Up to 70% of women with PCOS have undiagnosed insulin resistance. Oestrogen drops by up to 60% during perimenopause. Both drive fat storage in ways that calorie counting cannot touch. If you have been losing the same battle for years, the problem is not effort. It is biology.
Consultant Gynaecologist · Sheba CMO
Sheba does not guess. Every treatment plan starts with a clinical assessment of your hormonal and metabolic profile.
Answer questions about your health history, symptoms, and goals. Your answers help the specialist understand your hormonal picture before the consultation.
A consultant gynaecologist reviews your case — insulin function, hormonal profile, metabolic markers. This is the assessment your GP does not do.
If treatment is clinically appropriate, your specialist creates a plan matched to your hormonal profile. Ongoing reviews and dose adjustments are included.
"When I test a woman's insulin, her androgens, her oestrogen: the answer is almost always there. The data tells the story. The problem is that most women have never had these tests done."
Consultant Gynaecologist · Sheba Clinical Lead · GMC Registered · 15+ years specialist experience
Women's hormones shift constantly across your cycle, through pregnancy, into perimenopause and beyond. Each shift changes how your body handles weight. Here is what the science shows.
When your cells stop responding to insulin, your body overproduces it, driving fat storage, particularly visceral fat around the abdomen. Research shows insulin resistance can reduce metabolic efficiency by 20–30%. It affects up to 70% of women with PCOS and becomes increasingly common during perimenopause. No amount of calorie restriction overrides this signal.
Oestrogen regulates over 400 functions in the body, including fat metabolism and insulin sensitivity. During perimenopause, levels can drop by up to 60%, shifting fat storage to the abdomen, slowing resting metabolic rate by an estimated 4–8% per decade, and disrupting sleep. In PCOS, elevated androgens create a similarly hostile metabolic environment. These are measurable, clinical changes, not lifestyle choices.
Ghrelin (hunger), leptin (satiety), and GLP-1 (appetite regulation) are all disrupted by hormonal conditions. Studies show women with PCOS have significantly elevated ghrelin and reduced GLP-1 response compared to controls meaning your brain is receiving stronger hunger signals and weaker fullness signals. That persistent appetite is not a character flaw. It is measurable endocrine dysfunction.
Research shows that repeated dieting can lower resting metabolic rate by 15% or more, a phenomenon sometimes called adaptive thermogenesis. Your body becomes progressively more efficient at conserving energy, which is why each diet works less than the last. Women who have been cycling through calorie restriction for years are often operating at a significant metabolic disadvantage. Breaking that cycle requires clinical intervention, not another deficit.
PCOS. Perimenopause. Menopause. Post-pregnancy. Or simply years of hormonal shifts that nobody ever explained
Sheba starts with understanding the mechanism.
Your specialist will recommend the right treatment for your condition. Your monthly cost adjusts with your dose as you titrate.
All prices include medication, delivery, your monthly clinical review, and unlimited messaging. No separate consultation fees. Your titration schedule is set by your consultant.
Hormonal conditions change the metabolic rules. Insulin resistance which affects up to 70% of women with PCOS and becomes more common in perimenopause which causes your body to store fat more aggressively, regardless of intake. Oestrogen decline reduces metabolic rate by 4–8% per decade. And disrupted appetite hormones mean your brain is receiving stronger hunger signals. A calorie deficit cannot override these hormonal signals. Effective treatment requires addressing the endocrine dysfunction directly.
A consultant gynaecologist assesses your full hormonal and metabolic picture fasting insulin, HOMA-IR (insulin resistance index), androgen levels, oestrogen and progesterone status, thyroid function, and metabolic markers like HbA1c and lipid profile. Most GPs do not order these tests in the context of weight management — they are trained to recommend calorie reduction and exercise. That is the difference between a generalist and a specialist.
No. Sheba is a private specialist service. You can access it directly, without a referral, and book a consultation within days.
Sheba specialises in women whose weight is driven by hormonal factors. The most common conditions we see are PCOS, perimenopause, and menopause but we also support women with thyroid dysfunction, post-pregnancy hormonal changes, and unexplained weight gain that has not responded to conventional approaches. The specialist assessment determines whether a hormonal factor is involved.
The assessment is free. If your specialist recommends treatment, pricing starts from £66/month (Wegovy) or £145/month (Mounjaro) at the starting dose. All prices include medication, delivery, clinical reviews, and unlimited messaging. No hidden fees.
Yes. Month-to-month, no contract. Cancel before your next prescription is issued and you will not be charged for the following month.
A consultant gynaecologist looks at the hormonal picture that every diet has ignored. Start with a free assessment.
Start Your Free AssessmentReviewed by a consultant gynaecologist before any prescription is issued.