PCOS treatment in Dormagen

PCOS affects not only the cycle and hormones, but often the metabolism as well. So along with cycle complaints or fertility questions, we also look at possible metabolic factors. PCOS is a focus area of our work — we work in a structured way, explain findings clearly, and build a treatment plan with you.

Taking PCOS symptoms seriously – even when they look ambiguous

Many women walk around for years with a gut feeling that "something is off": the cycle keeps disappearing, pregnancy does not happen, complaints get framed differently from one appointment to the next. What stays behind is the feeling of not being heard.

Our PCOS care starts by taking your observations seriously. PCOS is not a single finding but a pattern of symptoms, hormone values and ultrasound signs. We look at the whole picture and map it out with you – without belittling and without drama.

What PCOS treatment with Elisa Mahlberg looks like

We work along the Rotterdam criteria and a structured pathway:

• Detailed history. Cycle since menarche, the symptom picture, prior conditions, family history, medication, prior findings, fertility plans.
• Exam and ultrasound. Uterus, ovaries (antral follicle count, ovarian volume), endometrium, signs of polycystic change.
• Targeted diagnostics. Which hormone values and metabolic parameters make sense depends on your situation and the specific question. We discuss this individually and decide together which workup makes sense in the individual case.
• Interpretation and plan. We discuss the findings calmly and build a plan: lifestyle, cycle regulation, prevention of metabolic risks, and fertility stimulation if needed.

PCOS diagnosis, medical therapy and fertility stimulation

The PCOS diagnosis is based on the Rotterdam criteria: two of three findings – irregular cycles/anovulation, clinical or lab hyperandrogenism, and polycystic ovaries on ultrasound – with other causes excluded beforehand. From diagnosis we build a treatment plan:

• Cycle regulation and endometrial protection: progestin schedules, combined pills, hormonal IUD – depending on age, fertility plans and tolerability.
• Metabolic perspective: we look at possible metabolic factors such as insulin resistance and discuss which measures — from lifestyle to medication — make sense in your situation. Whether a medication such as metformin is appropriate depends on the individual case.
• Fertility with PCOS: we offer medical stimulation protocols with follicle monitoring. Which medication fits in your case, we discuss in person. For many patients this leads to pregnancy without needing further reproductive medicine.

For young patients especially, careful framing matters. Cycle irregularities during puberty and adolescence can initially be normal. A PCOS diagnosis should therefore not be made prematurely — we hold back until the picture is genuinely clear.

Our scope: Elisa Mahlberg is a consultant in gynecology and obstetrics, not an endocrinologist. When the focus lies outside gynecology (complex metabolic or adrenal questions) we refer to an endocrinology practice and work with their findings. See also our hormone consultation.