What Your Doctor May Be Missing: The Real Reason for Moodiness, Acne, Weight Gain, and Anxiety

Episode of The Mel Robbins Podcast · November 14, 2026 · 50 min

OB-GYN Thaïs Aliabadi tells Mel Robbins how PMOS, endometriosis and PMDD are diagnosed and treated, and why women must advocate for themselves.

Summary

Mel Robbins hosted OB-GYN Thaïs Aliabadi, known as Dr. A, in the show's Boston studio for an episode on women's health conditions she said are routinely missed. Robbins opened by saying that after the taping she followed Aliabadi's protocol and one of her daughters was diagnosed with PMOS. Aliabadi, who calls her practice "the office of dismissed women," argued that most women are dismissed by the health care system and that a standard well-woman exam is inadequate.

Aliabadi explained that PMOS (polyendocrine metabolic ovarian syndrome) is the new name for PCOS, that it affects about 15% of women and that 75% go undiagnosed. She described the two-of-three diagnostic criteria, the role of insulin resistance in driving ovarian testosterone, weight gain, acne and hair changes, and the condition's effects on mood via the limbic system and prefrontal cortex. She recommended diet, post-meal walks, supplements, metformin and, for some patients, GLP-1 medications, and said many teenagers with eating disorders likely have undiagnosed PMOS.

On endometriosis, Aliabadi said prevalence is likely higher than the reported 10%, described its mechanism, pain patterns, central sensitization and staging, and said laparoscopic excision by a specialist is the gold standard, alongside progestin IUDs, GnRH antagonists and a new blood test. She described PMDD as an abnormal brain response to normal hormonal fluctuations, treatable with the pill Yaz and cyclical SSRIs.

Both speakers rejected the claim that birth control causes infertility, with Aliabadi arguing that stopping the pill unmasks underlying conditions. She reviewed how egg counts decline with age, reported that 61% of her PMOS patients also have endometriosis, and closed by urging listeners to seek second and third opinions and become their own health advocates.

Chapters

0:00
Introduction and personal stakes
Robbins introduces Dr. Aliabadi and reveals her daughter was diagnosed with PMOS after following the advice in the episode.
3:31
The office of dismissed women
Aliabadi describes how women are dismissed, criticizes the standard well-woman exam and cites gaps in gynecologic access.
8:21
What PMOS is and how to diagnose it
Aliabadi explains the renaming of PCOS to PMOS, its prevalence and the two-of-three diagnostic criteria.
12:00
Insulin resistance and hormonal cascade
Aliabadi details how insulin resistance drives visceral fat, ovarian testosterone, blocked ovulation and lowered SHBG.
15:21
PMOS and mental health
Aliabadi links PMOS to anxiety, depression, binge eating and eating disorders through effects on the limbic system and prefrontal cortex.
20:22
Treating PMOS
Aliabadi recommends diet, walking after meals, supplements, metformin and GLP-1 trials.
22:48
Understanding endometriosis
Aliabadi explains endometriosis prevalence, symptoms, mechanism, central sensitization, staging and surgical treatment.
30:14
Testing and treating endometriosis
Aliabadi outlines symptoms to report, pelvic ultrasound, a new blood test and medical and surgical treatment options.
34:06
PMDD
Aliabadi defines PMDD and recommends Yaz and cyclical SSRIs as treatment.
39:08
Birth control and infertility myths
Robbins and Aliabadi rebut claims that the pill causes infertility, arguing it masks underlying conditions.
42:21
Egg count and fertility
Aliabadi reviews egg decline across the lifespan and the overlap between PMOS and endometriosis.
44:44
Parting advice on self-advocacy
Aliabadi urges women to seek further opinions and advocate for themselves, and Robbins asks listeners to share the episode.

Key points

What was said, by whom, with the exact words. Timestamps jump to the moment.

Mel Robbins
Robbins recounts that after following Aliabadi's recommended protocol, one of her daughters was diagnosed with PMOS.
“it turns out one of our daughters has now been diagnosed with PMOS”
Listen from 1:05 · Polycystic ovary syndrome
Thais Aliabadi
Aliabadi argues that the typical well-woman exam of a pap smear, breast exam, STD talk and birth control is inadequate.
“They might talk about STD testing, maybe give you birth control, and off you go. That's not a well-woman exam”
Listen from 5:21 · Medical dismissal of women
Thais Aliabadi
Aliabadi states that half of U.S. counties lack a gynecologist.
“50% of counties in America don't have a gynecologist”
Listen from 6:14 · Medical dismissal of women
Thais Aliabadi
Aliabadi explains that PCOS was renamed PMOS because the old name was misleading, as there are no cysts on the ovaries.
“So PMOS is a new name for PCOS. PCOS was polycystic ovary syndrome. Completely wrong because there are no cysts on the ovaries”
Listen from 8:36 · Polycystic ovary syndrome
Thais Aliabadi
Aliabadi says PMOS affects 15% of women and that three quarters of them are never diagnosed.
“PMOS affects 15% of women. It takes doctors years to diagnose these patients. 75% of women go through life and they're never diagnosed”
Listen from 8:56 · Polycystic ovary syndrome
Thais Aliabadi
Aliabadi stresses that a high blood testosterone level is not required for a PMOS diagnosis.
“You do not need to have a high testosterone in your blood to get the diagnosis”
Listen from 10:02 · Polycystic ovary syndrome
Thais Aliabadi
Aliabadi believes many teenagers in eating disorder centers have undiagnosed PMOS.
“I would have her go knock on the doors of all these eating disorder centers where the teenagers are sitting. That's where PMOS patients are”
Listen from 16:26 · Eating disorders
Thais Aliabadi
Aliabadi says she began treating PMOS patients with GLP-1 drugs in 2014 because they address insulin resistance.
“In 2014, I was treating my PMOS patients with GLP-1s. It was a miracle medication for these patients because GLP-1s dress that insulin resistance”
Listen from 21:37 · GLP-1 receptor agonists
Thais Aliabadi
Aliabadi argues the commonly cited 10% prevalence of endometriosis underestimates the true figure because many women are undiagnosed.
“The literature says that 10% of women have endometriosis. I think that's an understatement because these women are not diagnosed”
Listen from 22:48 · Endometriosis
Thais Aliabadi
Aliabadi claims fewer than 1% of gynecologists can operate on or even diagnose advanced endometriosis.
“less than 1% of gynecologists know how to operate on advanced endometriosis or even diagnose it”
Listen from 28:51 · Laparoscopic surgery
Thais Aliabadi
Aliabadi explains that the new endometriosis blood test is only useful when positive, since a negative result does not rule out the disease.
“If the test is positive, it means you have it. If the test comes back negative, it doesn't mean you don't have it”
Listen from 30:34 · Endometriosis
Thais Aliabadi
Aliabadi recommends blocking ovulation with the birth control pill Yaz as a first treatment for PMDD.
“one of the easiest things to do with these patients is to stop them from ovulating. One of the best birth control pills to use is the birth control pill Yaz”
Listen from 34:52 · Combined oral contraceptive pill
Linked moment · 35:54Skip to 35:54 using a listen link in the info box.
Thais Aliabadi
Aliabadi says PMDD is not caused by abnormal hormone levels but by an abnormal brain response to normal cycle fluctuations.
“These patients, their brain reacts differently to the normal fluctuations of the hormones of the menstrual cycle”
Listen from 35:54 · Premenstrual dysphoric disorder
Thais Aliabadi
Aliabadi says PMDD patients can be treated with SSRIs only during the 10 to 14 days before their period.
“But if they only dip 10 days before their period, you can actually just treat them with SSRIs with antidepressants during that window”
Listen from 37:20 · Selective serotonin reuptake inhibitors
Thais Aliabadi
Aliabadi argues that infertility after stopping the pill is due to undiagnosed underlying conditions rather than the pill itself.
“They blame the birth control pill. Well, it's not the birth control pill because no one ever diagnosed you with that underlying condition”
Listen from 40:33 · Combined oral contraceptive pill
Mel Robbins
Robbins criticizes the fear and misinformation surrounding birth control, which she calls one of the safest studied medications for women.
“I see so much fear and misinformation directed at one of the safest medications that's been studied for women”
Listen from 40:44 · Combined oral contraceptive pill
Thais Aliabadi
Aliabadi reports that in her own practice 61% of PMOS patients also have endometriosis.
“in my practice, based on my data in my office, 61% of my PMOS patients also have endometriosis”
Listen from 42:28 · Female infertility
Thais Aliabadi
Aliabadi advises women who feel dismissed to seek second and third medical opinions.
“If you get dismissed, go get a second opinion. If you still get dismissed, go get a third opinion”
Listen from 45:06 · Medical dismissal of women

People

In the conversation

Mel RobbinsAmerican author, podcast host and former lawyer who hosts The Mel Robbins Podcast
Thais AliabadiOB-GYN and fertility expert previously interviewed on the podcast

Topics

From the publisher

This is the health advice every woman, particularly those in their teens, 20s, 30s, and 40s, needs to hear. Today, world-renowned OB-GYN and women’s health advocate Dr. Thaïs Aliabadi, MD, known as Dr. A, is here for a private appointment with you. She has shared before on this podcast about breast cancer. This episode covers entirely different topics: essential, life-changing information on fertility, PMS, PMDD, PMOS, and endometriosis. This conversation was so eye-opening for Mel that right after taping it, she flew herself and her two daughters, both in their 20s, across the country to see Dr. A to get answers about health concerns they had been struggling with. And now, Mel’s daughter has been diagnosed with PMOS and is following Dr. A’s exact advice. As a mother, Mel is grateful to Dr. A for coming to Boston and not only being a fierce advocate but also taking the time to give us a detailed checklist of exactly what we need to know and exactly what to ask for so that we can take better care of ourselves and the women we love. Dr. A has spent decades caring for women, performing advanced gynecological surgeries, and teaching medical students and residents at Cedars-Sinai Medical Center . She calls her medical practice “the Office of Dismissed Women.” In fact, Dr. A shares today that 75% of women with PMOS are walking or go through life without ever knowing it—and that PMOS is the leading cause of infertility together with endometriosis. It takes on average 11 years for someone to be diagnosed, but as Dr. A says, it doesn't have to be this way. In this episode, you'll learn: - How to properly diagnose PMOS - Why unexplained weight gain, acne, hair loss, and anxiety may be connected to an underlying hormonal condition - The warning signs of endometriosis - Why endometriosis can go undiagnosed for years - What PMDD is and why your mood can change dramatically before your period - The truth about birth control and infertility - What you need to know about your egg…

Summary, chapters and key points were generated from the episode transcript on November 15, 2026. Quotes are checked word for word against the transcript.

Categories: Medicine·Mental Health