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In this episode, I’m joined by Dr. Melanie Cree—physician-scientist, pediatric endocrinologist, and one of the leading researchers redefining how we understand and treat Polycystic Ovary Syndrome (PCOS). PCOS affects millions of women, yet it's still underdiagnosed, misunderstood, and often mistreated. Dr. Cree cuts through the confusion, offering a deeply scientific yet compassionate look at what’s really driving this complex condition—from insulin resistance and mitochondrial dysfunction to skeletal muscle quality and fertility trajectories across a woman’s lifespan. We cover: Why PCOS isn’t a single disease—and what two phenotypes may explain the full picture How muscle, liver, and fat interact in PCOS The misunderstood role of testosterone, insulin, and SHBG in diagnosis What muscle biopsies reveal about teenage girls with PCOS Intramuscular fat, mitochondrial impairment, and the true cost of sedentary muscle How early lifestyle and exercise interventions could change the future of PCOS care What GLP-1 agonists and amino acid supplements might offer for treatment Whether you’re a clinician, patient, or advocate for women’s health, this episode will give you a whole new lens on PCOS—and why skeletal muscle may be the most overlooked (and powerful) organ in the conversation. Who is Dr. Melanie Cree? Dr. Melanie Cree is a board-certified pediatric endocrinologist and Associate Professor at the University of Colorado and Children’s Hospital Colorado, where she directs a leading multidisciplinary PCOS clinic. Her research bridges metabolic medicine and muscle physiology, with clinical trials exploring semaglutide, amino acid therapy, liver metabolism, and insulin resistance in adolescents. This episode is brought to you by: LMNT – Get your free LMNT Sample Pack with any purchase → https://DrinkLMNT.com/DRLYON Cozy Earth – Get up to 40% off with code DRLYON → https://cozyearth.com/DRLYON OneSkin – Get 15% off with the code DRLYON at → https://OneSkin.co Timeline Nutrition – Get 10% off → https://timeline.com/LYON Find Dr. Melanie Cree at: University of Colorado - https://som.cuanschutz.edu/Profiles/F... Find me at: Instagram: @drgabriellelyon TikTok: @drgabriellelyon Facebook: facebook.com/doctorgabriellelyon YouTube: / @drgabriellelyon X (Twitter): x.com/drgabriellelyon Apply to become a patient – https://drgabriellelyon.com/new-patie... Join my weekly newsletter – https://institute-for-muscle-centric-... Get my book – https://drgabriellelyon.com/forever-s... Forever Strong Summit 2025 – Grab your ticket NOW before we sell out! https://drgabriellelyon.com/forever-s... Timestamps: 00:00 – Intro to PCOS: Why most women still don’t get real answers 03:00 – Dr. Melanie Cree’s mission: Advocacy, research, and a new liver pathway 07:00 – PCOS isn’t one disease: Metabolic vs. reproductive phenotypes 12:00 – Why lifestyle changes work—and why “just lose weight” isn’t enough 16:00 – Fertility, follicle congestion, and why some women conceive more easily after 35 21:00 – Diagnosing PCOS in teens vs. adults—and why ultrasounds mislead 26:00 – Testosterone, SHBG, and the lab mess misdiagnosing women 36:00 – Muscle in PCOS: Why high testosterone ≠ more muscle 41:00 – Mitochondrial dysfunction and insulin resistance in teen girls 46:00 – IMAT, marbled muscle, and early cardiovascular risk 53:00 – How fat in and around muscle affects insulin signaling 1:06:00 – MPS, amino acids, and resistance training in obesity 1:16:00 – Lifestyle vs. semaglutide: Surprising results from Dr. Cree’s trial 1:22:00 – Low-glycemic diets, liquid sugar, and reactive hypoglycemia 1:26:00 – Protein, GLP-1s, and lean mass loss: What matters most 1:30:00 – GLP-1s vs. metformin—and their full-body metabolic effects 1:37:00 – Can PCOS be reversed? Why “lifestyle-managed” is more accurate 1:40:00 – Brain remodeling, hunger, and GLP-1s in teens vs. adults 1:43:00 – Compounded GLP-1s, insurance gaps, and what’s next in PCOS care Disclaimer: The Dr. Gabrielle Lyon Podcast and YouTube are for general information purposes only and do not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast, YouTube, or materials linked from this podcast or YouTube is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay in obtaining medical advice for any medical condition they may have and should seek the assistance of their health care professional for any such conditions. This video includes paid sponsorships.