From Bethesda Magazine: This endocrinologist is a mechanic for the human body 

Dr. Monika Mannan is a mechanic for the human body. When “everything is in perfect balance, the human body is a perfectly running machine,” the Rockville endocrinologist says. But when hormones go awry, that machine can falter, leaving women feeling unwell and it is her job to figure out the problem.

When you think of a women’s health professional, the first person who comes to mind is likely a gynecologist. However, another specialist plays a vital role in the well-being of women: the endocrinologist. These experts help manage conditions that affect everything from metabolism to fertility. Mannan, 54, is one of those doctors who specialize in hormones and the glands that produce them. Endocrinologists diagnose and treat conditions related to hormonal imbalances, such as diabetes, thyroid disorders and adrenal or pituitary gland issues. 

Mannan graduated from Silchar Medical College in India, and completed her internal medicine residency at UM Prince George’s Hospital Center in Cheverly, Maryland. She earned her endocrinology and metabolism degree from George Washington University in 2004 and has been practicing as an endocrinologist since 2005. She specializes in diagnosing and treating hormonal disorders such as polycystic ovary syndrome (PCOS), thyroid disease, and other metabolic conditions such as diabetes and insulin resistance, helping patients—especially women—find answers after years of unexplained symptoms.

We chatted over Zoom with Mannan at her Rockville office, Montgomery Endocrinology, in mid-February to dissect the critical role endocrinologists play in women’s health, especially when it comes to deciphering misdiagnosed diseases. 

The case of the overlooked tumor

Mannan says her patients often come to her feeling unheard. Many have been referred by their primary care doctors after blood work indicated conditions such as thyroid disorders, Hashimoto’s thyroiditis, prediabetes or diabetes. 

However, a significant number find her through word of mouth, including recommendations from community groups and neighborhood WhatsApp chats in which patients share their experiences and seek trusted specialists.

Mannan says that some of her patients are women who have been told their fatigue is just “part of aging; their weight gain a consequence of motherhood; their palpitations a symptom of anxiety.”

She recalls the story of one patient, a young mother who had recently given birth to her third child. She was struggling with weight gain that diet and exercise would not fix. “She told me, ‘This is not me. I’m just gaining weight. Nobody listens to me,’ ” Mannan says.

Doctors had assured the woman that it was normal postpartum weight retention and dismissed her concerns as anxiety or stress from being overwhelmed by motherhood. But Mannan suspected something more. “I observed her frustration while she was giving me her history and the concern she had about her medical problem,” she says. “She had not come to see me for weight. She had come for other thyroid problems, and this was just a side thing I found by just listening to her and evaluating.” 

After running tests, Mannan found the culprit: a tumor on the woman’s adrenal gland, which was causing an overproduction of cortisol, the body’s stress hormone associated with weight gain. “Surgery removed the tumor, and [the patient] was happy with the result.”

“We are always thinking of uncommon problems in a common scenario,” Mannan says. “Had she gone untreated, she would have kept suffering.”

The silent dangers of PCOS

For years, PCOS has been discussed primarily as a fertility issue, but Mannan wants women to know it’s more than that. “PCOS is a complex condition,” she says. “Women who have PCOS are at increased risk of developing prediabetes, diabetes, high cholesterol and high blood pressure.”

PCOS affects 6% to 12% of women of reproductive age in the U.S. and is linked to serious health conditions such as diabetes, high blood pressure and heart disease, according to the U.S. Centers for Disease Control and Prevention. Symptoms such as irregular periods, acne and excess hair growth are common diagnostic criteria for PCOS. Despite its prevalence, up to 70% of women with PCOS remain undiagnosed worldwide according to the World Health Organization, suggesting that these symptoms may often go unrecognized or inadequately addressed.

“Staying physically active and eating less processed food decreases their insulin resistance,” Mannan says. Lifestyle adjustments, she says, can sometimes restore ovulation naturally, reducing the need for fertility treatments.

The woman who was ‘just stressed’

Mannan digs deeper into her patients’ cases by listening to them. “I listen carefully to their complaints and never disregard them as frivolous,” she says. “That encourages patients to talk more about their problems and concerns.” From there, she gathers critical details by asking targeted questions, conducting thorough physical exams and ordering relevant tests based on a patient’s history. 

“The answer is almost always in the patient’s history and exam,” she says, “and it’s complemented by imaging and blood work.”

Mannan recalls the case of an 80-year-old woman who, Mannan says, had suffered from heart palpitations for two decades. Each time the patient saw a doctor, Mannan says, she was told it was anxiety. “ ‘Don’t worry about it,’ they told her,” Mannan recalls. 

After a deeper look, Mannan discovered a 10-centimeter pheochromocytoma—a rare, hormonally active tumor that had been flooding the patient’s body with stress hormones for years. “I looked at her and said, ‘I’m so surprised, so glad that you’re alive,’ ” Mannan says. Left untreated, “the condition could have led to a fatal hypertensive crisis.”

The misinformation epidemic

For all the medical advancements in endocrinology, Mannan’s greatest battle isn’t always with disease—sometimes it’s with misinformation. “Everything is blamed on hormones,” she says. Patients come in demanding to have all their hormone levels checked, convinced their cortisol or thyroid is the root of all their issues.

She often explains that stress-related cortisol fluctuations don’t require medical treatment. “Unless the cortisol overproduction is pathologic—[which] means there’s a tumor source—there’s no treatment for that,” she says. Instead, she encourages patients to focus on such stress management techniques as mindfulness and better sleep habits.

Another trend that worries her is the rise of unregulated hormone therapies and supplements. “Patients should get their information from the right source,” she warns, adding that many wellness clinics sell costly hormone tests and treatments that lack scientific backing. “They need to seek care from board-certified specialists rather than falling for trendy health fads.”

When women should see an endocrinologist

Despite the critical role endocrinologists play, many women don’t know when they should see one.

“If your symptoms aren’t improving with standard treatment, or if you feel like something deeper is going on, an endocrinologist can help uncover the root cause,” she says.

Mannan believes that as awareness of hormonal health continues to grow, endocrinologists like her will remain allies for women trying to understand the complexities of their bodies. “Women need to know they’re not alone,” she says. “Their symptoms are real, and there are answers.” 

This appears in the May/June 2025 issue of Bethesda Magazine.