Hormone Optimisation Consultation

Specialist physician assessment of hormonal imbalances contributing to metabolic dysfunction, weight gain, fatigue, and reduced quality of life — including thyroid disorders, PCOS, testosterone deficiency, and perimenopause — with personalised hormone optimisation treatment plans.

The Hormone Optimisation Consultation at The Metabolic Clinic addresses the hormonal underpinnings of metabolic dysfunction, recognising that unexplained weight gain, fatigue, mood disturbance, and difficulty losing weight despite diet and exercise often have a hormonal root cause that standard GP assessments fail to identify. The service covers the full spectrum of hormonally-driven metabolic conditions in both men and women. For women, the clinic specialises in polycystic ovary syndrome (PCOS) — Singapore's most common endocrine disorder, affecting 6–10% of women of reproductive age — as well as perimenopausal and menopausal hormone changes. PCOS management combines insulin-sensitising strategies (metformin, lifestyle intervention, GLP-1 therapy where indicated), anti-androgen therapy for hyperandrogenism, and metabolic monitoring. For perimenopausal women, the clinic assesses the interplay between declining oestrogen and progesterone levels, metabolic rate, body composition changes (central adiposity accumulation), insulin sensitivity deterioration, and cardiovascular risk — and discusses evidence-based hormone replacement therapy (HRT) options where clinically appropriate and desired by the patient. For men, the clinic evaluates hypogonadism (low testosterone) — a condition increasingly recognised as contributing to central obesity, insulin resistance, reduced lean muscle mass, fatigue, low libido, and depression. Assessment follows Endocrine Society guidelines with morning total testosterone, sex hormone binding globulin (SHBG), LH, FSH, and prolactin. Where deficiency is confirmed, testosterone replacement therapy (TRT) options are discussed, including the risks, benefits, and monitoring requirements. Thyroid disorder management is integral to the clinic's metabolic remit. Subclinical and overt hypothyroidism drive weight gain and metabolic slowing, and the clinic's approach goes beyond TSH alone — assessing free T4, free T3, and thyroid antibodies to identify autoimmune thyroiditis (Hashimoto's disease) and suboptimal thyroid conversion even within normal TSH ranges. Where clinically indicated, thyroid hormone replacement or optimisation is prescribed and monitored. All hormone prescribing follows Singapore Ministry of Health and international clinical practice guidelines. Follow-up consultations review treatment response, adjust dosing, and monitor safety parameters including cardiovascular markers, haematocrit (for TRT), and bone density.