Doctor Ivana

07/10/2026

Mindfulness is medicine. At every age, and especially now.

We often treat mindfulness as a nice extra. In my clinical practice I see it as a genuine intervention, one that supports how we regulate stress, sleep, mood and our response to physical symptoms.

Menopause is a threshold. Hormones shift, bodies change, identities are re-examined. It asks to be honoured, not pushed through.

I see this transition as one of the last loud invitations life gives us to begin, or return to, the practice of mindful awareness. The hot flush at 3am, the unexpected tears, the brain fog in a meeting: each is a moment where we can choose to notice rather than fight.

Jon Kabat-Zinn, who brought mindfulness into Western medicine, describes it as "paying attention in a particular way: on purpose, in the present moment, and non-judgmentally."

This week, try this: when a symptom arrives, pause for three slow breaths. Notice where you feel it. Name it without judgement. Let it pass through.

You are not broken. You are changing. And you deserve to be present for it.🌿

If you'd like company on this path, my final Mastering Menopause CBT group for 2026 begins at Maxwell Medical on Thursday 15 October. For any information, please call 03 7036 2450.

30/09/2026

MASTERING MENOPAUSE

Continuing on fascia, connective tissue and restorative practices...

Fascia isn't just structural — it's one of the richest sensory tissues in the body, dense with nerve endings that feed into interoception (sensing what's happening inside you) and proprioception (sensing where you are in space).

This is part of why slow, sustained movement — like yoga — can change how a body feels to live in, not just how it moves.

We don't yet have solid evidence that yoga measurably improves interoception itself — recent research testing this over 10 weeks found no clear change. But no solid evidence of benefit is not the same as evidence of no benefit.

And when a practice carries little to no risk, and already has proven benefits for mindfulness, stress and mobility, women dealing with symptoms now don't need to wait years for long-term studies to give the green light to start.

More in this month's blog.

Free information evening — 1st October, 6pm, Maxwell Medical Group. No registration required.

I am Dr Ivana — GP, Lifestyle Physician, and a woman. 🌿

🔗 doctorivana.com.au

23/09/2026

MASTERING MENOPAUSE

Last week we met fascia — the connective tissue web that glides, stretches and senses movement throughout your body.

Fascia isn't just wrapped around your nerves — it's threaded with them.

That's why a "tight" fascia can feel like pain, and why releasing it can feel like relief — you're not just moving tissue, you're communicating with your nervous system.

It's also part of why stress and poor sleep can leave you feeling physically stiffer, even when nothing in your body has structurally changed overnight.

Fascia is where hormones, nerve signals and immune markers of inflammation talk to each other — and right now, we only have a small, early picture of what the science is uncovering and hypothesising here.

Movement remains one of the simplest ways to keep this communication line open.

Full science of fascia — nerves, hormones, ageing — in this month's blog, live now on my website.

If you'd like to meet in person and hear more about how lifestyle changes can help manage your perimenopause or Menopause symptoms, come along to my free information evening — 1st October, 6pm, Maxwell Medical Group. No registration required.

I am Dr Ivana — GP, Lifestyle Physician, and a woman. 🌿

🔗 doctorivana.com.au

16/09/2026

MASTERING MENOPAUSE-FASCIA STORY

Ever wonder why your joints feel stiffer, your movements less fluid, some movements feel painful, and some injuries take longer to recover from, as you move through perimenopause and Menopause?

Meet fascia — the connective tissue web wrapping every muscle, joint, ligament and organ in your body. It glides, stretches, senses movement, and is woven into our immune, endocrine and nervous systems.

It's not just falling oestrogen. Collagen and elastin change as our hormones shift, but inflammation plays a big role too — shaped by food, movement, sleep, stress, relationships, and our own genetic blueprint for ageing. We put so much focus on muscles — strength, mass — and forget this connective tissue holding it all together.

I want to introduce yoga as a slow, quiet, but powerful intervention. It's well-studied for pain, stress and mobility — but the research is still developing when it comes to perimenopause and Menopause specifically, where hormonal changes play such a significant role.

YOGA moves fascia the way it's meant to move — long holds, rotational stretches, weight shifts through the joints. Through those movements, it trains two quieter senses: interoception (awareness of what's happening inside the body) and proprioception (sense of where the body is in space) — both start fading early in sedentary Western life, and both may help keep fascia healthy.

Hormones, the nervous system, inflammation, visceral fat, muscle loss — none of this sits in isolation. It's all part of the same fascia story, and why lifestyle matters more than ever through this transition.

More on the power of fascia/connective tissue in October's blog on my website.

I am Dr Ivana — GP, Lifestyle Physician, and a woman. 🌿

🔗 doctorivana.com.au

09/09/2026

MASTERING MENOPAUSE

Skin and hair — where our connective tissue is most visible, and often where hormonal changes are first seen.

Skin loses up to 30% of its collagen in the first 5 years after menopause, then ~2% a year after (Brincat et al.). Rashes and reactivity can rise too, as declining estrogen leaves histamine less checked. Hair thinning is common but highly individual — it tracks how estrogen, progesterone, and testosterone shift relative to each other, and that ratio changes differently for every woman.

Timing varies widely, and lifestyle is a real lever — smoking, sun, hydration, diet, sleep, and movement all shape how skin and hair hold up.

This isn't just "getting older" to accept — the trajectory can be influenced.

More next week.

I am Dr Ivana — GP, Lifestyle Physician, and a woman. 🌿

🔗 doctorivana.com.au

02/09/2026

No one's talking about Lungs 🫁 and Menopause.

We all talk hot flushes, libido, weight gain, mood changes… all important — but don't forget your vital organs, like your lungs.

Here's why they matter here: your lungs rely on collagen and elastin — the connective tissue that keeps them elastic and able to expand and recoil. As oestrogen declines in Menopause, so does this connective tissue — and that can affect your lung capacity too.

Asthma history, smoker, ex-smoker, live with a smoker — and your breath isn't what it used to be, or that cough won't quit? Don't brush it off as "just getting older" or "not being fit." Ask your doctor to check your lungs.

Try this: Breathing Mindfulness Exercises are a simple, powerful tool — they can help support lung capacity, not only calm your mind. And moving and hydrating your connective tissue is particularly important in perimenopause and Menopause. 🫁

Next week: more on connective tissue — collagen and elastin — skin and hair in Menopause... 👀

26/08/2026

MASTERING MENOPAUSE

We've talked about the brain - gut axis. The brain - heart axis.

But what's actually the axis part of those conversations?

Meet FASCIA — a continuous, body-wide web of connective tissue surrounding your organs, vessels, muscles, joints, nerves, and glands.

It's not just an empty space packaging.

It's richly innervated, responsive to hormonal signals, and increasingly understood to actively contribute to immune communication too — not simply holding the body together, but taking an active part in the nerve signalling, hormonal activity, and immune messaging we've been talking about.

This is still an emerging area of research. Much of the mechanistic detail is newer and evolving, and there's a lot we don't yet fully understand — especially how this changes across the hormonal shifts of a woman's life.

We'll come back to fascia in more depth soon. For now — just know it's there, connecting and actively taking part in everything we've been talking about.

In the meantime, move — often, and as naturally as your body likes to. Fascia thrives on movement, and mindful breathing is a form of that movement too.

More next week.

🔗 doctorivana.com.au

19/08/2026

MASTERING MENOPAUSE

Brain fog. Sleep that won't cooperate. Mood swings that feel out of nowhere.

These are driven by real hormonal shifts in perimenopause and menopause — and understanding why they happen is the first step to managing them well.

The hormonal change is usually the trigger. Some women need HRT, some don't — and when needed, HRT is the bridge to where the gold is. The gold is our daily thoughts, habits, actions, and relationships — what we broadly call lifestyle.

More next week.

I am Dr Ivana — GP, Lifestyle Physician, and a woman. 🌿

🔗 doctorivana.com.au

12/08/2026

MASTERING MENOPAUSE
THE HEART-BRAIN AXIS

Your heart and your brain are talking to each other — constantly.

The heart isn't just a pump.

It has its own network of neurons, and it sends signals to the brain just as much as it receives them — a bidirectional conversation science is still working to fully understand.

Part of that conversation includes our thoughts.

Emotional and mental states influence heart rhythm and vascular function, not just the other way around — which is part of why chronic stress is now understood as a genuine cardiovascular risk factor, not just a separate "mental health" one.

The autonomic nervous system is one pathway in this exchange.

One measure of it, heart rate variability, is well established in mainstream medicine — though outside the clinic it's often oversimplified by wellness culture as a simple daily "score," which isn't really what the science supports.

Add in shared risk factors — inflammation, blood vessel health, blood pressure — and it's clear why heart health and brain health are increasingly understood as connected, not separate systems.

For women of all ages, this interplay is nuanced — intertwined with shifts in s*x hormones through puberty, throughout the cycle, in perimenopause, and in menopause.

The science is still catching up, and there are real gaps in what's known, particularly around how these hormonal changes across a woman's lifespan shape this connection.

Knowing — and naming — what we still don't know is the first step toward new knowledge.

I am Dr Ivana — GP, Lifestyle Physician, and a woman. 🌿

More next week.

🔗 doctorivana.com.au

05/08/2026

MASTERING MENOPAUSE

Last week we talked about your gut trying to tell you something. This week, let's talk about why it's talking louder right now.

There's a real, measurable connection between changing hormones and gut diversity — researchers call this the "estrobolome," the community of gut bacteria, viruses, protozoa, and other microbes that helps metabolise and regulate circulating oestrogen. This isn't in your head — the evidence for this link is solid.

What's still young is the science on solutions. We don't yet have long-term studies on which probiotic strains, supplements, or doses reliably help — and there isn't even strong evidence that HRT (MHT) makes a difference here. Anyone promising a precise "fix in a pill" is ahead of the evidence.

What we do have solid evidence for is what's always mattered — diet diversity, sleep, stress management, and movement. Eat the rainbow. A mostly plant-based, real-food diet has never mattered more than in this third stage of a woman's life, helping reduce risk across cardiovascular, musculoskeletal, genitourinary, mental health, breast cancer, and body composition outcomes.

Understanding this gap is part of learning to work with your body through this transition, not against it.

📖 Missed last week's post? doctorivana.com.au/blog/what-your-gut-has-been-trying-to-tell-you

I am Dr Ivana — GP, Lifestyle Physician, and a woman. 🌿

More next week.

🔗 doctorivana.com.au

The estrobolome is the community of gut bacteria involved in how oestrogen is processed and recirculated. It runs both ways — your hormones shape your gut, and your gut helps shape your hormones. Here's what that means in perimenopause and menopause.