WORLD’S TOP OBGYN Dr. Aliabadi: The #1 Hormone Problem Affecting Millions of Women (And The 4 Changes That Can Reverse It)
In this episode of On Purpose with Jay Shetty, Dr. Thaïs Aliabadi examines two frequently undiagnosed conditions affecting women's health: PCOS and endometriosis. She explains how these conditions impact millions of women, with PCOS affecting 15% of women and endometriosis affecting 10-20%, yet the vast majority of cases remain undiagnosed. The discussion covers the underlying causes of these conditions, including insulin resistance in PCOS and immune system dysfunction in endometriosis.
Dr. Aliabadi details the various treatment approaches for both conditions, from managing insulin resistance through diet and medication to hormonal therapies and surgical options for endometriosis. She also addresses the challenges women face in getting proper diagnoses and treatment, providing practical guidance for becoming better advocates for their own health care, including specific screening tests to request and symptoms to monitor.
This is a preview of the Shortform summary of the Mar 11, 2026 episode of the On Purpose with Jay Shetty
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1-Page Summary
Overview and Prevalence of PCOS and Endometriosis
Thaïs Aliabadi discusses two severely underdiagnosed conditions affecting women's health: PCOS and endometriosis. PCOS affects 15% of women, with 75% remaining undiagnosed, while endometriosis impacts 10-20% of women, with over 90% of cases going unrecognized. These conditions are leading causes of infertility and require greater awareness for proper diagnosis and treatment.
Underlying Causes, Symptoms, and Impact on Women's Health
According to Aliabadi, PCOS stems from [restricted term] resistance, leading to hormonal imbalances that cause weight gain, mood disorders, and fertility issues. About 75% of PCOS patients struggle with weight gain despite maintaining healthy habits, and up to 80% experience ovulation problems.
For endometriosis, Aliabadi explains that the condition occurs when the immune system fails to clear displaced uterine tissue, resulting in chronic inflammation. This leads to severe pelvic pain, painful periods, and fertility challenges. The condition can damage eggs, block fallopian tubes, and create a hostile environment for conception.
Diagnostic Challenges and Need For Better Approaches
Aliabadi highlights that women often face dismissal of their symptoms or misdiagnosis, with endometriosis typically taking 9-11 years to diagnose. She advocates for mandatory pelvic ultrasounds during well-woman exams and comprehensive screening that includes reproductive, metabolic, and autoimmune factors.
Comprehensive Treatment Strategies
For PCOS, Aliabadi recommends managing [restricted term] resistance through diet, exercise, supplements, and medications like [restricted term]. She has successfully used GLP-1 agonists since 2014 for weight loss and metabolic health improvement in PCOS patients.
Endometriosis treatment involves hormonal suppression through progesterone-based therapies and, when necessary, laparoscopic surgery. Aliabadi emphasizes the importance of immediate suppression post-surgery to prevent recurrence.
Early Detection and Women's Empowerment in Healthcare
Aliabadi encourages women to become their own health advocates, emphasizing the importance of comprehensive screening before attempting pregnancy. She recommends tools like online PCOS calculators and urges women to demand thorough care, including pelvic ultrasounds and AMH tests for ovarian reserve assessment when experiencing symptoms.
1-Page Summary
Additional Materials
Actionables
- Create a personal health diary to track symptoms and patterns that could indicate PCOS or endometriosis, noting details like menstrual cycle irregularities, pain levels, and weight changes. This diary can be a valuable tool when discussing symptoms with healthcare providers, ensuring that nothing is overlooked and potentially speeding up the diagnosis process.
- Develop a habit of conducting regular self-education sessions on reproductive health, using reputable sources to understand the latest research and treatment options for conditions like PCOS and endometriosis. This knowledge can empower you to have informed discussions with your doctor and advocate for the care you need.
- Form a peer support group with friends or find an online community focused on PCOS and endometriosis to share experiences, tips, and resources for managing symptoms and navigating the healthcare system. Peer support can provide emotional comfort and practical advice, making it easier to cope with the challenges of these conditions.
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Overview and Prevalence of Pcos and Endometriosis
Thaïs Aliabadi emphasizes the importance of awareness and diagnosis for conditions like PCOS and endometriosis, which are leading causes of infertility but often go undetreated or misdiagnosed.
Pcos Affects 15% of Women; 75% Undiagnosed
PCOS, or Polycystic Ovary Syndrome, is a common condition, affecting 15% of women in the U.S. and even higher rates in countries like India. Despite its prevalence, 75% of women with PCOS remain undiagnosed. PCOS can be identified by two of the following three criteria: irregular periods, polycystic ovaries on an ultrasound featuring at least 20 follicles, and elevated levels of [restricted term] or androgen, which may cause symptoms like facial hair, acne, or male pattern hair thinning.
Endometriosis Affects 10-20% of Women, With Over 90% Unrecognized
Endometriosis, another significant condition affecting women's health, remains undiagnosed in over 90% of cases. It is characterized by the growth of uterine-like tissue outside of the uterus, which can cause severe pain and lead to infertility. Endometriosis may present with deep infiltrated implants in areas such as the bowel and bladder and often leads to adhesions. It ...
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Overview and Prevalence of Pcos and Endometriosis
Additional Materials
Actionables
- You can track your menstrual cycle using a smartphone app to identify any irregularities that may suggest PCOS or endometriosis. By logging your period start and end dates, symptoms like pain or heavy bleeding, and any other related symptoms such as acne or hair growth patterns, you create a detailed record that can be valuable during medical consultations.
- Create a personal health diary to note down daily well-being, including any pain or discomfort that could be related to PCOS or endometriosis. This diary should include diet, exercise, stress levels, and sleep patterns, as these can all influence symptoms. When you visit a healthcare provider, this diary can help communicate your experiences more effectively.
- Engage in peer support groups online to share experienc ...
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Underlying Causes, Symptoms, and Impact on Women's Health
Aliabadi and other experts delve into the complexities of disorders affecting women's health, particularly PCOS and endometriosis, shedding light on their origins, manifestations, and profound impacts.
Pcos Stemming From [restricted term] Resistance: Hormonal, Metabolic, Reproductive, and Neurological Effects
PCOS, rooted in [restricted term] resistance, impacts women's hormonal balance, metabolic functioning, reproductive systems, and neurological health.
Pcos Patients Often Face Weight Gain, Mood/Eating Disorders, and Infertility
PCOS patients frequently experience weight gain, mood swings, eating disorders, and infertility. Despite maintaining a diet and exercise routine, about 75% of PCOS patients gain weight. Around 25% of patients may be lean but still struggle with eating disorders. Aliabadi notes that [restricted term] resistance leads to increased androgen production in the ovaries, causing irregular estrogen secretion and ovulation issues. These hormonal fluctuations contribute to menstruation irregularities, making fertility a challenge. Up to 80% of PCOS patients don't ovulate, and those who do may not have consistent periods, as the irregularity could stem from hormonal withdrawal rather than ovulation.
The condition also adversely affects mental health, as unstable hormone levels result in anxiety, depression, and brain fog, sometimes leading to eating disorders and feelings akin to a personality disorder. Aliabadi emphasizes that treatment targeting metabolic health can improve symptoms, including PMS, mood disorders, and weight gain.
Women with PCOS may exhibit a range of symptoms, such as acne, hair loss, hirsutism, and mood disorders. One patient case includes infertility, indicating that the condition can exhaust egg reserves prematurely.
Endometriosis Occurs When the Immune System Fails to Clear Displaced Uterine Tissue, Causing Chronic Inflammation and Nerve Sensitization
Endometriosis stems from the immune system's inability to clear ectopic uterine tissue, leading to perpetual inflammation.
Endometriosis Causes Pelvic Pain, Painful Periods, Intercourse, Gastrointestinal, and Fertility Issues
Endometriosis is characterized by chronic pelvic pain and fertility challenges. The displaced tissue, inflamed and estrogen-dependent, creates a hostile environment that can damage eggs and impede their travel through the fallopian tubes. Scarring can block ...
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Underlying Causes, Symptoms, and Impact on Women's Health
Additional Materials
Actionables
- You can track your menstrual cycle using a dedicated app to identify patterns that may indicate PCOS or endometriosis. By logging symptoms such as menstrual irregularities, pain levels, mood changes, and other related symptoms daily, you'll have a detailed record to discuss with a healthcare provider, which can aid in early diagnosis and management.
- Create a low-glycemic meal plan to potentially mitigate [restricted term] resistance associated with PCOS. Focus on incorporating whole foods, lean proteins, and fiber-rich vegetables while avoiding processed sugars and refined carbs. This approach may help in managing weight and hormonal imbalances, even if you're not e ...
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Diagnostic Challenges and Need For Better Approaches
Aliabadi and other experts share the difficulties women face in getting proper diagnosis and treatment for disorders like PCOS and Endometriosis and advocate for a holistic approach in healthcare.
Doctors Often Miss Diverse Pcos and Endometriosis Presentations
Women Dismissed, Symptoms Deemed Normal or "In Their Head", Struggle For Years Without Proper Treatment
Dr. Aliabadi illustrates the challenges women encounter, particularly with PCOS and endometriosis, where they often face dismissal or misdiagnosis. She expresses frustration with the healthcare system that frequently dismisses women, contributing to years of untreated pain and symptoms. Aliabadi reports that many PCOS patients end up in eating disorder centers due to being undiagnosed and notes that the symptoms related to irregular estrogen secretion and androgen effects often go misinterpreted.
Aliabadi also highlights that symptoms of endometriosis are often dismissed as normal, leading women on a lengthy and painful journey toward diagnosis. She notes that it typically takes 9 to 11 years to diagnose endometriosis. Patients often feel validated only upon diagnosis after years of being told their symptoms were all in their head. She emphasizes that if a woman suspects she has endometriosis and is dismissed by her doctor, she should seek out another doctor or an endometriosis specialist.
Current Healthcare Is Symptom-Focused, Not Comprehensive
Mandatory Pelvic Ultrasounds and Holistic Screening Improve Early Detection of Reproductive, Metabolic, and Autoimmune Factors
Aliabadi details the necessity of mandatory pelvic ultrasounds for sexually active females and comprehensive screening. She performs pelvic ultrasounds to check for PCOS and other conditions such as chocolate cysts and utilizes 3D imaging of the uterus to check for issues like ...
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Diagnostic Challenges and Need For Better Approaches
Additional Materials
Counterarguments
- Mandatory pelvic ultrasounds may not be cost-effective or necessary for all sexually active females, as the prevalence of conditions like PCOS and endometriosis might not justify the expense and resources for universal screening.
- Some experts may argue that the focus on pelvic ultrasounds could lead to overdiagnosis and overtreatment, which can have its own set of risks and complications.
- There is a debate about the balance between comprehensive screening and the potential for increased healthcare costs, which could impact access to care for some populations.
- While holistic healthcare is ideal, practical constraints such as time, resources, and training may limit the ability of healthcare providers to offer this level of care universally.
- The comparison of failing to perform a pelvic ultrasound to expecting someone to read without their glasses might be seen as an oversimplification, as not all conditions can be detected or ruled out by ultrasound alone.
- Some may argue that the emphasis on specialist care for conditions like endometriosis could inadvertently undermine the role of primary care physicians in managing and coordinating care for these patients.
- There could be concerns about the privacy and autonomy of patients regarding mandatory medical procedures, such as pelvic ultrasounds, and the need to balance these with the benefits of early detection ...
Actionables
- You can create a personal health diary to track symptoms and patterns related to PCOS and endometriosis, which can be a powerful tool when discussing your health with doctors. Start by noting daily symptoms, diet, exercise, and stress levels to identify triggers or patterns. This record can help you advocate for yourself during medical appointments and may provide your healthcare provider with insights that could lead to a more accurate diagnosis.
- Develop a list of questions and concerns before medical appointments to ensure you address all your symptoms and worries with your healthcare provider. Research suggests that patients who come prepared with specific questions may receive more thorough care. Include questions about comprehensive metabolic screenings, the potential for holistic care approaches, and the benefits of pelvic ultrasounds.
- Consider joining o ...
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Comprehensive Treatment Strategies, Including Lifestyle, Supplements, and Medications
PCOS: Managing [restricted term] Resistance Through Diet, Exercise, Supplements, and [restricted term] Regulates Hormones and Improves Symptoms
In managing PCOS, Dr. Aliabadi places emphasis on [restricted term] sensitivity, treating patients with [restricted term] before they try for pregnancy. She supports integrating lifestyle changes such as a low carbohydrate diet and post-meal walking to activate [restricted term] receptors. Regular exercise is also encouraged. Supplements play a significant role, specifically the OV supplement containing wild mulberry leaf, which blocks 40% of carbohydrate absorption. [restricted term], prescribed to promote [restricted term] sensitivity, can cause nausea but is generally well-adapted to over time. Lifestyle adjustments like exercise and an anti-inflammatory diet are key to managing [restricted term] resistance in PCOS. Addressing the neurological effects involves managing inflammation and hormonal imbalances. For patients looking to conceive, supplements like OVY paired with [restricted term] can induce ovulation, potentially steering clear of fertility clinics.
GLP-1 Agonists Promote Weight Loss and Restore Metabolic Health in PCOS
Dr. Aliabadi's treatment of PCOS with GLP-1 agonists since 2014 has proven effective not only for weight loss but also for [restricted term] regulation. Patients experience better cognition, fertility, and menstrual regularity, highlighting the benefits of GLP-1 agonists like Ozempic and Wegovy in managing PCOS. Aliabadi stresses their use specifically for overweight or obese PCOS patients dealing with related health issues. Treatment duration varies by individual weight loss goals and [restricted term] resistance, which persists even post-treatment. Aliabadi incorporates [restricted term] into the treatment plan along with GLP-1s, while also using the OV supplement to address [restricted term] resistance, chronic inflammation, and carbohydrate absorption. However, some treatments might only address surface symptoms without tackling core issues such as inflammation or [restricted term] resistance.
Endometriosis: Hormonal Suppression, Surgery, and Comorbidity Management
Hormonal suppression in endometriosis uses progesterone-based therapies, including birth control pills or IUDs, but if these fail, GnRH agonists or antagonists can be employed. These methods can have side effects like hot flashes or mood changes. For those who cannot afford egg freezing, hormonal suppressants like progesterone I ...
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Comprehensive Treatment Strategies, Including Lifestyle, Supplements, and Medications
Additional Materials
Counterarguments
- While [restricted term] is commonly used to manage [restricted term] resistance in PCOS, some patients may not tolerate it well or may prefer not to take medication. Alternatives like inositol supplements or other [restricted term]-sensitizing drugs could be considered.
- The claim that the OV supplement blocks 40% of carbohydrate absorption may need further scientific validation, as the effectiveness of supplements can vary widely among individuals.
- GLP-1 agonists have shown promise in managing PCOS, but they are relatively new and long-term effects are not fully understood. Additionally, they can be expensive and may not be covered by insurance.
- The emphasis on weight loss for overweight or obese PCOS patients may overlook the fact that PCOS can affect individuals of all body types, and weight loss is not a one-size-fits-all solution.
- Hormonal suppression as a treatment for endometriosis can be effective, but it may not be suitable for all patients, especially those who wish to conceive or who experience adverse side effects from hormonal therapies.
- The use of progesterone-based therapies, such as IUDs, may not be appropriate for all patients with endometriosis, and some may prefer non-hormonal pain management strategies.
- While surgery is mentioned as a treatment for advanced endometriosis, it is important to note that surgery carries its own risks and may not be a viable option for ev ...
Actionables
- You can track your meals and physical activity using a smartphone app to better understand your personal [restricted term] response. By logging what you eat, particularly noting carbohydrate intake, and recording your physical activity levels, you can identify patterns in how your body responds to different foods and exercise. This self-monitoring can help you make more informed decisions about your diet and activity to manage PCOS symptoms effectively.
- Create a simple home-based exercise routine that includes resistance training to potentially improve [restricted term] sensitivity. Resistance exercises like squats, lunges, and push-ups can be done with minimal equipment and have been shown to help with [restricted term] resistance. By establishing a routine and gradually increasing the intensity, you can work towards better managing PCOS symptoms from the comfort of your home.
- Consider starting a peer ...
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Early Detection and Women's Empowerment in Healthcare
As emphasized by healthcare professionals like Dr. Aliabadi, early detection of PCOS and endometriosis is critical to prevent long-term damage and improve women's health outcomes.
Early Detection of PCOS and Endometriosis Essential to Prevent Damage
Women Must Advocate For Their Health and Not Accept Dismissive Attitudes From Providers
Dr. Aliabadi highlights the importance of comprehensive screening for conditions that can affect fertility, such as PCOS and endometriosis, before advising women to try getting pregnant. She encourages women to become their own health advocates to counter dismissive attitudes from healthcare providers, using tools like an online PCOS calculator to assess their risk. Women are urged to communicate effectively with their OBGYN and demand thorough care.
Healthcare providers should listen carefully and diagnose endometriosis with over 90% accuracy by recognizing symptoms instead of immediately resorting to surgery. Dr. Aliabadi insists on checks for ovarian reserve through an AMH test for women experiencing painful and debilitating periods and encourages them not to accept a dismissive stance from their doctors. Dr. Aliabadi sees pelvic ultrasounds as an essential tool that patients should demand as part of comprehensive care.
Screening, Education, and Multidisciplinary Care Could Transform Outlook for Affected Women
Empowering Women to Address Fertility Issues Caused by Undiagnosed PCOS and Endometriosis
The importance of early detection is discussed in relation to preventing the necessity for many fertility clinics. Dr. Aliabadi extends her practice to screen for pre-diabetes, anxiety, depression, and fertility issues, suggesting a multidisciplinary approach to care, which could significantly improve outcomes for women with these conditio ...
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Early Detection and Women's Empowerment in Healthcare
Additional Materials
Counterarguments
- While early detection is important, it is also crucial to ensure that increased screening does not lead to overdiagnosis and overtreatment, which can have its own set of risks and negative outcomes.
- Advocating for one's health is essential, but it is also important to recognize that not all patients have the same level of health literacy or confidence to effectively communicate with healthcare providers.
- Online tools like PCOS calculators can be helpful, but they should not replace professional medical advice, as they may not be accurate for every individual and could cause unnecessary anxiety.
- Diagnosing endometriosis with over 90% accuracy based solely on symptoms may not always be feasible, as symptoms can vary widely and overlap with other conditions, potentially leading to misdiagnosis.
- While pelvic ultrasounds are valuable, they are not always definitive for diagnosing conditions like endometriosis, which may require laparoscopic surgery for a conclusive diagnosis.
- A multidisciplinary approach to care is beneficial, but it may not be accessible to all women due to socioeconomic factors, insurance coverage, and availability of specialists.
- The assertion that leaky gut is prevalent in 90% of endometriosis patients may need more robust scientific evidence to support it, as the relationship between gut health and endometriosis is still an emerg ...
Actionables
- Create a personal health diary to track menstrual cycles, symptoms, and any changes in your body, which can be a valuable tool when discussing your health with a doctor. By noting the frequency, intensity, and type of symptoms you experience, you can provide concrete data to your healthcare provider, making it easier to advocate for further testing or treatment.
- Develop a checklist of symptoms and questions to take to medical appointments, ensuring you cover all your concerns and symptoms with your healthcare provider. This can include questions about specific tests for PCOS and endometriosis, inquiries about the implications of your symptoms, and what steps to take next if you're planning to conceive.
- Partner with a friend or family member ...
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1-Page Summary- Overview and Prevalence of Pcos and Endometriosis
- Underlying Causes, Symptoms, and Impact on Women's Health
- Diagnostic Challenges and Need For Better Approaches
- Comprehensive Treatment Strategies, Including Lifestyle, Supplements, and Medications
- Early Detection and Women's Empowerment in Healthcare
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