In South Africa, the intersection of menopause, metabolic syndrome, and impaired glucose regulation represents a major public health concern. Declining estrogen levels combined with distinct local cardiometabolic risk profiles significantly elevate rates of insulin resistance, prediabetes, and type 2 diabetes among middle-aged women. 1. Prevalence of Metabolic Syndrome & Insulin Resistance Relevant SA clinical studies demonstrate a sharp increase in Metabolic Syndrome (MetS)