Huberman Lab Podcast Summary:
Female Hormone Health, PCOS, Endometriosis, Fertility & Breast Cancer | Dr. Thaïs Aliabadi
Date: Nov 24, 2025
Host: Dr. Andrew Huberman
Guest: Dr. Thaïs Aliabadi

Overview and Main Theme

In this episode, Dr. Andrew Huberman speaks with Dr. Thaïs Aliabadi, a leading OB/GYN, passionate advocate for women’s health, and reproductive surgeon. The conversation dives deep into misunderstood, underdiagnosed, and mismanaged women’s health concerns—particularly PCOS (polycystic ovary syndrome), endometriosis, fertility issues, and breast cancer risk. Dr. Aliabadi explains why misdiagnosis and dismissal by clinicians are so frequent, the actionable markers of these conditions, and actionable steps women (and their families) can take to advocate for proper diagnosis, management, and care—often before symptoms progress to infertility or severe chronic pain. The episode offers practical information, tools, and encouragement for women to become empowered advocates for their health.

Key Discussion Points and Insights

1. Systemic Dismissal of Women’s Health

• Widespread Dismissal: Women’s symptoms—pelvic pain, cycle irregularity, hair loss, mood changes, infertility—are regularly minimized or dismissed by healthcare providers, leading to years of suffering and missed diagnoses.
  • "[Women's symptoms] get dismissed, minimized or...completely ignored...millions and millions of women suffering undiagnosed PCOS, endometriosis, chronic pelvic pain, infertility..." (04:04)
• Impact: Misdiagnosis or lack of diagnosis leads to unnecessary suffering, unnecessary fertility costs, and irreversible reproductive harm.
• Analogy: Compared under-diagnosing PCOS to ignoring cataracts in eye care—something unthinkable in other fields (00:12, 60:05).

2. Fertility Trajectory & Early Screening

• Limited Value of 'Average' Data: Typical fertility charts are misleading because underlying, undiagnosed conditions (esp. PCOS/endometriosis) are not factored into 'average' statistics.
  • “If you’re in your 20s, you’re going to be fine. It’s not true. Every girl...needs to be screened for endometriosis [and] PCOS, and they need to know their egg count.” (07:45)
• Egg Count (AMH): Test AMH even in teens with severe pain or other symptoms. Early intervention prevents infertility and egg depletion (04:00–08:16).

3. PCOS – Recognition, Diagnosis, and Management

• Prevalence & Underdiagnosis: At least 15% (often 20%+) of women have PCOS; Dr. Aliabadi estimates 90%+ undiagnosed (15:30).
• Symptoms can be subtle or variable (four phenotypes): irregular cycles, androgen excess (hair loss, acne, facial/body hair), PCOS morphology on ultrasound, mood disorders, disordered eating, and visceral fat increase—even in lean women (18:29–32:30).
• Diagnosis: Must meet 2 out of 3 (and now possibly 4) criteria (18:52–21:29).
  • High testosterone symptoms (not just lab values), ovulatory dysfunction, and "PCOS ovaries" on ultrasound or high AMH.
  • "You do not need to have a high testosterone in the blood to get the diagnosis of PCOS..." (18:54)
• Societal Impact: Women bounce around providers, told symptoms are ‘normal’ or ‘in their heads’ while their fertility is being compromised (09:02, 25:10, 60:24).
• Treatment Pillars:
  • Target insulin resistance: metformin, inositol, Vitamin D, GLP-1 agonists (Trulicity, Ozempic), lifestyle measures (65:53–73:29).
  • Manage chronic inflammation and genetics/epigenetics triggers.
  • Birth control (estrogen/progestin) can help with symptoms, but should not be the only intervention (63:15).
  • Supplements (Aliabadi’s “OVII”): inositol, Vitamin D, coQ10, mulberry leaf (67:18, 87:49).
  • Surgical diagnosis not required for PCOS.

4. Endometriosis – Recognition, Diagnosis, and Management

• Prevalence: True prevalence likely 20%+ among women (96:14, 127:36).
• Symptoms:
  • Painful periods that disrupt life (driving to ER, missing school/work), deep dyspareunia, chronic pelvic pain, bloating, GU/GI pain, recurrent "UTIs" with negative cultures, and more (100:18).
  • "[Painful periods] are not normal. If the pain disrupts your life...that’s not normal" (99:15, 100:18).
• Diagnosis: Clinical—based on listening and symptom history, not just imaging.
  • “[My] accuracy is 99.9% just by listening to the patient.” (97:13)
  • Laparoscopic surgery is “gold standard” if unclear (121:38–124:53).
• Impact: Nine to eleven years to diagnosis on average; often diagnosed after years of needless suffering (97:21, 104:26).
• Treatment: Hormonal suppression (progestin-only pills/IUD), GNRH antagonists, laparoscopy for excision/resection; surgery must be precise, by skilled surgeons (137:03–143:46).

5. Fertility, Egg Freezing, and Age

• Egg quality rapidly declines after 28–30, especially with undiagnosed PCOS or endometriosis.
  • “For my PCOS patients, generally speaking, we...freeze 20 eggs...as you get older...might want 40 eggs.” (88:15)
• Egg freezing should be offered younger and to those with symptoms—even as young as teens in some endo cases (07:45, 88:23).
• IVF Misconceptions: High follicle number does not equal healthy eggs; misdiagnosed PCOS often skews egg count/IVF expectations (54:22–55:21).

6. The Healthcare System Fails

• Pelvic ultrasound is NOT routine: Many OB/GYNs don’t perform pelvic ultrasounds or lack training (25:10–25:25).
  • “How can I diagnose you? Pelvic ultrasound should be mandatory...” (25:30)
• Short appointments: 10 minutes per patient means detailed, holistic care is nearly impossible (85:40).
• Advocacy: Patients must be assertive—ask for AMH, ultrasound, hormone panels, autoimmune panels if relevant (119:15, 152:20).
• Geographic Inequality: 50% of US counties lack an OB/GYN (58:41).

7. Autonomy, Tools, and Patient Empowerment

• Self-diagnosis tools:
  • Dr. Aliabadi’s OVII platform for PCOS and other calculators for breast cancer risk (67:18 / 158:25).
• Action steps:
  • Track symptoms
  • Ask for relevant labs (AMH, hormones, autoimmune panel) and imaging
  • Insist on proper evaluation
  • Freeze eggs early if possible (88:23)
  • Calculate breast cancer lifetime risk and act accordingly (158:08–168:25)

8. Notable Quotes & Memorable Moments

Dismissal & Dismissed Patients

• “Women’s health is a different monster...That cataract patient that goes to 20 ophthalmologists and she keeps saying ‘I can’t see,’ and the ophthalmologist says ‘You’re crazy, there’s nothing wrong with you.’” – Dr. Aliabadi (60:24)
• “If every 20-year-old in this country would go through my office once...I would shut down these fertility clinics...” (07:45)

Patient Advocacy

• “If you’re being dismissed, you need to listen to podcasts like yourself...they don’t need to come to my office to see me. I’m telling them what to do. But you have to teach them to become their own health advocate.” (91:09)

Medical System Critique

• “Do you know that in Los Angeles there’s maybe two of us that can do a laparoscopic hysterectomy...that should be standard of care.” (133:16)
• “You need to separate OB from Gyn...Empower gynecologists to spend more time with their patients...” (132:12)

Breast Cancer & Proactive Testing

• “If you know your first name, your last name and your date of birth, you need to know your lifetime risk of breast cancer. It’s mandatory.” (158:25)

On Empathy and Mission

• “I feel like over the past 25 years, their trauma has become my trauma. I literally can cry right now.” (51:30)
• “This world will be a better place if we take care of our women.” (184:51)

Notable Timestamps for Key Segments

• Dismissal in Women’s Health: 00:12–04:00, 60:05–61:04
• Fertility trajectory, importance of egg count & AMH: 04:00–08:16
• PCOS diagnosis, phenotypes, symptoms: 15:30–32:30
• PCOS treatment pillars: 65:53–73:29, 75:08–77:32
• Endometriosis clinical criteria & diagnosis: 96:14–100:18
• Endometriosis surgical treatment: 121:38–124:53, 137:03–143:46
• Egg freezing, age, and quality: 84:57–89:08
• Advocacy and self-testing: 119:15–122:10, 152:20
• Healthcare system critique (ultrasound, access, provider shortage): 25:10–26:13, 58:41, 117:09–119:15
• Breast cancer risk calculation and management: 158:08–168:25
• Actionable summary/reminders: 92:39–94:56
• Empathy and societal change for women’s health: 91:09, 130:57–132:13, 184:30–184:51

Actionable Advice & Resources

• Know and advocate for your symptoms: Painful periods, pelvic pain, acne, hair loss, irregular cycles, mood fluctuations, and fertility struggles deserve proper investigation—NOT dismissal.
• Request/insist on:
  • Blood panel (AMH, hormones, autoimmune markers)
  • Pelvic ultrasound
  • Breast cancer risk calculation (Tyrer-Cuzick, available online)
  • Early egg freezing for those interested in future fertility (esp. if symptomatic)
• PCOS support: Consider supplement-based approaches (inositol, coQ10, Vitamin D, mulberry leaf), especially when access to clinicians is limited (67:18, 87:49).
• Use online self-assessment tools:
  • OVII: ovii.com — for PCOS/endometriosis risk
  • Breast cancer risk calculator (Tyrer-Cuzick) — for lifetime risk assessment
• Refer to reputable medical podcasts like this and “SheMD” (Dr. Aliabadi’s own)

Tone & Closing Message

Dr. Aliabadi balances passionate advocacy with matter-of-fact, sometimes blunt (but always caring) delivery. The episode closes with a reaffirmation that women are not crazy, they deserve to be heard, and every family—across generations and regardless of whether they want children—ought to pay attention to women’s hormone health. Dr. Huberman lauds Dr. Aliabadi for her clarity, depth, and impact, urging listeners to share these actionable insights as the foundation of meaningful change.

For further resources, self-assessment tools, and in-depth information, visit:

• ovii.com
• SheMD Podcast
• Tyrer-Cuzick Calculator
• Huberman Lab Newsletter, show notes, and episode links

Summary compiled by AI based on the November 24, 2025 episode of Huberman Lab with Dr. Thaïs Aliabadi.