The guest
Dr. Thaïs Aliabadi: A Los Angeles obstetrician, gynecologist, and laparoscopic surgeon with 30 years in women's health, host of the She MD podcast, and creator of the OVII self-assessment tools for PCOS and endometriosis.
What this episode covers
Andrew Huberman talks with OB/GYN Dr. Thaïs Aliabadi about why female reproductive conditions go unrecognized for years. They cover PCOS in depth, including its four phenotypes, the role of insulin resistance, inflammation, and the brain-pituitary-ovary axis, and a stepwise treatment plan from lifestyle and supplements to metformin and GLP-1s. They then turn to endometriosis, its self-diagnosis through symptoms, hormonal suppression, and laparoscopic surgery. The conversation closes with fibroids, fertility 'buckets,' perimenopause, and breast-cancer risk, where Aliabadi shares how calculating her own lifetime risk led to a double mastectomy that uncovered an undetected cancer.
The guest's own work
BookBy the guestISBN verified
Protocols: An Operating Manual for the Human Body
Andrew Huberman
“I have a new book coming out. It's my very first book. It's entitled Protocols: An Operating Manual for the Human Body.”— Andrew Huberman
ProductBy the guest
OVII (Ovii hormone/PCOS quiz platform)
Dr. Thaïs Aliabadi
“I actually developed a calculator it's called it's a platform called OV women can go on it... it's my algorithm that I've developed over the past 25 years”— Dr. Thaïs Aliabadi
ProductBy the guest
OVII PCOS Supplement
Dr. Thaïs Aliabadi
“the OV supplement I created, I literally did it here. Diagnose yourself and if you're being dismissed, start with the supplement.”— Dr. Thaïs Aliabadi
Also referenced (named, not recommended)
ProductReferenced
Metformin
(generic, inferred)
“that's why a lot of PCOS patients get prescribed metformin... Metformin basically makes us more insulin sensitive.”— Dr. Thaïs Aliabadi
ProductReferenced
Berberine
(supplement, inferred)
“an over-the-counter version called bourberine which I believe comes from a tree bark um which is supposed to be a pretty potent glucose scavenger”— Andrew Huberman
ProductReferenced
Inositol
(supplement, inferred)
“I like to start them on supplements that has inactol in it and sub vitamin D... different forms of anacettol that work um to uh to increase sensitivity to insulin”— Dr. Thaïs Aliabadi
ProductReferenced
Trulicity (dulaglutide)
Eli Lilly
“in 2014 back then I had trulicity as GLP1 and that's what I used to use for my PCOS patients and they would lose 50 60 80 100 pounds”— Dr. Thaïs Aliabadi
ProductReferenced
Ozempic (semaglutide)
Novo Nordisk
“The first thing I asked is can he tolerate micro doing of ompic because it shuts down their cravings”— Dr. Thaïs Aliabadi
ProductReferenced
Letrozole
(generic, inferred)
“One is a medication called let and the other one is Clomid. Both of those basically um regulate that hypothalamus pituitary ovarian axis”— Dr. Thaïs Aliabadi
ProductReferenced
Clomid (clomiphene)
(generic, inferred)
“the other one is Clomid. Both of those basically um regulate that hypothalamus pituitary ovarian axis and pushes these patients to ovulate.”— Dr. Thaïs Aliabadi
ProductReferenced
Slynd (drospirenone progestin-only pill)
Exeltis
“there's a progesterone only birth control pill now called slend that helps with um it's very anti-androgenic that I try for PCOS patients”— Dr. Thaïs Aliabadi
ProductReferenced
Mirena IUD (levonorgestrel)
Bayer
“a proesterine IUD like Kylina or Merina IUD. Morina IUD is the most common progesterone IUD used in this country.”— Dr. Thaïs Aliabadi
ProductReferenced
Kyleena IUD (levonorgestrel)
Bayer
“for young girls who haven't had children I tend to go with the smaller IUD... I love the Kylina IUD and I'm not advertising for it I'm just saying it because it really works”— Dr. Thaïs Aliabadi
ProductReferenced
Orilissa (elagolix)
AbbVie
“we have u G&R antagonist. I don't know if you've heard of these pills or Alyssa or my famry.”— Dr. Thaïs Aliabadi
ProductReferenced
Myfembree (relugolix combination)
Myovant/Pfizer
“we have u G&R antagonist. I don't know if you've heard of these pills or Alyssa or my famry.”— Dr. Thaïs Aliabadi
ProductReferenced
Accutane (isotretinoin)
(generic, inferred)
“she has acne, she's on spirolactone, she takes Accutane, these are criteria. She meets the criteria of PCOS.”— Dr. Thaïs Aliabadi
ProductReferenced
Spironolactone
(generic, inferred)
“if you're twer than 25 and you're struggling with acne and you come to my office and you're asking for sperolactone and Accutane, something's not right.”— Dr. Thaïs Aliabadi
ProductReferenced
Tamoxifen
(generic, inferred)
“asking their doctor for a medication called temoxifen... that reduces the risk of breast cancer by 50% in the next 10 years”— Dr. Thaïs Aliabadi
ProductReferenced
Lovenox (enoxaparin)
Sanofi
“you can give them blood thinners like Lovenox in pregnancy and it'll help uh bring that flow.”— Dr. Thaïs Aliabadi
ProductReferenced
Prozac (fluoxetine)
(generic, inferred)
“you can prescribe 20 milligrams of Prozac 10 to 14 days before their period.”— Dr. Thaïs Aliabadi
ProductReferenced
Zoloft (sertraline)
(generic, inferred)
“You can also treat them with 25 milligrams of Zoloft. For some reason, their brain responds really well to this pulsatile treatment”— Dr. Thaïs Aliabadi
ProductReferenced
Yaz (drospirenone/ethinyl estradiol)
Bayer
“there's one form of birth control. Yas, I don't usually go to it. It helps with the symptoms of PMDD”— Dr. Thaïs Aliabadi
ProductReferenced
Minoxidil (oral / Rogaine)
(generic / Rogaine, inferred)
“I usually treat these patients with minoxidil. You can either do like ro gain on your scalp or you can take oral minoxidil.”— Dr. Thaïs Aliabadi
ProductReferenced
Coenzyme Q10 (CoQ10)
(supplement, inferred)
“I've seen a few papers um that suggest that co-enzyme Q10 and Lcarnitine might be beneficial for egg quality.”— Andrew Huberman
ProductReferenced
L-carnitine
(supplement, inferred)
“co-enzyme Q10 and Lcarnitine might be beneficial for egg quality.”— Andrew Huberman
ProductReferenced
Vitamin D
(supplement, inferred)
“Did you know that low vitamin D makes you insulin resistant?”— Dr. Thaïs Aliabadi
ProductReferenced
Curcumin
(supplement, inferred)
“like you mentioned vitamin D uh curcumin uh chromium uh um anacettol there's so many things we can do to increase that insulin sensitivity”— Dr. Thaïs Aliabadi
ProductReferenced
Chromium
(supplement, inferred)
“vitamin D uh curcumin uh chromium uh um anacettol there's so many things we can do to increase that insulin sensitivity”— Dr. Thaïs Aliabadi
ProductReferenced
Myriad Genetics cancer testing
Myriad Genetics
“The company I use in my office, I've used for I don't know over 10 years, is Marriott... Marriott only checks 63 genes which is fine.”— Dr. Thaïs Aliabadi
Big reveals from this episode
- Claims that if every 20-year-old passed through her office once, she could shut down the fertility clinics.
- Says she started using GLP-1s (Trulicity) on PCOS patients back in 2014, years before they were mainstream.
- States her clinic average is 24 pounds of weight loss in four months on properly dosed GLP-1s.
- Offers an unpublished hypothesis that over 50% of her PCOS patients also have endometriosis.
- Claims maybe two surgeons in Los Angeles can remove a watermelon-sized uterus laparoscopically, and she may be the only one doing it outpatient.
- Reveals she had a double mastectomy at 48 despite no family history; pathology then found cancer in the opposite breast they hadn't been investigating.
- Says in 25 years of practice she has never lost a patient under her care to cancer.
- Argues the 'mammograms start at 40' message is misleading and dangerous for higher-risk women.
Worth remembering
- PCOS affects about 15% of US women (over 20% in some Middle Eastern countries) yet she estimates over 90% go undiagnosed.
- 'Polycystic ovary syndrome' does not mean cysts; it's a 'string of pearls' follicle pattern on ultrasound, and the name itself drives misdiagnosis.
- 70-80% of PCOS patients do not ovulate, even some with seemingly regular cycles.
- A rough rule: every 0.1 of AMH equals about one follicle, so AMH of 1.0 means roughly 10 follicles.
- Wild mulberry leaf taken before a heavy meal can reportedly block carbohydrate absorption by about 40%.
- In the US it takes 9-11 years and seeing 5-10 doctors on average to get an endometriosis diagnosis.
- About 50% of US counties have no OB/GYN, forcing some women to drive 2-4 hours for care.
- The average American woman has roughly a 12.5% lifetime risk of breast cancer; 20%+ qualifies for earlier imaging at 30.
- About 85% of women who get breast cancer have no family history and fewer than 5% carry a genetic mutation.
- PMDD is the brain's extreme reaction to normal hormone shifts, and suicide risk spikes in the premenstrual window.
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