What’s New in Osteoporosis

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    Impacts of psychological stress on osteoporosis: clinical implications and treatment interactions

    While osteoporosis and psychological stress occur via differing mechanisms, there are several potential molecular links that exist between a pathological response to stress and the development of bone disease. Although not a comprehensive list, these…

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    Role of cortisol in the pathogenesis of postmenopausal osteoporosis: relationship to bone structure

    Excess glucocorticoids are well recognised as a cause of osteoporosis; they inhibit osteoblast function and increase osteoblast and osteocyte apoptosis resulting in thinning of the trabeculae. The circadian rhythm of bone turnover, which is linked…

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    Stress factors increase osteoporosis: a comparative assessment of osteocalcin and cortisol levels in menopausal women

    Osteoporosis, a consequence of menopause in the biological cycle of women, emerges with the conclusion of reproductive capabi lities.Hormonal changes during this phase contribute to the development of the disease. The study evaluated the relationship…

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    Association of menopausal vasomotor symptoms with increased bone turnover during the menopausal transition

    The purpose of this study was to determine the longitudinal association between menopausal vasomotor symptoms (VMS) and urinary N-telopeptide level (NTX) according to menopausal stage. We conclude that among early perimenopausal and late perimenopausal women, those…

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    Presence of vasomotor symptoms is associated with lower bone mineral density

    Objective: To determine whether women with vasomotor symptoms (VMS) have lower bone mineral density (BMD) than women without VMS. Design We analyzed data from baseline to annual follow-up visit 5 for 2213 participants in the…

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    Endocrinal metabolic regulation on the skeletal system in post-menopausal women

    Loss of estrogen results in reduced osteoblast mediated bone formation and enhanced osteoclastic resorption (Emmanuelle et al., 2021). Given the recent expansion of interest in understanding how these cellular processes are regulated via metabolic flux and bioenergetic…

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    Osteocalcin, a promising marker of osteoporosis: evaluation in post-menopausal females with osteoporosis

    Background: Osteocalcin, has high affinity for calcium. In osteoporotic women, deficiency of calcium may lead to lowering of the formation of hydroxyapatite crystals. Thus, in the state of hypo mineralization, free osteocalcin available in the circulation.…

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    A reassessment of diet and osteoporosis — Possible role for copper

    Surprisingly little if any attention has been given to the role of copper in the aetiology of postmenopausal osteoporosis. For example, Freudenheim et al. (40). investigated relationships between usual intake of energy and 14 nutrients…

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    Could your wrinkles be a sign of osteoporosis?

    Skin and bone are built from the same collagen and make their own oestrogen the same way — so as that local supply runs short in later perimenopause, deeper wrinkles and thinning bone are often…

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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.

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  • 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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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.