Clearly Hormonal

Komal Patil-Sisodia, MD
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Have you ever wondered why your body feels like it's falling apart just as you're hitting your stride in other areas of your life? Join Dr. Komal Patil-Sisodia as she explores women’s metabolic health changes that start in perimenopause. The episodes center around educating and empowering women to have open dialogue with their doctors so that they can achieve their best metabolic health. Dr. Patil-Sisodia is board certified in Endocrinology,  Obesity Medicine and Internal Medicine. She is also a Menopause Society Certified Practitioner. Any medical discussion on this podcast is purely for educational purposes and is not individualized medical advice. Please consult with your doctor to discuss any health concerns you may have.

  1. 5 days ago

    PMOS After the Reproductive Years: Why It Doesn't Go Away

    📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question. PMOS Awareness Month kicks off with a reframe: PMOS is not a condition that resolves once your cycles regulate or once you're done having kids. It is a lifelong cardiometabolic condition that happens to announce itself first through reproductive symptoms. Dr. Komal Patil-Sisodia walks through the three diagnostic criteria (irregular periods, high androgens, and polycystic ovarian morphology) and explains why the biology underneath, insulin resistance, visceral fat, and unfavorable cholesterol, persists even when periods look normal. She unpacks what worsens in perimenopause, the clinical blind spot that causes PMOS histories to get dropped from the chart, and what she actually changes in her own practice: earlier and trend-based lab monitoring, a shift in treatment goals from fertility to long-term metabolic and heart protection, and more individualized hormone therapy decisions. In This Episode Why the three PMOS diagnostic criteria are not the whole diseaseThe underlying biology: insulin resistance, visceral fat, and cholesterol changes that often start in the teenage yearsWhat worsens at perimenopause: insulin resistance, LDL and triglycerides, and belly fatThe missed clinical question that keeps PMOS histories from shaping midlife careWhy 20+ years of a less favorable metabolic starting point matters for heart disease riskWhat changes in practice: trend-based monitoring, shifting treatment goals, and individualized hormone therapyA preview of the rest of the PMOS Awareness Month seriesTimestamps 00:00 — Welcome to Clearly Hormonal01:03 — PMOS Beyond Fertility02:14 — PMOS Is Lifelong04:05 — Perimenopause Metabolic Shifts06:17 — The Missed Clinical Question07:52 — Heart Risk Over Decades09:38 — What To Do In Practice11:34 — Key Takeaways & Next Episodes12:46 — Mini Course InvitationComing Up in This Series Episode 2 — Lean PMOS (sometimes called "skinny PMOS") and why it gets missedEpisode 3 — Where GLP-1s and other weight management tools fit into PMOS careEpisode 4 — The long road to diagnosis and its toll on mental healthLinks Join the email list for the PMOS mini-course: eastsidemm.com/newsletterThanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

  2. 26 Aug

    Equality & the Executive Suite: The Menopause Penalty Revisited

    📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question. On Women's Equality Day, host Dr. Komal Patil-Sisodia revisits an idea from an early episode of Clearly Hormonal: the menopause penalty, the disproportionate income loss, leadership attrition, and career disruption that midlife women face. This episode goes past the data to ask what it actually feels like to lead through sleep disruption, cognitive overload, and hormonal change while carrying the weight of an executive role. Guest Dr. Brooke Buckley traces her path from a punishing early surgical practice through hospital operations, an MBA negotiated into her first CMO contract, and a system-level leadership role she stepped into during the pandemic. She speaks candidly about infertility and loss, being the only woman in her surgical residency class, and the coaching and community that carried her through. The conversation moves into trauma-informed leadership, why physiology cannot be negotiated away, and the hard pivot Buckley made in walking away from the operating room to protect her own health. Audio Stamps00:00  Why Equality Still Lags 01:48  The Menopause Penalty 02:34  Meet Dr. Brooke Buckley 04:04  From Surgeon to Executive 07:32  Lessons From Organized Medicine 11:44  Midlife Friction and Storytelling 15:13  Boundaries as Superpower 18:07  Leading Through the Pandemic 21:29  Community, Coaching, and Accountability 27:20  Trauma-Informed Leadership 32:07  AI, Physiology, and the Future of Work 35:05  Hard Pivots and Closing Takeaways Guest BioDr. Brooke Buckley is a board-certified general surgeon and physician executive, board-certified in lifestyle medicine, and currently serves as System Vice President of Medical Affairs for Henry Ford Health. She previously served as chief medical officer and holds an MBA from Johns Hopkins. She has held national leadership roles with the American Hospital Association and The Joint Commission and is a widely followed voice on physician wellness, trauma-informed leadership, and healthcare system transformation. Instagram: play_your_story Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

  3. 19 Aug

    Same Diagnosis, Different Bodies: The Four PMOS Phenotypes

    📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question. Two women get the same diagnosis, PMOS (formerly known as PCOS), and end up with completely different symptoms. One has irregular periods, acne, and high androgens. The other has none of that, just an ultrasound finding. How can that be the same condition? In this episode, Dr. Komal Patil-Sisodia breaks down the Rotterdam criteria, the three features used to diagnose PMOS, and explains why you only need two of the three to qualify. That single fact is the reason PMOS shows up as four distinct phenotypes (A, B, C, and D), each with its own symptom pattern and metabolic risk profile. You'll learn: What hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology actually mean (without the jargon)The four PMOS phenotypes and which one carries the highest, and lowest, metabolic riskWhy insulin resistance, not BMI, may be the real driver of your riskWhy phenotype D ("the mild one") still deserves your attentionThree questions to bring to your next appointment to get more personalized careWhether you were diagnosed years ago or are newly navigating a PMOS diagnosis, this episode gives you language to better understand your own body, and better questions to ask the people caring for it. Audio Stamps: 00:00 Welcome to Clearly Hormonal 01:03 Why PMOS Looks Different 02:43 Rotterdam Criteria Explained 05:15 Phenotype A: Full House 06:03 Phenotypes B Through D 08:27 Why Phenotype Matters 11:00 Phenotype D Still Counts 12:44 Three Takeaways and Next Steps 14:39 Recap and Final Message This podcast is for educational purposes only and is not a substitute for personalized medical advice. Please discuss your own care with your healthcare team. Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

  4. 12 Aug

    Perimenopause or Something Else? Bringing Nuance Back to Midlife Symptoms

    📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question. Perimenopause is having a cultural moment, and endocrinologist Dr. Komal Patil-Sisodia is glad it is, but in this launch episode of Clearly Hormonal, she pushes back on social media's habit of attributing nearly any midlife symptom to hormones. She defines perimenopause as the years leading up to menopause (recognized after 12 months without a period, average age ~51) and explains that it's marked by hormonal variability, not simply “low estrogen,” with menstrual-cycle changes serving as an important clinical clue. She walks through why most women don't need single-point hormone testing, since levels fluctuate day to day, per current ACOG guidance. Using a composite patient example (“Jen”), she shows how fatigue, sleep issues, hair loss, and weight gain may reflect iron deficiency, thyroid disease, sleep apnea, nutrition, stress, medications, or life changes, not hormones by default. She closes with a four-question framework for sorting it out: where you are in the reproductive transition, whether a symptom is plausibly related to it, what else could explain it, and whether treating perimenopause would actually help. Taking symptoms seriously, she argues, requires evidence and continued curiosity, not a single convenient explanation. Timestamps 00:00  Welcome to Clearly Hormonal 01:03  Perimenopause Everywhere 01:32  Why Nuance Matters 03:24  How Social Media Shaped It 05:22  Defining Perimenopause 07:51  Hormone Testing Reality 09:29  Patient Example: Jen 11:51  Fatigue and Weight Gain 13:58  Brain Fog and Mood 15:35  Hair, Sleep, Libido, Joints 18:54  When “It's Just Perimenopause” Becomes a Problem 21:38  The Four-Question Framework 23:33  Key Takeaways and Invite 25:26  Quick Question: 3 AM Wakeups Key Takeaways Perimenopause is hormonal variability, not simply low estrogen: levels fluctuate rather than steadily decline in the early transition.Menopause is recognized after 12 consecutive months without a period; average age in the U.S. is around 51.Most women don't need a single hormone test to identify perimenopause: age, symptoms, and menstrual changes usually tell us more (ACOG).Common midlife symptoms (fatigue, weight change, hair loss, brain fog, mood shifts, low libido, joint pain) can have multiple causes beyond hormones.The four-question framework: (1) Where am I in the reproductive transition? (2) Is this symptom plausibly related to perimenopause? (3) Is there another explanation to consider? (4) Would treating perimenopause actually improve it?Taking a symptom seriously and attributing it to hormones by default are not the same thing.Resources & Links ACOG: Do I need to have testing of my hormone levels during perimenopause? (acog.org)Follow along: Instagram & TikTok @drpatilsisodiaGot a question for “Is This Actually Hormonal?”: DM @drpatilsisodia or send a note through the show's fan mail link.Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

  5. 5 Aug

    Peptides: Evidence-Based Medicine vs. Social Media Hype

    📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question. Endocrinologist Dr. Komal Patil-Sisodia defines peptides as short amino-acid chains (with examples like insulin) and notes that any package or claim stating “contains peptides” is meaningless without knowing which peptide, how it was tested, and what it's proven to do. She outlines the FDA approval pathway from preclinical work through Phase 1–3 trials and FDA review, then lists the FDA-approved peptides she prescribes for metabolic health (insulin analogs, GLP-1/GIP agents, glucagon, pramlintide), osteoporosis and calcium disorders (teriparatide, abaloparatide, palopegteriparatide, calcitonin), and reproductive/pituitary conditions (GnRH agonists, somatostatin analogs, vasopressin/desmopressin, cosyntropin, setmelanotide, bremelanotide). She contrasts these with trending “gray market” peptides (e.g., BPC-157, TB-500, GHK-Cu), noting most lack published peer-reviewed randomized human trials and are often sold as “research chemicals” without purity oversight. Her key filter: ask what high-quality human evidence supports a claim — emphasizing informed choices, doctor-guided decisions, and evidence over hype. In This Episode What a peptide actually is — and why the word alone doesn't mean anythingThe FDA's Phase 1–3 approval pathway, explained in plain languageThe full list of FDA-approved peptides Dr. Patil-Sisodia prescribes, organized by conditionWhy trending “gray market” peptides like BPC-157, TB-500, and GHK-Cu haven't cleared that same evidence barThe backlash from a recent social post — and what it revealed about asking for sourcesThe one question to ask before trying any new treatmentTimestamps 00:00 | Welcome to Clearly Hormonal 01:03 | Peptides Everywhere Now 01:51 | Peptides Explained Simply 02:47 | How FDA Approval Works 05:13 | Peptides I Prescribe 08:42 | Social Media Peptide Hype 10:43 | My Viral Post Backlash 12:53 | Spotting Real Evidence 13:46 | Final Takeaways and Wrap Connect Practice: eastsidemm.comInstagram & TikTok: @drpatilsisodiaThanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

  6. 29 Jul

    The Peptide Vote: What the FDA's Advisors Just Recommended

    📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question. Dr. Komal Patil-Sisodia explains that headlines claiming “FDA approves peptides” are misleading: an FDA advisory committee narrowly voted to recommend adding six peptides (BPC-157, TB-500, KPV, MOTS-c, Epitalon, Semax) to a compounding list, a step that is not FDA approval and still faces a formal FDA process. She notes FDA scientists opposed adding all six and that some voting members sell these peptides. Reviewing the evidence, she explains that BPC-157 has only three small, weak human studies; TB-500 has zero human trials for the injury uses it's marketed for (while full thymosin beta-4 has some real human data); KPV has no human studies at all; MOTS-c has an unpublished Phase 1b trial and only observational, exercise-related human data; Epitalon lacks Western peer-reviewed human trials; and Semax is approved in Russia but with limited-quality stroke data. She emphasizes that all six are synthetic despite being marketed as "natural," that marketing to midlife women is running well ahead of the evidence, that contamination and mislabeled dosing have been documented in online peptide products, that compounded drugs bypass typical FDA review, and that proven options already exist for symptoms like hot flashes, bone loss, and metabolic changes. Time Stamps: 00:00  Welcome to Clearly Hormonal 01:03  The FDA Vote Explained 03:09  BPC-157 Evidence Check 04:31  TB-500 vs. Thymosin Beta-4 06:01  KPV and Animal Data Limits 07:25  MOTS-c, Epitalon, Semax 11:32  Midlife Marketing Reality 13:37  What the List Means 14:23  Safety and Contamination Risks 16:06  Bottom Line and Next Steps 17:31  Wrap Up and Where to Follow Resources & Mentions Follow Dr. Patil-Sisodia on Instagram and TikTok: @drpatilsisodiaJAMA: “Under FDA, Unapproved Peptides Likely to Become More Widely Available” (Rita Rubin, MA, 2026)ABC News: “FDA advisers narrowly vote to add 6 peptides to a drug compounding list. What's next?” (July 24, 2026)Talanta (2018): impurity analysis of falsified peptide drugs seized from online pharmaciesExpert Opinion on Drug Safety (2026): FAERS pharmacovigilance study on compounded GLP-1 receptor agonistsJournal of Cellular and Molecular Medicine (2021): Phase I dose-escalation trial of recombinant human thymosin beta-4Zhurnal Nevrologii I Psikhiatrii (2018): Semax post-stroke rehabilitation studyThanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

  7. 22 Jul

    The Biggest Myths About Type 1 Diabetes (and the Truth Behind Them)

    📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question. Type 1 diabetes isn't just a childhood disease, and it isn't caused by sugar, weight, or lifestyle. In this episode, Dr. Komal Patil-Sisodia breaks down why type 1 diabetes is so often missed in adults, especially in people mislabeled as type 2, and introduces LADA (latent autoimmune diabetes in adults), a slow-moving form of type 1 that may account for up to a quarter of adult diagnoses. She walks through the clues that should prompt testing, the two blood tests that can change a diagnosis, and how perimenopause and menopause complicate blood sugar control for women living with type 1. The episode also covers pregnancy planning, the real (and often overstated) genetic risk to children, the underappreciated heart disease risk in women with type 1, and why needing insulin is never a sign of failure. In This Episode Why type 1 diabetes has nothing to do with sugar, weight, or lifestyleHow adult-onset type 1 gets misdiagnosed as type 2, and whyLADA (type 1.5): what it is and why it hides in plain sightThe clues that should prompt a GAD antibody and C-peptide testHow perimenopause and menopause make blood sugar harder to controlPregnancy with type 1 diabetes: what's actually trueThe real genetic risk to children (it's lower than you think)Why heart disease risk is elevated and underdiscussed in women with type 1Why insulin is not a “last resort” and never a sign you did something wrongThe technology (CGMs and automated insulin delivery) changing type 1 care Timestamps: 00:00   Why Type 1 Gets Missed 00:30   A Misdiagnosed Patient Story 02:52   Myth: Sugar Causes Type 1 05:31   Myth: Only Kids Get It 06:29   Adult Onset and the Honeymoon Period 08:41   LADA (Type 1.5) Explained 10:13   Perimenopause Makes It Harder 11:53   When to Test for Type 1 14:34   Pregnancy Myths and Facts 16:41   Heart Risk in Women 18:24   Insulin Shame and Stigma 20:44   Tech That Changed Diabetes Care 22:01   Perimenopause Management Tips 22:49   Key Takeaways and Next Steps 25:14   Final Thoughts and Share Resources Mentioned: GAD antibody test (glutamic acid decarboxylase antibody): the key immune marker for LADAC-peptide test: measures how much insulin your body is still producing on its ownContinuous glucose monitors (CGMs) and automated insulin delivery systemsMaternal-fetal medicine (perinatology) preconception counseling for planned pregnancies Disclaimer:  This podcast is for education, not personalized medical advice. Please discuss anything that resonates with your own healthcare team. Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

  8. 15 Jul

    Type 2 Diabetes Isn't a Moral Failing: Genetics, Hormones, Stigma, and the Truth About Insulin

    📱 Send Us a Text Message! We’d love to hear from you! Please include your name and email address so we can reply. Don’t worry — this won’t sign you up for our email list. We’ll only use your info to respond to your question. Type 2 Diabetes Isn't a Moral Failing: Genetics, Hormones, Stigma, and the Truth About Insulin If you've ever been told — or told yourself — that your type 2 diabetes is something you caused and something you could fix if you just tried a little harder, this episode is for you. Dr. Komal Patil-Sisodia spends 17 years of clinical experience (and personal family history) dismantling one of the most damaging narratives in medicine: that type 2 diabetes is a lifestyle disease you can will your way out of. In reality, it's a complex, progressive metabolic condition shaped by genetics, hormones, sleep, stress, and — for women specifically — perimenopause and menopause. This episode covers the real biology behind insulin resistance and beta-cell decline, why stigma is measurably making patient outcomes worse, why so many people misunderstand what insulin actually does, and why "remission" — not "reversal" — is the accurate, honest term for what's possible. In this episode: 00:00 — Welcome and Mission Introduction to Clearly Hormonal and why this particular episode is personal.01:00 — Diabetes Myths and Stigma The core myth — that diabetes is caused by bad choices and reversible through willpower — and the data on how stigma affects A1C, depression, and self-care engagement.03:18 — A Patient Story: A Midlife Shift A composite patient story of someone doing everything "right" whose A1C climbs anyway once perimenopause hits.04:15 — What Type 2 Diabetes Actually Is Insulin resistance, beta-cell decline, and why genetics account for 40–80% of risk.05:31 — Hormones, Sleep, and PMOS Estrogen as an insulin sensitizer, cortisol and chronic stress, the impact of poor sleep, and PMOS (formerly PCOS) as a major independent risk factor.08:52 — Type 1 vs. Type 2 Clarifier A quick, important distinction — type 1 diabetes is autoimmune and not the topic of this episode.09:15 — CGMs and the "I Can Feel It" Myth Why 64% of patients believe they can feel high blood sugar — and the story of using a CGM to show her dad he couldn't.12:48 — Insulin Fear and Complications Why so many patients believe insulin causes kidney damage, blindness, or amputations — and what actually causes those complications.15:07 — Diet Myths and Shame Vegetarian diets, "only sugar counts," and how internalized shame changes patient behavior.17:32 — Remission, Not Reversal The real data on remission rates over time, and why relapse is disease progression, not failure.19:59 — What Patients Deserve A call for full access to treatment — metformin, GLP-1s, SGLT2 inhibitors, insulin — without having to "earn" it first.22:38 — Menopause and the Diabetes Care Gap Why standard diabetes care ignores perimenopause and menopause, and what should be asked instead.23:48 — Key Takeaways and Share A recap and an invitation to pass this along to anyone who's been made to feel like their diabetes is their fault.Resources & Mentions: Continuous glucose monitors (CGMs) as standard-of-care discussionPMOS (formerly known as PCOS)Type 2 diabetes remission criteria (A1C 6.5% for 3+ months without medication)Disclaimer: This podcast is for educational purposes only and is not personalized medical advice. Please discuss anything you hear here with your own healthcare team. Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

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About

Have you ever wondered why your body feels like it's falling apart just as you're hitting your stride in other areas of your life? Join Dr. Komal Patil-Sisodia as she explores women’s metabolic health changes that start in perimenopause. The episodes center around educating and empowering women to have open dialogue with their doctors so that they can achieve their best metabolic health. Dr. Patil-Sisodia is board certified in Endocrinology,  Obesity Medicine and Internal Medicine. She is also a Menopause Society Certified Practitioner. Any medical discussion on this podcast is purely for educational purposes and is not individualized medical advice. Please consult with your doctor to discuss any health concerns you may have.

Information

  • Creator
    Komal Patil-Sisodia, MD
  • Years Active
    2024 - 2026
  • Episodes
    60
  • Rating
    Explicit
  • Copyright
    © 2026 Clearly Hormonal
  • Show Website
    Clearly Hormonal