Female Hormone Health, PCOS, Endometriosis, Fertility & Breast Cancer | Dr. Thaïs Aliabadi
Timestamps are as accurate as they can be but may be slightly off. We encourage you to listen to the full context.
Podcast Summary
This episode features Dr. Thaïs Aliabadi, an OB/GYN and leading women's health expert, who reveals the shocking reality that 90% of PCOS and endometriosis cases go undiagnosed. (00:52) These conditions represent the leading causes of infertility globally, yet women's symptoms are routinely dismissed as "normal," "stress-related," or "in their heads." Dr. Aliabadi breaks down the complex diagnostic criteria for both conditions, explains their underlying mechanisms, and provides actionable tools for early detection and treatment. (06:56) The discussion also covers critical information about fertility preservation, hormone optimization, and breast cancer screening that could be life-changing for women of all ages. • **Core Focus**: Empowering women to become their own health advocates through education about PCOS, endometriosis, fertility preservation, and comprehensive women's health screening
Speakers
Dr. Thaïs Aliabadi
Dr. Aliabadi is a board-certified OB/GYN, surgeon, and leading expert in women's health with 30 years of experience in the field. She has developed innovative diagnostic tools including the OVII platform for PCOS assessment and has been pioneering the use of GLP-1 medications for PCOS treatment since 2014. Dr. Aliabadi is also the host of the "She MD" podcast and is passionate about addressing the widespread dismissal of women's symptoms in healthcare.
Key Takeaways
Early Screening Is Critical for Fertility Preservation
Dr. Aliabadi emphasizes that every woman should know her egg count (AMH) by age 20, especially if experiencing painful periods or other concerning symptoms. (06:56) She explains that some patients as young as 14 have egg counts equivalent to 40-year-olds due to undiagnosed endometriosis. The key insight is that waiting for "normal" fertility timelines can be devastating for women with these conditions - early detection and intervention, including egg freezing before age 30, can preserve future fertility options.
Women Must Advocate for Comprehensive Pelvic Ultrasounds
A shocking revelation is that many gynecologists don't perform pelvic ultrasounds as part of routine exams. (25:25) Dr. Aliabadi states this should be mandatory for well-woman exams, as it can detect PCOS ovarian morphology, endometriomas, fibroids, and other critical conditions. Women need to specifically request pelvic ultrasounds and not accept dismissal - this simple test can reveal conditions that would otherwise go undiagnosed for years.
Insulin Resistance Is the Central Driver of PCOS
PCOS affects the brain-pituitary-ovary axis, but insulin resistance is the underlying metabolic issue driving 80% of cases. (40:30) High insulin stimulates androgen production, blocks ovulation, and creates visceral fat that releases inflammatory cytokines. This creates a vicious cycle where inflammation worsens insulin resistance. Treatment must address this root cause through supplements like inositol, metformin, lifestyle changes, and in some cases GLP-1 medications rather than just prescribing birth control.
Painful Periods Are Never Normal and Signal Endometriosis
Dr. Aliabadi's core message: if period pain disrupts your life - causing you to miss school/work, stay in bed, change social plans, or visit emergency rooms - this is endometriosis until proven otherwise. (100:25) Additional red flags include painful sex with deep penetration, chronic bloating, painful bowel movements, and recurrent UTI symptoms with negative cultures. The condition affects likely 20%+ of women but takes doctors 9-11 years to diagnose on average.
Know Your Lifetime Breast Cancer Risk by Age 30
Every woman should calculate her lifetime breast cancer risk using the Tyrer-Cuzick calculator (available free on various platforms). (158:17) If your risk is 20% or higher, you qualify for breast imaging starting at age 30, not 40. Dr. Aliabadi discovered her own breast cancer at age 48 through this process despite having no family history or genetic mutations. This calculation considers factors like breast density, family history, and reproductive history to provide personalized risk assessment.
Statistics & Facts
- 90% of PCOS patients are never diagnosed, despite PCOS affecting 15% of women in reproductive age (up to 20% in Middle Eastern countries). (15:58)
- 70-80% of PCOS patients don't ovulate, even when they have regular menstrual cycles, because the cycles represent estrogen withdrawal rather than progesterone from actual ovulation. (34:02)
- The average American woman has a 12.5% lifetime risk of breast cancer, but women with 20% or higher risk can start breast imaging at age 30 instead of waiting until 40. (159:12)
