Podcast Summary: On Purpose with Jay Shetty

Episode Title: WORLD’S TOP OBGYN Dr. Aliabadi: The #1 Hormone Problem Affecting Millions of Women (And The 4 Changes That Can Reverse It)
Air Date: March 11, 2026
Host: Jay Shetty
Guest: Dr. Thais Aliabadi (referred to as Dr. A)

Episode Overview

This episode features an in-depth and urgent conversation between Jay Shetty and Dr. Thais Aliabadi—one of the world’s top OB/GYNs—shining a spotlight on the fertility crisis and the two most underdiagnosed conditions in women’s health: PCOS (Polycystic Ovary Syndrome) and endometriosis. Dr. Aliabadi passionately unpacks why millions of women go undiagnosed, debunks harmful myths, and lays out actionable steps for women to advocate for their own health. The episode is both a masterclass and a rallying cry for change in the often dismissive field of women’s health.

1. The Fertility Crisis, Underdiagnosis, and Gaslighting

• Key Statistics:

  • PCOS: Affects 15% (up to 20% in countries like India); 75% undiagnosed.
  • Endometriosis: Affects 10–20%; over 90% undiagnosed.
  • Together, they are the leading cause of infertility on the planet.
    (02:11–02:39)

• Quote:

  “Let me tell women what they deserve to know. If you take PCOS, 75% of these women are not diagnosed. If you take endometriosis, over 90% of these women are not diagnosed.”
  —Dr. Aliabadi (02:11)

• Gaslighting in Health Care: Dr. A describes the routine dismissal of women’s pain and symptoms starting often in adolescence.
  (03:21–05:36)

• Quote:

  "I've reached a point in my life that I said enough, enough is enough, enough dismissing women, enough normalizing their pain, ... telling them it’s in their head, they’re crazy, they’re anxious—it’s none of that."
  —Dr. Aliabadi (03:21)

2. Deep Dive: PCOS (Polycystic Ovary Syndrome)

What Is PCOS?

• Definition: Chronic hormonal, metabolic, inflammatory, and neurological condition.

• Diagnosis Criteria (Need 2 of 3):

  1. Ovarian/ovulation dysfunction (irregular periods)
  2. Polycystic ovaries on ultrasound or high AMH
  3. Elevated androgens (testosterone), or symptoms: facial/body hair, acne, hair loss
     (06:36–09:50)

• Symptoms Often Dismissed: Mood disorders, weight gain, eating disorders, infertility, anxiety.

• Self-Advocacy: Dr. A encourages women to self-diagnose using these criteria before seeing a doctor.

• Quote:

  “You don’t need a doctor to really diagnose you. If you listen to this podcast from home, you can self-diagnose. I’m giving you the tools."
  —Dr. Aliabadi (10:13)

Why Is PCOS Undiagnosed?

• Highly variable presentation (lean, overweight, various symptoms/combinations)
• Many physicians are unfamiliar with diagnostic nuances
  (10:13–12:00)

3. The Four Pillars of PCOS (and How to Heal)

(12:00–34:18)

First Pillar: Insulin Resistance

• The Domino Effect: Central driver of PCOS symptoms.
• Explanation: Insulin resistance leads to increased androgens, irregular cycles, fertility problems.
• Practical Solutions:
  • Low carbohydrate diet
  • 10–20 min walk after meals (wakes up insulin receptors) (18:44)
  • Exercise (cardio 4+ times/week)
  • Supplements (Dr. A mentions her “OV” supplement with wild mulberry leaf, among others)
  • Prescription: Metformin (minimum dose 1500mg), GLP-1 receptor agonists (Ozempic, Wegovy, Mounjaro)—mainly for patients with significant insulin resistance/weight concerns (20:15–23:11)
• Quote:

  “Eat less carbohydrates, walk 10-20 minutes after each meal. Exercise makes a huge difference.”
  —Dr. Aliabadi (18:44)

Second Pillar: The Hormonal Pillar

• Insulin resistance leads to overproduction of androgens—creates a vicious feedback loop
• Birth control pills can regulate cycles but don’t solve the root metabolic/inflammatory causes
  (25:10–27:41)

Third Pillar: Chronic Inflammation

• PCOS patients typically have chronic inflammation (due to visceral fat, stress, sleep disturbances, gut health, etc.)
• Lifestyle Change Needed:
  • Anti-inflammatory diet
  • Stress reduction
  • Good sleep
    Memorable Quote:

  "Your genetics load the gun, but your lifestyle pulls the trigger. And that's exactly what happens with PCOS."
  —Dr. Aliabadi (27:43)

Fourth Pillar: Neurological Impact

• Hormonal imbalances (unstable estrogen/progesterone, high androgens, inflammation) devastate mental health—causing anxiety, depression, brain fog, food cravings
• Quote:

  “These poor patients...Their body is on fire, their brain is on fire, their hormones are raging...someone needs to go to their rescue.”
  —Dr. Aliabadi (32:24)

4. Endometriosis: The Invisible Epidemic

What Is Endometriosis?

• Definition: Chronic, inflammatory, neuroimmune condition affecting 10–20% of women
• Classic Symptom: Painful periods are not normal—any period pain that disrupts life (vomiting, ER visits, missed school/work) is NOT normal
• Quote:

  “If I could print a T-shirt that said painful periods are not normal, I would do it.”
  —Dr. Aliabadi (38:03)

Symptoms & Clinical Clues:

• Painful periods, painful sex, bladder symptoms, bowel pain, chronic pelvic pain, chronic bloating—all suggest endometriosis until proven otherwise
• The Validation Gap:

  “Every single patient … the first thing they do, they cry and say, ‘I feel validated.’”
  —Dr. Aliabadi (44:14)

Diagnosis & Treatment:

• Diagnosis can be clinical—surgery is not required to diagnose!
• First-line Treatment: Hormonal therapies (progesterone pills, IUDs)
• If Hormonal Suppression Fails: Surgery by a true specialist, then immediate suppression afterward to prevent recurrence
• AMH Test: Checks ovarian reserve; recommended for teens with severe pain and all patients with endo (egg freezing if low reserve)
• Quote:

  “The most devastating part for endometriosis is fertility, because endometriosis ... destroys the egg count and quality.”
  —Dr. Aliabadi (52:41)

5. The Cost of Dismissal & Systemic Failures

• Endometriosis and PCOS routinely lead to missed or delayed diagnosis; patients often see 10+ doctors before answers (50:55)
• Average endo diagnosis: 9–11 years, often after egg reserve is lost
• The consequences: infertility, chronic pain, debilitating mental health issues, and years of unnecessary suffering (52:32–56:29)
• Personal Story: Dr. A shares her own trauma as a practitioner and advocate, absorbing her patients’ pain (79:59–83:40)

6. Advocacy, Tools & Steps to Self-Empowerment

• Dr. Aliabadi’s Free Tool: PCOS calculator at ovii.com
  (34:32)
• Become your own advocate: Print symptoms and solutions, take them to your doctor
• Quote:

  “Until we have a better healthcare system and we educate our doctors not to dismiss women, this is what we have for now: making women become their own health advocate.”
  —Dr. Aliabadi (36:20)

7. Fertility Checklist & Proactive Health Steps

(67:59–74:21)

• Anyone trying to conceive should:

  • Get a thorough history and screen for PCOS/endo
  • Pelvic ultrasound (check ovaries, uterus anatomy)
  • Labwork: Thyroid, prolactin, testosterone, DHEAS, AMH
  • Male partner: Semen analysis
  • HSG (to check for tubal patency)
  • Rule out/Manage underlying inflammation, autoimmune conditions
  • Start prenatals 3 months pre-conception
  • Minimize stress

• If not conceiving after a year (<35yrs) or 6 months (>35yrs): Repeat full evaluation (hormonal, anatomical, immunological, male factor)

8. Notable Quotes & Memorable Moments

• On self-advocacy:

  "You have to be your own health advocate in this specific bucket because it will get dismissed."
  —Dr. Aliabadi (74:10)

• On systemic failings:

  “If you send every 20-year-old to my office once ... I would shut down a lot of these fertility centers because I would not dismiss a woman with endometriosis. … This is my broken heart. This is my trauma.”
  —Dr. Aliabadi (80:02–81:00)

• On gaslighting:

  “Talk about gaslighting. ... Put yourself in that girl's shoes.”
  —Dr. Aliabadi (52:19)

• On hope:

  "I want to scream. ... Give me that mic for 20 minutes only. Let me tell women what they deserve to know."
  —Dr. Aliabadi (83:43)

[Timestamps: Key Segments]

• Fertility Crisis & Dismissal: 02:11–05:36
• PCOS Definition & Diagnosis: 06:36–12:00
• The Four Pillars of PCOS: 12:00–34:18
• Free PCOS Calculator: 34:32
• Endometriosis Deep-Dive: 37:56–52:32
• Birth Control, Fertility, and Ovarian Reserve: 56:15–59:20
• Gut Health, Inflammation, and Systemic Approach: 61:04–67:39
• Checklist for Women Trying to Conceive: 67:59–74:21
• Advocacy and Call for Change: 79:59–84:40

Conclusion: The Call to Action

Dr. Aliabadi ends with a resounding call for awareness, advocacy, and radically improved care for women. She encourages women to become their own advocates, get informed, push for comprehensive evaluation, and—above all—not accept dismissal or minimization of their symptoms.

Jay Shetty closes:

"Women's health has been ignored for a long time. It is at the core of how we exist as humans. So for us to not understand it—there is no excuse for it."
(85:55)

Recommended Next Steps for Listeners:

• Visit ovii.com for the PCOS calculator
• Share this episode with anyone experiencing unexplained symptoms or fertility issues
• Listen to Dr. Aliabadi’s GMD podcast for more deep dives on women’s health advocacy