Huberman Lab

Podcast with Dr. Tais Aliabadi on Women’s Health: PCOS, Endometriosis, and Fertility

Dr. Tais Aliabadi reveals why PCOS and endometriosis remain largely undiagnosed despite being leading causes of infertility, and shares actionable steps for diagnosis, treatment, and fertility preservation.

Dr. Tais Aliabadi, an obstetrician, gynecologist, and surgeon, brings over 30 years of experience to a critical discussion on women’s reproductive health. She exposes the widespread dismissal of symptoms like painful periods, irregular cycles, and mood disorders that often signal polycystic ovary syndrome (PCOS) or endometriosis. Both conditions severely impact fertility but remain undiagnosed in up to 90% of cases.

PCOS: A Complex and Common Hormonal Disorder

PCOS affects about 15% of women in the U.S., with even higher rates in some regions. Diagnosis requires two of three criteria: symptoms of high androgens (acne, hair thinning, excess body hair), ovulation dysfunction (irregular or infrequent periods), and characteristic ovarian ultrasound findings or elevated AMH levels. Dr. Aliabadi stresses that many doctors misunderstand or overlook these signs, often dismissing patients’ concerns. Insulin resistance plays a central role in PCOS, fueling androgen production and worsening symptoms. Treatment extends beyond birth control pills to include insulin-sensitizing agents like metformin, supplements such as inositol and vitamin D, lifestyle changes, and newer medications like GLP-1 receptor agonists.

Endometriosis: The Silent Epidemic of Chronic Pain and Infertility

Endometriosis occurs when uterine-like tissue grows outside the uterus, causing internal bleeding, inflammation, and scarring. It affects an estimated 20% or more of women but takes an average of 9 to 11 years to diagnose. Symptoms include debilitating menstrual pain, painful intercourse, bloating, and recurrent urinary or bowel issues. Diagnosis relies heavily on patient history and pelvic ultrasound, though laparoscopy remains the gold standard. Treatment involves hormonal suppression, pain management, and surgical excision of lesions. Dr. Aliabadi highlights the urgent need for better awareness and earlier intervention to preserve fertility and quality of life.

Fertility Preservation and the Importance of Early Screening

Women are born with a finite number of eggs, which decline in quantity and quality with age. Both PCOS and endometriosis accelerate this decline. Dr. Aliabadi urges young women, even teenagers with severe symptoms, to get their egg count measured via AMH testing and consider egg freezing early. She warns that high AMH levels in PCOS do not indicate good egg quality. Early diagnosis and treatment can prevent costly and emotionally taxing fertility treatments later in life.

Breast Cancer Risk: Know Your Numbers and Act Early

Dr. Aliabadi emphasizes the importance of calculating lifetime breast cancer risk using tools like the Tyrer-Cuzick model. Women with a risk above 20% should begin breast imaging as early as age 30, including mammograms, ultrasounds, and MRIs. Genetic testing is recommended for those with family histories of breast or related cancers. She shares her personal story of detecting breast cancer early through vigilant screening, underscoring the life-saving potential of proactive health advocacy.

Empowering Women to Advocate for Their Health

Throughout the conversation, Dr. Aliabadi stresses that women know their bodies best and must be their own health advocates. She calls for systemic changes in healthcare, including separating obstetrics from gynecology to allow more focused care on chronic reproductive conditions. She encourages women to demand thorough exams, including pelvic ultrasounds and hormone testing, and to seek second opinions when dismissed. Her free online tools and supplements offer accessible starting points for those facing barriers to care.

This discussion sheds light on the urgent need to recognize and treat women’s reproductive health issues with the seriousness they deserve, offering hope through knowledge, early intervention, and comprehensive care.