From my Substack
I write regularly about menopause, symptoms, biology, and the wider story women are so often not told. Some of the articles will be part of my book. If you want to go deeper into the thinking behind my work, you can start here.
The Centre for Longitudinal Studies presented findings from more than 50,000 women participating in nine studies worldwide. The results showed women who have never given birth or been pregnant have twice the odds of reaching menopause before the age of 40. They’re also 30 percent more likely to begin menopause between ages 40 and 44.
In 2011, the average age for a woman to begin perimenopause—the up to 10-year-long estrogen drop that marks a decline in fertility—was 45 years…
Only humans and a few toothed whales undergo the menopause, many sources will tell you. But a paper by Ivana Winkler and Angela Goncalves at the German Cancer Research Center claims that the menopause is, in fact, widespread among mammals. So which is right? The surprising answer is both.
Goncalves studies how the female reproductive tract ages in mice. “It’s absolutely clear that our mice in captivity reach something that is like menopause in humans,” she says. “And yet every time that…
In post-menopausal women, the earliest change in the brain appears to be a fall in the amount of glucose used by the brain, indicating reduced brain activity. This is due to falling estrogen levels, this hormone being vital for brain glucose metabolism.
Vasomotor symptoms (VMS) are the symptom characteristic of the menopausal transition but may occur before, during, or after menopause. These symptoms include hot flashes and night sweats.
At present, it is thought that the hippocampus, parahippocampus, and…
Women who have used hormone therapy for menopausal symptoms may be more likely to develop gastroesophageal reflux disease, or GERD, a new analysis suggests.
The study, published online June 27, 2023, by the journal Menopause, analyzed data from five earlier studies involving more than one million women, none of whom had been diagnosed with GERD before the study’s start. Researchers found that participants who were current or past users of hormone therapy for relieving menopausal symptoms were 29% more likely…
Reduced levels of oestrogen and progesterone seem to be what makes post-menopausal women more likely to have symptoms of sleep apnoea, including snoring, irregular breathing or gasping at night.
Middle-aged women who have lower levels of oestrogen and progesterone are more likely to snore, breathe irregularly and gasp while sleeping, which are all symptoms of sleep apnoea.
The involvement of these chemicals means targeted hormone therapy might prove useful for post-menopausal women, says Kai Triebner at the University of Bergen in Norway.
“Women…
People who have been pregnant or have breastfed a baby are less likely to experience an early menopause. This may be because ovulation is temporarily stopped during pregnancy and slowed down during breastfeeding, maintaining a reserve of eggs for longer.
The team found that people who had experienced pregnancies that lasted at least six months had a lower risk of experiencing an early menopause – defined as menopause before the age of 45 – than those who hadn’t.
“We…
Social stress may release hormones that affect bone loss, a finding that might be linked to the higher incidence of bone fractures after the menopause.
In a study of more than 8000 women aged 50 to 79, researchers found that those who reported higher levels of social stress – defined as strained relationships or stress related to social ties – were also at higher risk of bone fractures.
Women who reported high social strain and poorer quality relationships – and…
What kind of hot flasher are you?
The hot flash — that sudden feeling of warmth that can leave a woman flushed and drenched in sweat — has long been considered the defining symptom of menopause. But new research shows that the timing and duration of hot flashes can vary significantly from woman to woman, and that women appear to fall evenly into four hot-flash categories.
Some women, called “early onset” hot flashers, begin to experience hot flashes long…
For some women, reaching the menopause can be one of life’s milestones, but when it will happen is a big unknown. Now a blood test can help predict when a woman’s last menstrual period is likely to be.
The test, called MenoCheck, can’t give a firm date, but it can tell women who are over 47 if they are likely to stop having periods within the next year. It would be most useful for those considering being sterilised or…
I am sick to death of hearing women should focus on cardio exercise and leave strength training to men, says Dr Bernadine Jones.
Rose George writes about women’s exercise plummeting (Pandemic knocked you off your stride? An active woman’s tips for getting fit again, 26 July). The NHS wants us to vigorously run and moderately mow the lawn, and then also strength train twice a week. Those of us who do all the housework and all the career-aspiring thinking work and…
Steroid hormones regulate metabolic flexibility at the level of the mitochondria. Estradiol, the most frequently studied among the steroid hormones, plays a pivotal role in determining how food fuel is converted into cellular fuel or ATP.
When we eliminate estradiol with medications such Lupron and other GnRH agonists or antagonists, or when we remove a woman’s ovaries, depleting her primary source for estrogen synthesis, metabolic flexibility diminishes significantly.*
With the lack of metabolic flexibility comes a number…
..Sometimes my own perimenopausal moods are more rage than anxiety. I woke up the other day and noticed that my husband had placed a couple of champagne corks on top of a picture frame. It made me want to start breaking things. What is this, a goddamned student house? In this state, I noticed things I had missed before: bags spilling out of cupboards, stacks of receipts and change on a table, my son’s stuff everywhere. “It’s like living…
Women who have sex more than once a month go into menopause later.
Having regular sex during the perimenopausal and menopausal period can also help make sex less painful with time because it helps keep the vagina open, she points out — so sex sessions on the regular certainly can’t hurt.
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A number of things can be going on with your body if you’ve started bleeding after menopause, Julian Peskin, MD, an ob-gyn at Cleveland Clinic, tells Health.
But let’s be clear about one thing: It’s not your period. “If a patient’s postmenopausal, there should be no reason for them to bleed,” says Dr. Peskin. Once you’ve hit menopause, there’s no going back. So don’t try to convince yourself it’s probably just one more period to avoid another doctor’s visit.
In…
‘They are not mentally ill, antidepressants are not appropriate. Once they have the label, it doesn’t help them,’ says expert.
Hot flushes and night sweats are the most well-known symptoms in peri/menopause, but the most common ones are anxiety, depression and brain fog. So many women who are looking for help get prescribed anti-depressants, despite the fact that:
“Menopause guidelines are very clear that antidepressants should not be given first-line for low mood associated with the menopause because there…
Breathing is information. The more stressed you feel, the faster you breathe, and your brain will notice this and read it as a signal that things are not going well. That fast, shallow breathing which happens when you’re stressed is effectively telling your brain that you’re running from a lion. But the reverse of this rule is also true: if you breathe slowly, you’re giving your brain a signal that you’re in a place of calm. You will start…
Postmenopausal women can fight off hot flashes and night sweats by pumping iron, a new clinical trial shows.
“Resistance training is already recommended for all women always, but now we can see it may be effective also for hot flashes around menopause,” Dr. Emilia Berin of Linkoping University in Sweden, who led the study, told Reuters Health.
Reuters
Determined to enjoy longer and healthier lives, two women researched the science to find the key. Here, they share what they discovered.
When Susan Saunders was 36, her mother was diagnosed with severe dementia. “I had a toddler, a newborn, a full-time job as a TV producer – and I became a carer as well.” As a teenager, she had watched her mum care for her own mother, who had the same condition. “I became determined to do everything…
We tend to think that a loss of mental acuity is just part of getting older — but age is not the only contributing factor to cognitive decline. Our lifestyle also plays a key role. Failing to follow a nutritious diet, a lack of sleep and exercise, ongoing stress, smoking, drinking alcohol excessively and environmental pollutants can all damage our brain cells.
Fortunately, mental deterioration is not irreversible. In fact, the brain is incredibly dynamic and has the potential and…
It was once thought that hearing loss in older women might be linked to loss of estrogen and progesterone following menopause and that hormone therapy might reduce that risk. Recent results from the Nurses’ Health Study II indicate just the opposite — that late natural menopause and the use of oral hormone therapy are linked to a higher risk of hearing loss.
…Further studies are needed to determine whether hormone use causes hearing loss. As of now, the results,…
Hot flashes, undoubtedly the most common symptom of menopause, are not just uncomfortable and inconvenient, but numerous studies demonstrate they may increase the risk of serious health problems, including heart disease. A new study suggests that hot flashes (especially when accompanied by night sweats) also may increase the risk of developing diabetes.
As reported in “Vasomotor symptom characteristics: are they risk factors for incident diabetes?” data was analyzed from the more than 150,000 postmenopausal women who participated in the…
If you feel as though you can’t do as much physically as you’ve gotten older, there may be a reason. Both aging and menopause are known to affect sarcopenia, which is a loss of muscle mass and strength, which in turn affects balance, gait, and overall ability to perform tasks of daily living. A new study is one of the first to link alcohol consumption with a higher prevalence of sarcopenia in postmenopausal women. The study outcomes are being…
A new study of more than 2,000 perimenopausal and menopausal women showed that moderate-severe vasomotor symptoms (hot flashes or night sweats) were an independent and significant risk factor for moderate-severe depression. Researchers explored the controversial link between hot flashes and depressive symptoms by focusing on more severe forms of both conditions and concluding that there is likely a common underlying cause, as reported in an article published in Journal of Women’s Health, a peer-reviewed publication from Mary Ann Liebert, Inc.,…
You think the menopause signals the end? For these four women, it was only the beginning. Here they share their stories about how the menopause. was the trigger to improve their lives, careers, relationships and even sex lives…
Hot flushes, mood swings and a diminished sex drive. The menopause s seen as a pretty miserable time for women – but new research suggests that it can actually trigger bursts of energy, creativity, and even renewed intimacy.
According to a recent…
The menopause is so often regarded as a negative experience, but it can be a new chapter in which many women find themselves with a new lease of life.
The rush of energy and increased confidence that women can experience can be the perfect springboard for pursuing long-held ambitions or new dreams, whether that’s embarking on a new career, taking up a new sport or hobby, or simply taking the time to focus on feeling your best.
Here we…
Almost 4,000 women in the UK undergo operations each year to remove their ovaries. The procedure, which triggers the menopause, is often carried out on younger women to prevent cancer.
But now scientists from Toronto University have linked the surgery with a reduction in memory and thinking skills.
Experts fear this may eventually lead to early-onset dementia for many women, and even to Alzheimer’s.
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The therapeutic benefits of omega-3 fatty acids – which are abundant in certain fish oils – have long been known. In the 1950s, upon the discovery that omega-3 improves brain development, cod liver oil was given for free to young children, pregnant women, and nursing mothers. In the 80s, scientists reported that eskimos enjoy better coronary health than their mainland counterparts as a result of their fish rich diets. And in 2009, a study published in the Menopause journal…
Postmenopausal women with a more diverse population of gut bacteria may be more efficient at breaking down estrogen, a new study suggests. Because estrogen plays a role in causing breast cancer, researchers speculate a healthy bacterial population may lower the risk for cancer.
“The composition and diversity of the intestinal microbiota were associated with patterns of estrogen metabolism that are predictive of the risk of breast cancer in postmenopausal women,”
Estrogen is metabolized in the liver and in other…
Postmenopausal vulvovaginal atrophy is associated with age-related changes in the vaginal microbiome, with a shift from Lactobacillus-dominated strains in premenopause to a predominance of anaerobic organisms, new research shows.
“We have not yet identified specific interventions, but we are interested in pursuing personalized selections of probiotics and prebiotics for a given woman,” said lead investigator Rebecca Brotman, PhD.
“We have been advocating probiotics or prebiotics to improve vaginal health for almost 30 years,” said Gregor Reid, PhD.
“I 100% support…
Brain imaging and gene analyses in twins reveal that white matter integrity is linked to an iron homeostasis gene.
Iron deficiency is a well-known cause of impaired cognitive, language, and motor development, but a report out today (January 9) in Proceedings of the National Academy of Sciences reveals that even in apparently healthy young adults, variations in iron levels correlate with variations in brain structure integrity.
“[The researchers] make a very interesting connection between the issue of iron metabolism…
Overweight women who experience hot flashes—the uncomfortable flushing and sweating spells that accompany menopause—may be able to cool those symptoms by losing weight, a new study suggests.
“If you’re a woman who is overweight or obese, you can substantially improve your hot flashes by losing weight through diet and exercise,” says Alison Huang, MD, the lead author of the study and a professor of internal medicine at the University of California, San Francisco.
“Weight loss isn’t just something that will benefit your…
Psychologists are helping women sidestep the stereotypes associated with menopause and transform this developmental passage into a vital new phase of life.
… In a 2008 qualitative study in the Women’s Studies International Forum (Vol. 31, No. 4), for instance, 21 midlife Australian women reported greater confidence and wisdom, more time for themselves, and greater self-awareness and self-worth, despite some sadness about ageing. Likewise, a 2008 article in Maturitas (Vol. 39, No. 1) by University of Copenhagen physician Lott Hvas, MD, found…
More forgetful? Not thinking as clearly? Simple arithmetic coming more slowly? Worried that mental functions are worsening? Are the processes of ageing catching up? There is much that can be done to prevent worsening mental functioning and memory loss. For some, memory loss heralds the onset of dementia. Regardless of a person’s occupation or social environment, loss of memory is the most feared consequence of ageing…
…Specific nutritional interventions and nutritional supplements can help to detox and protect individual…
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Sandra Ishkanes Natural Menopause Specialist based in Brighton, serving clients worldwide via Online Consultations
BSc Molecular Biology (King’s College London) | DipION | Functional Medicine Practitioner
Registered member, Association of Naturopathic Practitioners (ANP) – the UK professional body for accredited naturopathic and functional medicine practitioners. ANP members hold accredited qualifications, carry professional indemnity insurance, and follow a strict code of ethics.
© 2026 Sandra Ishkanes · sandraishkanes.co.uk
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The information provided on this website is for educational and informational purposes only and is not intended as medical advice, diagnosis, or treatment. Sandra Ishkanes is a Functional Medicine Practitioner and Molecular Biologist, not a medical doctor. Always seek the advice of your GP or other qualified healthcare provider with any questions you may have regarding a medical condition or before making any changes to your diet, lifestyle, or supplement regimen—especially if you are currently taking prescription medication or HRT. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.