Jay Shetty & Dr. Aliabadi ON How to Reverse Women's Hormonal Issues

Have you ever been told that your debilitating period pain is simply a normal part of being a woman, only to discover years later that your body was signaling a silent, systemic medical crisis?

In this On Purpose episode, Jay Shetty sat down with Dr. Thaïs Aliabadi, a world-renowned OB-GYN and a leading authority on fertility, Polycystic Ovary Syndrome (PCOS), and endometriosis. Aliabadi advocates for women's health and has dedicated her career to treating patients whose symptoms have been repeatedly dismissed or gaslit by the traditional medical establishment.

Painful Periods Aren’t Normal

Dr. Aliabadi shared with Jay Shetty that millions of women worldwide suffer from conditions that prevent them from achieving calm. She explained to Jay Shetty that, while society today highlights the benefits of meditation and mindfulness, women with undiagnosed conditions such as PCOS or endometriosis live in constant stress, because their hormones, inflammatory pathways, and nervous systems are in a state of chaos.

Modern society has normalized extreme suffering, such as the image of a young teenage girl curled up in agony on the bathroom floor during her period. According to Dr. Aliabadi, this narrative is dangerous because it leads to a significant diagnostic gap. She told Jay Shetty that up to 75% of women with PCOS and over 90% of women with endometriosis remain undiagnosed for years.^{1, 2}‍

Moreover, failing to catch the condition sooner is one of the primary drivers for the current fertility crisis, where 10% of couples struggle to conceive.³ Dr. Thaïs Aliabadi told Jay Shetty that, besides the male-factor issues, most of the unexplained infertility is rooted in these conditions that doctors don't investigate.

How to Identify PCOS

Dr. Aliabadi explained to Jay Shetty that PCOS is a chronic, hormonal, metabolic, inflammatory, and neurological condition. She believes the term Polycystic Ovary Syndrome is not entirely accurate because the condition is characterized by a specific group of follicles, rather than medical cysts.

Dr. Aliabadi explained that, if a woman meets two of the three specific PCOS criteria, she is very likely to receive a diagnosis:

1. Ovarian or ovulation dysfunction characterized by irregular periods (less than eight times a year);
2. A polycystic appearance on an ultrasound (enlarged ovaries with at least 20 follicles) or an elevated egg count;
3. Clinical signs of high testosterone, which can include facial hair, acne, and male-pattern hair-thinning.

Dr. Thaïs Aliabadi told Jay Shetty that many doctors still believe you must have all three signs to make a diagnosis, but she explained that two are already enough.

PCOS and Insulin Resistance

According to Dr. Aliabadi, insulin resistance can trigger PCOS.⁴ She explained to Jay Shetty that, when we eat carbohydrates, the body usually breaks them down into glucose, which triggers our pancreas to release insulin. Then, insulin supports the process of turning sugar into energy.

However, women with PCOS are often predisposed to insulin resistance, which means that sugar remains in the bloodstream and forces the pancreas to secrete more insulin, which is a fat-storage and highly inflammatory hormone. When insulin levels are high, the liver stores sugar as visceral fat, surrounding the internal organs rather than being deposited under the skin. This metabolic dysfunction explains why a large number of PCOS patients struggle with weight gain despite exercising.⁵‍

The PCOS Hormonal Cycle

In a healthy menstrual cycle, the hypothalamus – the brain's master regulator – releases GnRH (Gonadotropin-Releasing Hormone), which prompts the pituitary gland to release two hormones, FSH (Follicle-Stimulating Hormone) and LH (Luteinizing Hormone) in a timed sequence to stimulate follicle growth and trigger ovulation.

However, in women with PCOS, high insulin levels stimulate theca cells in the ovaries to secrete excess androgens. These high androgen levels trigger the brain to fire GnRH too quickly, freezing the follicles and preventing them from growing normally or releasing an egg, Dr. Aliabadi explained to Jay Shetty. This is the reason why many PCOS patients have irregular periods and do not always ovulate.

How PCOS Affects Mental Health

Moreover, healthy levels of estrogen and progesterone are supposed to have a calming effect on the brain, stimulating serotonin and binding to GABA (Gamma-Aminobutyric Acid) receptors, the brain's inhibitory neurotransmitter. PCOS, on the other hand, is marked by unstable estrogen, low progesterone, and high androgen, a chemical combination that leads to anxiety, irritability, and depression.

Dr. Thaïs Aliabadi explained to Jay Shetty that the brain's fear center, the amygdala, becomes hyperactive due to a hormonal imbalance. Additionally, fluctuations in dopamine lead to a lack of motivation, chronic fatigue, and brain fog. She expressed concern about unfairly labeling women affected by these conditions as crazy or having a personality disorder when, in reality, their brains respond to inflammation and hormonal imbalances.

Dr. Aliabadi also warns that PCOS can turn into a total-body health crisis. Symptoms associated with it, such as brain fog and cravings, can significantly impact a patient's mental and emotional well-being; they often push women towards unhealthy eating behaviors and can even lead to the onset of eating disorders.

Strategies for Metabolic Restoration

When it comes to treating PCOS, Dr. Thaïs Aliabadi told Jay Shetty that the primary concern is to make the body insulin-sensitive again. First and foremost, she recommends lifestyle changes, such as following a low-carb diet and taking a 10-20 minute walk after every meal, to wake up insulin receptors. It is also important, she emphasized, to add targeted supplements to your diet, such as her OV formulation, which contains wild mulberry, to block carbohydrate absorption.

Additionally, Dr. Aliabadi explained to Jay Shetty that prescription medication may also be necessary to address insulin resistance at the cellular level, starting at a lower dose and progressively increasing it. Sometimes, weight loss drugs such as Ozempic may be an option for PCOS patients who are obese or have high metabolic risks. She explained that they are tools to regulate insulin and restore fertility, yet they must be paired with supplements and lifestyle changes to prevent rebound after treatment is finished. However, it's necessary to consult with your healthcare provider before starting any treatment.

What Is Endometriosis?

Dr. Thaïs Aliabadi told Jay Shetty that endometriosis is a chronic inflammatory and neuro-immune condition in which tissue similar to the uterine lining grows outside of the organ. She explained that one leading theory for this is retrograde menstruation, where menstrual blood flows backward through the fallopian tubes and into the pelvis.⁶ In a healthy immune system, these cells are cleared away, but in patients with endometriosis, the immune system fails and helps the cells stick to the pelvic wall instead.

Dr. Alliabadi clarified to Jay Shetty that these implants respond to the monthly hormonal cycle and bleed into the pelvic cavity. This blood causes intense inflammation, scar tissue, and adhesions to blood vessels or grows its own nerve fibers. Dr. Aliabadi added that the nerve fibers can cause many various pains, such as bladder pain, painful bowel movements, and sciatic pain, depending on their location in the body.

It takes an average of nine to eleven years for a woman to be diagnosed with endometriosis⁷, and the chronic firing of nerve fibers eventually rewires the central nervous system, leading to increased pain, even from minor stimuli.⁸ Dr. Aliabadi told Jay Shetty that chronic pain fuels anxiety, depression, and PTSD, especially when doctors refuse to acknowledge the symptoms and dismiss them as the patient's imagination.

The Cost of Undiagnosed Endometriosis

When Dr. Aliabadi finally diagnoses a patient after years of dismissal, they usually cry with relief for finally being taken seriously. According to her, if a doctor listens to a patient with endometriosis for about 5 minutes, they can accurately diagnose it in about 90% of cases.

One of the most heartbreaking consequences of undiagnosed endometriosis is the dramatic reduction of the woman's eggs. She shared with Jay Shetty the case of a 14-year-old girl who had the egg count of a 40-year-old due to the condition's inflammatory disease. Therefore, she strongly recommends doing a baseline egg count check as early as 18 for any girl experiencing painful periods.

The goal of endometriosis treatment is to suppress its progression, Dr. Aliabadi explained to Jay Shetty. Before surgery, which is the last resort, she recommends using progesterone-only birth control or IUDs to freeze the pelvic area in a healthy state and prevent further damage from inflammation. She added that birth control doesn't directly lead to infertility; for an endometriosis patient, this may be the only way they can have children later in life. Without suppression, endometriosis can lead to a silent loss of eggs, potentially leaving women in their 30s with zero reserves because their symptoms were ignored for decades.⁹‍

From Mysterious Infertility to Diagnosis

If you are trying to conceive, Dr. Thaïs Aliabadi shared with Jay Shetty a checklist for every woman in her mid-30s, which includes:

• Checking hormones – thyroid panel, prolactin, testosterone, DHEAS;
• Testing the AHM (Anti-Müllerian Hormone) for egg reserve;
• Performing a pelvic ultrasound to identify possible fibroids, polyps, or cysts that can prevent pregnancy or cause miscarriage.

According to Dr. Aliabadi, there are six main causes of infertility:

1. Female factors (hormones)
2. Male factors (semen analysis)
3. Anatomy (fibroids, polyps, septa)
4. Endometriosis
5. PCOS
6. Autoimmune conditions

She told Jay Shetty that, by checking these six possibilities, we can move from the label of unexplained fertility to a real answer and diagnosis, and towards potential treatment.

Dr. Thaïs Aliabadi's mission remains to change the healthcare system so that no woman is left traumatized or dismissed by her healthcare providers. She told Jay Shetty that her SHE MD podcast and her free online tools aim to empower women to become their own health advocates and stand up for the care they deserve. She believes that women's health has been deprioritized for far too long, and it's time to change that.

More From Jay Shetty

Listen to the entire On Purpose with Jay Shetty podcast episode “WORLD’S TOP OBGYN Dr. Aliabadi: The #1 Hormone Problem Affecting Millions of Women (And The 4 Changes That Can Reverse It)” now in the iTunes store or on Spotify. For more inspirational stories and messages like this, check out Jay’s website at jayshetty.me.

Disclaimer: The practices described are based on personal experiences and preliminary research. They are not medical advice, nor are results guaranteed. Individual outcomes vary, and some claims are still being studied. Always consult a qualified healthcare professional before beginning any new health, wellness, or therapeutic practice.

¹World Health Organization, “Polycystic Ovary Syndrome,” updated January 21, 2026, https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome. 

²De Corte P, Klinghardt M, von Stockum S, Heinemann K. Time to Diagnose Endometriosis: Current Status, Challenges and Regional Characteristics-A Systematic Literature Review. BJOG. 2025 Jan;132(2):118-130. doi: 10.1111/1471-0528.17973. Epub 2024 Oct 7. Erratum in: BJOG. 2025 Jun;132(7):1018. doi: 10.1111/1471-0528.18149. PMID: 39373298; PMCID: PMC11625652. 

³Schliep KC, Ghabayen L, Shaaban M, Hughes FR, Pollack AZ, Stanford JB, Brady KA, Kiser A, Peterson CM. Examining the co-occurrence of endometriosis and polycystic ovarian syndrome. AJOG Glob Rep. 2023 Aug 28;3(3):100259. doi: 10.1016/j.xagr.2023.100259. PMID: 37663310; PMCID: PMC10472311. 

⁴Purwar A, Nagpure S. Insulin Resistance in Polycystic Ovarian Syndrome. Cureus. 2022 Oct 16;14(10):e30351. doi: 10.7759/cureus.30351. PMID: 36407241; PMCID: PMC9665922. 

⁵Purwar A, Nagpure S. Insulin Resistance in Polycystic Ovarian Syndrome. Cureus. 2022 Oct 16;14(10):e30351. doi: 10.7759/cureus.30351. PMID: 36407241; PMCID: PMC9665922. 

⁶Lamceva J, Uljanovs R, Strumfa I. The Main Theories on the Pathogenesis of Endometriosis. Int J Mol Sci. 2023 Feb 21;24(5):4254. doi: 10.3390/ijms24054254. PMID: 36901685; PMCID: PMC10001466. 

⁷World Health Organization. “Endometriosis.” World Health Organization. Published October 14, 2025. https://www.who.int/news-room/fact-sheets/detail/endometriosis. 

⁸Bajaj P, Bajaj P, Madsen H, Arendt-Nielsen L. Endometriosis is associated with central sensitization: a psychophysical controlled study. J Pain. 2003 Sep;4(7):372-80. doi: 10.1016/s1526-5900(03)00720-x. PMID: 14622679. 

⁹Tan Z, Gong X, Wang CC, Zhang T, Huang J. Diminished Ovarian Reserve in Endometriosis: Insights from In Vitro, In Vivo, and Human Studies-A Systematic Review. Int J Mol Sci. 2023 Nov 4;24(21):15967. doi: 10.3390/ijms242115967. PMID: 37958954; PMCID: PMC10647261.