Summary
Overview
Dr. Taiz Aliabadi, a leading OBGYN and surgeon, discusses the widespread misdiagnosis of PCOS and endometriosis—the two leading causes of infertility affecting potentially 20%+ of women. She reveals why 90% of PCOS cases and most endometriosis cases go undiagnosed, explains how to recognize symptoms, and provides actionable protocols including supplements, lifestyle changes, and when to seek treatment. The conversation also covers fertility preservation, breast cancer screening, and why women's symptoms are routinely dismissed in healthcare.
The Crisis of Misdiagnosis in Women's Health
Dr. Aliabadi opens with a powerful analogy: while every ophthalmologist recognizes cataracts, 90% of women with PCOS—the leading cause of infertility—remain undiagnosed. She explains how women's symptoms are consistently dismissed, minimized, or normalized, leading to devastating consequences for fertility and overall health. The discussion establishes that PCOS and endometriosis are not rare conditions but extremely common, affecting millions of women who suffer in silence.
- PCOS is the leading cause of infertility, yet 90% of women are never diagnosed despite it being extremely common
- Women's symptoms are routinely dismissed, minimized, or normalized in healthcare, leading to years of suffering
- If every 20-year-old was properly screened for PCOS and endometriosis, fertility clinics could largely be shut down
" Why is it that the leading cause of infertility on this planet, 90% of women are not diagnosed? "
" Women's health is very different than other fields of medicine. It's a different monster. It's 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. "
Understanding PCOS: Beyond the Misconceptions
Dr. Aliabadi provides a comprehensive breakdown of PCOS (Polycystic Ovary Syndrome), explaining that despite its name, it's not actually about cysts. She details the diagnostic criteria, the four different phenotypes, and the underlying mechanisms involving the brain-pituitary-ovary axis, insulin resistance, and chronic inflammation. Crucially, she emphasizes that PCOS can affect lean women and that high egg count doesn't necessarily mean good quality eggs.
- PCOS affects 15% of women in the US (over 20% in Middle Eastern countries), making it the most common hormone disorder in reproductive-age women
- You need to meet only 2 of 3 criteria for diagnosis: symptoms of high testosterone, irregular periods, or PCOS-looking ovaries on ultrasound
- High AMH (egg count) in PCOS doesn't mean good quality eggs—these patients can have 30 eggs at age 40 but can't make a single viable embryo
- 75% of PCOS patients gain weight, but 25% are very lean—weight is not a diagnostic requirement
" PCOS is the most common hormone disorder in women in the reproductive age. The most common. So we're not talking about some rare diagnosis. It affects 15% of women in this country. "
" If you're sitting at home, if you have irregular period, if you have a daughter who gets laser of, you know, constantly is lasering her face, she has acne, she's on spironolactone, she takes Accutane, these are criteria. She meets the criteria of PCOS. "
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