What’s New in Anxiety

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    Perimenopausal Anxiety: Why You’re Suddenly Anxious in Your 40s

    Sudden perimenopausal anxiety and worsening ADHD in early perimenopause are driven by a biochemical traffic jam. As progesterone drops and heavy bleeding drains iron, chaotic oestrogen spikes actively suppress the COMT enzyme, trapping adrenaline in your body.…

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    Does Risk for Anxiety Increase During the Menopausal Transition?

    3,000 women were followed for 10 years to ask a simple question: does the menopausal transition itself increase the risk of significant anxiety symptoms? What was done Participants were 42–52 years old at the start, pre‑…

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    Anxiety as a risk factor for menopausal hot flashes

    This long-term study followed 233 women from before menopause to after their final period to see how different types of anxiety relate to hot flushes. Anxiety was split into two parts: somatic anxiety (physical tension symptoms such…

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    Severe peri-menopausal symptoms despite HRT reduced by 80% in 4 weeks

    When Helen came to see me at 48, she’d been told her only option was more HRT — but her hot flushes, anxiety, poor sleep and brain fog were still running her life. We treated…

Get Better Now

  • I now understand and can control the flushes! And on top of this I have shifted 16lbs and feel better than ever.

  • I couldn’t believe how Sandra resolved my vaginal dryness so quickly and easily.

  • Menopausal symptoms can be resolved, there are many roads. I am eternally grateful as now I know how to take care of my health.

  • I have lost 2 stone, and haven’t had a migraine for 11 weeks! That has not happened since I was 15.

  • 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 all my symptoms almost gone!

  • I’d recommend it to any woman – not as a diet, but as a way of rethinking how your body works, and how to fuel it properly.

  • Within just a week I was feeling much healthier, clearer headed, and energised.

  • I was amazed at how quickly my weight started dropping and soon my migraines all but disappeared.

Book a Peri/Menopause Strategy call

Re-think your Peri/Menopausal Biology

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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 Study

If you’ve been told HRT is your only option, or you’re on hormones and still feel awful, there is another way. Your symptoms are driven by metabolic shifts, nervous system load, and inflammation. My practice is built to target these exact cellular roots.

Ready for a clear roadmap?
Book a free peri/menopause strategy call

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.

Book a Peri/Menopause Strategy Call and in 30 minutes you can:

  • Understand why you have your symptom pattern
  • Get a clear picture of what testing and treatment could look like
  • Ask any questions — no commitment, no pressure
  • Leave with actionable next-steps blueprint
Book a Peri/Menopause Strategy call

30 minutes · Free · No obligation

Not ready to book? Follow my thinking on Substack

As featured in

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.