On Purpose with Jay Shetty
On Purpose with Jay Shetty

WORLD’S TOP OBGYN Dr. Aliabadi: The #1 Hormone Problem Affecting Millions of Women (And The 4 Changes That Can Reverse It)

March 11, 2026

AI Summary

5 min read

The Hidden Hormone Crisis Affecting Millions of Women

Dr. Aliabadi opens with a startling statistic: 75% of women with PCOS and over 90% of women with endometriosis are never diagnosed. These two conditions together are the leading cause of infertility on the planet, yet most women suffering from them are told their symptoms are normal, that they're eating too much, or that it's all in their head. The real problem, she argues, is not that these conditions are rare or untreatable—it's that the healthcare system systematically dismisses women's pain and fails to look for the underlying causes.

PCOS: The Four Pillars of a Misunderstood Condition

Polycystic Ovary Syndrome affects 15% of women in the U.S. and over 20% in countries like India, yet 75% of cases go undiagnosed. Dr. Aliabadi explains that PCOS is not about cysts on the ovaries—the name refers to a cluster of follicles visible on ultrasound. Diagnosis requires meeting two of three criteria: irregular periods (fewer than eight per year or cycles longer than 35 days), PCOS-looking ovaries on ultrasound (enlarged ovaries with at least twenty follicles), and elevated testosterone or androgen symptoms like facial hair, acne, or male-pattern hair thinning.

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What you'll learn

  • 1 (02:18) **Why Dr. A is on a Mission** - She explains that millions of women cannot reach a calm mental state because of undiagnosed conditions like PCOS and endometriosis, not because they aren't trying hard enough.
  • 2 (05:57) **The Fertility Crisis & Defining PCOS** - Dr. A states we are in a fertility crisis, with PCOS and endometriosis as the leading causes of infertility, yet 75% of PCOS and 90% of endometriosis cases go undiagnosed.
  • 3 (10:12) **Why PCOS is Missed** - Explains why PCOS is so frequently undiagnosed: doctors lack knowledge, and the condition presents in different morphologies (lean vs. overweight, different symptom combinations).
  • 4 (12:08) **Pillar 1: Insulin Resistance (The First Domino)** - Dr. A explains that insulin resistance is the root cause of the PCOS storm, driving fat storage, inflammation, and androgen production.
  • 5 (17:15) **Pillar 2: The Hormone Vicious Cycle** - Describes how high insulin stimulates the ovaries to produce androgens, which then disrupts the brain's GnRH/LH/FSH cycle, blocking ovulation and creating a self-reinforcing loop.
  • 6 (18:33) **Pillar 3: Chronic Inflammation** - Explains that PCOS patients have high inflammation from visceral fat, high cortisol, frozen follicles, sleep disturbances, and gut dysbiosis, which worsens insulin resistance and androgen production.
  • 7 (20:48) **Pillar 4: The Neurologic & Mental Health Impact** - Details how unstable estrogen, low progesterone, and high androgens disrupt the brain's limbic system, causing anxiety, depression, brain fog, and food cravings.

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Show Notes

For many women, the real challenge isn’t just unexplained health problems, it’s being heard when they seek help.

Jay sits down with Dr. Thaïs Aliabadi, or "Dr. A", to unpack a silent crisis affecting millions of women around the world: undiagnosed PCOS and endometriosis. This isn’t just a discussion about fertility, but a masterclass on hormones, inflammation, mental health, and the painful reality of medical gaslighting. PCOS, a condition shaped by insulin resistance, hormonal imbalance, chronic inflammation, and neurological disruption, is often overlooked, leaving women struggling with anxiety, depression, weight gain, irregular periods, and infertility without answers. Dr. A shares how insulin resistance acts as the “first domino,” triggering a domino effect that impacts everything from ovulation to mood, and emphasizes that true healing requires addressing all four pillars, not just masking symptoms with birth control.

Dr. A challenges the outdated belief that painful periods are “normal,” explaining that severe pain, painful sex, chronic bloating, bladder symptoms, and bowel discomfort are signs something deeper may be wrong. She reveals that diagnosis takes an average of 9–11 years, and that many women are told their pain is psychological before they’re ever taken seriously.

Through both science and lived clinical experience, she makes it clear: when inflammation and hormones are out of balance, mental health suffers too. Anxiety, depression, brain fog, and eating disorders are not personal failings, they are often physiological signals that something deeper is happening in the body.

In this interview, you'll learn:

How to Recognize the Signs of PCOS Early

How to Reduce Insulin Resistance Naturally

How to Tell if Your Period Pain Is “Normal”

How to Protect Your Fertility in Your 20s and 30s

How to Balance Hormones Beyond Birth Control

How to Spot Hidden Symptoms of Endometriosis

How to Lower Inflammation Through Lifestyle Changes

If there’s one thing to take away from this conversation, it’s this: your body is not working against you, it’s communicating with you. Pain is not weakness. It is a signal and you deserve to have those signals taken seriously.

To learn more about Dr. A’s advocacy on women’s health, check out: https://www.shemdpodcast.com/ 

With Love and Gratitude,

Jay Shetty

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