Women’s Health Breakdown with Dr. Huberman & Dr. Aliabadi

Women’s health has long been under-researched, under-discussed, and misunderstood—even by medical professionals. That’s why the conversation between Dr. Andrew Huberman, Stanford neuroscientist and host of the Huberman Lab Podcast, and world-renowned OB/GYN Dr. Tais Aliabadi has struck such a massive chord. Their discussion pulls back the curtain on topics women have been dismissed for generations: PCOS, endometriosis, fertility decline, hormone testing, breast cancer risk, pregnancy, and menopause.

Why Women’s Pain Should Never Be Ignored

One of the most powerful messages from Dr. Aliabadi is that women’s pain is frequently minimized or dismissed not because it’s “normal,” but because healthcare systems are failing them. Symptoms like severe menstrual pain, bloating, acne, hair loss, mood changes, or irregular periods are often brushed off as “stress,” “normal PMS,” or “hormonal.”

Yet behind those symptoms lie the top two causes of infertility worldwide:

✔️ Polycystic Ovary Syndrome (PCOS)

✔️ Endometriosis

Both conditions are shockingly underdiagnosed. Dr. Aliabadi estimates that:

• 90% of women with PCOS are never diagnosed.
  
  

• From first symptoms to diagnosis, endometriosis takes 9–11 years.
  
  

• Over 50% of patients with PCOS also have endometriosis.
  
  

This isn't a small issue—it’s affecting millions of women worldwide.

PCOS: The Most Common Hormonal Disorder in Women

PCOS affects up to 20% of women, yet most never get a diagnosis because the symptoms can vary dramatically across four different phenotypes.

To meet the diagnostic criteria, women only need two of the following three:

1. Signs of high androgens

• Facial or body hair
  

• Acne
  

• Hair thinning
  

• Oily skin
  

2. Irregular periods

• Cycles longer than 35 days
  

• Fewer than 8 periods per year
  

• Difficulty predicting ovulation
  

3. PCOS-type ovaries or high AMH

• “String of pearls” follicles on ultrasound
  

• Elevated AMH (egg count), which can be misleading
  

Myth-busting insight:
➡️ You can have regular periods and still not be ovulating normally.
➡️ You can be thin and still have insulin-resistant PCOS.
➡️ You can have normal testosterone on labs and still qualify for diagnosis.

The True Drivers of PCOS

Dr. Aliabadi identifies five overlapping “pillars”:

• Brain–ovary signaling disruption
  

• Insulin resistance (even in lean women)
  

• Chronic inflammation
  

• Genetics
  

• Epigenetics (stress, sleep, diet, toxins)
  

These create a cycle of inflammation → insulin resistance → androgen elevation → ovulatory dysfunction → worsening symptoms.

When untreated, PCOS can impact:

• Fertility
  

• Egg quality
  

• Mood and mental health
  

• Weight regulation
  

• Long-term metabolic health
  

Endometriosis: The #1 Cause of Chronic Pelvic Pain

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus—on the ovaries, bladder, bowel, or pelvis. Each month, these tissues respond to hormones and bleed internally, causing inflammation, adhesions, nerve pain, and scarring.

Common Symptoms

• Debilitating period pain
  

• Painful sex (especially with deep penetration)
  

• Chronic bloating
  

• Painful bowel movements
  

• Recurring UTI symptoms with negative tests
  

• Difficulty getting pregnant
  

• Chronic pelvic pain
  

Because ultrasound and MRI often fail to detect endometriosis, many women are told everything is normal—even as the disease worsens.

Why Early Diagnosis Matters

Endometriosis can:

• Destroy egg quality
  

• Lower egg count dramatically
  

• Cause tubal scarring
  

• Increase miscarriage risk
  

• Increase risk of ectopic pregnancy
  

Dr. Aliabadi stresses that painful periods are NOT normal. Any menstrual pain that disrupts daily life is a red flag.

Hormone Testing: What Women MUST Know

Dr. Aliabadi and Dr. Huberman emphasize a test every woman should get:

AMH — Anti-Müllerian Hormone (Egg Count)

• High AMH = possible PCOS
  

• Low AMH = possible endometriosis or diminished ovarian reserve
  

• Normal AMH varies by age
  

• Every woman should know her AMH by age 20, according to Dr. Aliabadi
  

Other tests women should request:

• Estradiol
  

• Progesterone
  

• LH / FSH
  

• Testosterone & DHEA-S
  

• Thyroid panel
  

• Vitamin D
  

• Fasting insulin & A1C
  

These tests often reveal hormone dysfunction long before symptoms become severe.

Fertility: What Women Aren’t Being Told

Dr. Aliabadi explains that egg count and egg quality decline long before most women realize. PCOS can give a false sense of having “lots of eggs,” while endometriosis can destroy ovarian reserve shockingly early—even in teenagers.

Egg Freezing

• Best age window: 28–30 years old
  
  

• Earlier for women with endometriosis
  

• Can be life-changing for future family planning
  

Trying to Conceive with PCOS

Treat insulin resistance first:

• Inositol
  

• Metformin
  

• GLP-1 medications
  

• Vitamin D
  

• Anti-inflammatory nutrition
  

• Strength training + walking after meals
  

For ovulation:

• Letrozole (first line)
  

• Clomid
  

Breast Cancer Risk: What Women Should Know Now

Dr. Aliabadi discusses that many conditions she treats—PCOS, hormonal imbalances, chronic inflammation—overlap with known breast cancer risk factors. She stresses screening for:

• Family history
  

• BRCA mutations
  

• Early and consistent breast imaging
  

• Hormone patterns that may elevate risk
  

She also created zero-cost online tools to help women assess their personal breast cancer risk early.

Pregnancy: Why PCOS & Endometriosis Matter So Much

Both conditions can interfere with:

• Ovulation
  

• Egg quality
  

• Tube health
  

• Implantation
  

• Placental development
  

Women with these conditions are also more likely to:

• Need fertility support
  

• Experience miscarriage
  

• Experience complications during pregnancy
  

Early diagnosis = early intervention = better outcomes.

Perimenopause & Menopause: The Most Misunderstood Life Stage

According to Dr. Aliabadi:

• Perimenopause starts as early as age 35–40
  
  

• Symptoms last 7–10 years
  
  

• Most women never get diagnosed
  

• Hormone therapy can be transformative
  

Common symptoms include:

• Weight gain
  

• Mood changes
  

• Hot flashes
  

• Joint pain
  

• Hair thinning
  

• Loss of libido
  

• Sleep disruption
  

Dr. Aliabadi explains that perimenopause is highly treatable using targeted hormone therapy, often starting with micronized progesterone to improve sleep, mood, and anxiety, and adding estrogen for hot flashes, cognitive support, and overall hormonal balance after proper risk assessment. She also uses low-dose testosterone to support libido, energy, and mood. Her approach always includes full hormone testing and, when needed—especially for women with endometriosis—combining estrogen with progesterone to prevent symptoms from worsening. Overall, she stresses that women don’t have to suffer; with the right evaluation and hormone support, perimenopause can be managed effectively.

The Bottom Line: Your Pain Is Real. Your Symptoms Are Real. You Deserve Answers.

The message from Dr. Huberman and Dr. Aliabadi is as powerful as it is necessary:

✨ You are not crazy. You are not exaggerating. Your symptoms are real—and diagnojnsable.
 ✨ Painful periods are NOT normal.
 ✨ Irregular cycles are NOT normal.
 ✨ You deserve proper testing, real answers, and evidence-based support.

This conversation is a turning point for women everywhere, and the truth is finally loud enough to be heard.

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