The deficiency is not in you. It’s in the medical model.
Mainstream medicine is still working with a 1950s framework — one that treats oestrogen deficiency as the root cause of everything you’re feeling, which is why HRT makes sense for them. But there is one powerful dissenting voice.
Dr Nanette Santoro is a menopause scientist elected to the US National Academy of Medicine and chair at the University of Colorado School of Medicine. As lead investigator on the Study of Women’s Health Across the Nation (SWAN), she has followed more than 3,000 women aged 42–54 since the mid-1990s to understand the menopause transition and its consequences on women’s health. She has concluded that:
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Women need a sophisticated understanding of the root cause of symptoms and health risks – otherwise they will forever be stuck with an oversimplified model that blames low oestrogen for everything.
—Dr Nanette Santoro, lead investigator SWAN
In the last decade, the science of menopause has moved significantly. We now understand that symptoms are driven by far more than oestrogen decline — by metabolic shifts, nervous system load, inflammation, and the conditions in which this transition has to happen. Dr Santoro is clear: symptoms cluster together — hot flushes, brain fog, low mood, and broken sleep don’t arrive randomly. They share root causes. Which means they can be addressed at the root. My practice is built on that research.
If you’ve been told your symptoms are just low oestrogen — or that HRT is your only option — there is another way. It doesn’t matter where you are with HRT. The work is the same: your biology, your root causes, your protocol.
The discovery call is free, 30 minutes, and no obligation. Let’s have that conversation.
Book a discovery call and in 30 minutes you can:
- Understand the root causes behind your specific symptoms
- Learn whether functional medicine is right for your situation
- Get a clear picture of what testing and treatment could look like
- Ask any questions — no commitment, no pressure
- Leave with actionable clarity, regardless of next steps
30 minutes · Free · No obligation
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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.