What’s New in HRT

  • Symptoms After Stopping HRT — and How to Come Off Well

    If you have come off HRT — by choice, or because you had to — and the symptoms have come flooding back, it does not mean stopping was a mistake, or that you are tied…

  • Menopause Without HRT: How to Come Through It Well

    “Without HRT” does not mean without support, or simply enduring it. Whether HRT is closed to you or you would rather not take it, menopause is a transition the body can be helped through —…

  • Why HRT is not working and what you are missing

    If you are on HRT and still not yourself — the flushes quieter, but the fog, the flatness and the fatigue still there — the answer may not be your dose. Falling oestrogen set all…

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    HRT linked to higher risks of acid reflux

    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…

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    Sore Breasts in Perimenopause & HRT: Iodine to the Rescue

    Sore, swollen breasts in early perimenopause often come down to low iodine leaving breast tissue over-reactive to oestrogen — not a shortage of oestrogen to top up with HRT.

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    Why pain under your right ribs matters in perimenopause

    Pain under your right ribs that creeps round to your back or shoulder is one of those symptoms women often dismiss as “just indigestion” or “I must have eaten too fast.” In my clinic, it’s…

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    Later menopause, hormone therapy tied to hearing loss

    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…

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 discovery call

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:

“

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.

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 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
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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.

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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.