We are heading for a metabolic health disaster and women are going to be sitting in the centre of it. As women enter the perimenopause, which can be as young as 35 years of age, a triad of events begin to unfold. Progesterone levels fall meaning its effects as a neurosteroid decline - women start to experience increased brain fog, anxiety, sleep changes and depression. Then declining levels of oestrogen result in reduced metabolic flexibility meaning cells are limited in their ability to utilise differing substrates for ATP production. Finally post covid living is stressful especially where we see women taking on even more roles than ever before, driving up cortisol with subsequent spiking of blood sugars all associated with insulin resistance. All of which leads to weight loss resistance as one of many downstream consequences in perimenopausal women. This maelstrom of cellular changes creates the perfect environment for metabolic diseases, namely diabetes, cardiovascular disease, Alzheimer's and cancer which all have significant emotional and socio-economic consequences, at a time when women need their brains and bodies available to them to live their best lives. Therefore, if we want to improve longevity globally, we MUST improve women’s metabolic and hormone health at a personalized level as their hormones change and fluctuate.