Clearly Hormonal

Komal Patil-Sisodia, MD

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. 6d ago

    You Deserve More Than a Diagnosis: Turning PMOS Knowledge Into Better Care

    📱 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. About one in eight women lives with PMOS, polyendocrine metabolic ovarian syndrome, formerly called PCOS. It is one of the most common hormone conditions there is, and still one of the most misunderstood, by patients and by many clinicians. In this final episode of September PMOS Awareness Month, Dr. Komal Patil-Sisodia explains why the name changed, why the condition is about far more than ovarian cysts, and why the metabolic and cardiovascular pieces so often get missed when a visit stays focused on periods, acne, or hair growth. She also shares what the data shows about diagnosis delays and disparities, and a piece of her own story. Then she moves from the science to the practical: what to ask, what to track, and what to do when you raise a reasonable concern and do not get a useful answer. She introduces her new six-module course, The PMOS Conversation You Deserve, built to help you walk into your next appointment better informed and better prepared. IN THIS EPISODE Why PMOS stands for polyendocrine metabolic ovarian syndrome, and why the change from PCOS was more than a rebrandHow PMOS can show up across the lifespan, from adolescence through the reproductive years, perimenopause, and beyondThe metabolic side of PMOS: insulin resistance, blood sugar, cholesterol, blood pressure, and long-term cardiovascular riskWhat one large international study found about diagnostic delays: about one in three women waited more than two years, and nearly half saw at least three healthcare professionalsDisparities in who gets diagnosed, including findings in a safety net health system study for Black women and patients on Medicaid or charity careWhy knowing the science is not the same as knowing how to use it in an appointmentA first look at The PMOS Conversation You Deserve, including the pushback module, the workbook, and three months of live Q&ATIMESTAMPS 00:00  Welcome to Clearly Hormonal 01:08  PMOS: Why It Matters 02:22  PMOS Name Change Explained 02:57  Symptoms and Lifespan Impact 04:04  Diagnosis Delays and Disparities 05:51  Turning Knowledge Into Care 07:17  Course: The Conversation You Deserve 08:53  Enrollment Dates and Details 09:45  Final Takeaways and Wrap Up COURSE DATES Pre-order opens: October 7Introductory pricing through: October 13Regular price begins: October 14First live Q&A: October 21LINKS AND RESOURCES The PMOS Conversation You Deserve (pre-order opens October 7): Sign up here to get on the list.Eastside Menopause & Metabolism: eastsidemm.comFollow Dr. Patil-Sisodia on Instagram and TikTok: @drpatilsisodiaDISCLAIMER This podcast is for education and is not personalized medical advice. Please discuss what resonates with your own healthcare team. Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

  2. Sep 23

    The Long Road to Diagnosis: PMOS and Mental Health

    📱 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. In the final episode of PMOS Awareness Month, I focus on something that does not get talked about enough: the mental health toll of PMOS and the harm caused by waiting years for a diagnosis. We walk through what weight-matched studies show about depression, anxiety, and eating disorders, why so many people carry these burdens long before anyone connects them to PMOS, and what real care should look like. In this episode Why people with PMOS are about four times more likely to have depression and more than five times more likely to have anxietyWhy a PMOS diagnosis often comes before a new diagnosis of depression, anxiety, or sleep problemsHow eating disorder risk rises with PMOS, and why it is not limited to larger bodiesHow years of scattered symptoms and "it is just stress" responses make things worseWhy body image distress from visible symptoms is a real pathway to disordered eatingWhat good care includes: screening at diagnosis, CBT as a first step, careful medication choices, treating physical symptoms, and mind-body approaches Timestamps 00:00 Welcome to Clearly Hormonal 01:01 PMOS Series Finale Setup 02:04 Mental Health Stats in PMOS 03:24 Eating Disorders and PMOS 04:00 Why Diagnosis Takes Years 05:37 Body Image and Visible Symptoms 06:56 What Good Care Looks Like 08:50 What This Means for You 09:51 Series Wrap Up and Resources 11:02 PMOS Mini Course Announcement Key numbers from the episode About 4 times more likely to have depression with PMOS, in weight-matched studiesMore than 5 times more likely to have anxiety with PMOSAbout 1 in 3 people with PMOS have moderate to severe depression; more than 4 in 10 have real anxiety symptoms; well under 15 percent without PMOSAbout 1.5 times more likely to have an eating disorder, with the biggest increases in binge eating disorder and bulimia The full PMOS Awareness Month series Episode 1: What happens in PMOS after your childbearing yearsEpisode 2: Why PMOS gets missed in people with a normal BMI (lean PMOS)Episode 3: Where GLP-1 medications fit into PMOS treatmentEpisode 4: PMOS and mental health (this episode) A note on support If anything in this episode brought up something personal for you, especially around food, body image, or how you have been feeling emotionally, please do not sit with that alone. Talk to your doctor or a mental health professional. If you are in crisis in the US, you can call or text 988 at any time. Connect Instagram and TikTok: @drpatilsisodiaeastsidemm.comThis episode is for education and is not a substitute for individual medical advice. Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

  3. Sep 21

    Why We Withdrew From the ADA Webinar, and Why Peer & Lived Experience Must Be Central to Obesity Care

    📱 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, obesity advocate Michael Donnelly-Boylen, and Dr. Matthea Rentea explain why they withdrew from a planned ADA-hosted webinar in support of a broader boycott, after an ADA Scientific Sessions keynote by a MAHA representative and the removal of peacefully protesting scientists were followed by an organizational response the three of them found unsatisfying. They still share the content they had planned to present: integrating peer and lived experience into obesity care, to address a trust gap driven by weight stigma, shaming language, and oversimplified messaging that can delay or derail care, including preventive screening and procedures. They talk through curiosity, person-first language, motivational interviewing, and acknowledging medical trauma, along with practical solutions such as moderated peer support groups, credible online resources, and comprehensive programs that combine lifestyle foundations, medications, bariatric pathways, and clinic infrastructure shaped by patient input. Timestamps 00:00  Why This Episode Changed 00:47  ADA Boycott Context 02:15  Meet The Panel 03:26  Inside The Keynote Fallout 06:41  Protest And Conference Mood 10:01  Choosing To Withdraw 11:18  Webinar Topic And Roadmap 13:47  Trust Gap And Weight Stigma 18:37  Language That Builds Safety 23:23  Peer Support And Community 25:09  Social Media And Group Coaching 27:19  Why I Started Posting 28:43  Building a Comprehensive Program 30:32  Three Pathways of Care 33:32  Designing for Real Bodies 35:54  Practical Clinician Changes 37:48  Mountain Dew Lesson 41:30  Trauma and Safe Spaces 42:25  Peer Support Communities 44:20  Insurance and Advocacy 46:27  Fighting Wellness Misinformation 47:55  How to Build Support Groups 50:53  Wrap Up and Where to Find Us Connect Dr. Komal Patil-Sisodia: Instagram and TikTok @drpatilsisodia. Podcast: Clearly Hormonal. Dr. Matthea Rentea: Instagram, TikTok, and YouTube. Podcast: The Obesity Guide with Matthea Rentea, MD, at renteaclinic.com. Michael Donnelly-Boylen: Instagram and TikTok as Mike On A Mission. Podcast: Weight and Measure with Mike and Zach, at weightandmeasurepod.com. Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

  4. Sep 16

    Beyond the Buzz: Where GLP-1s Really Fit in PMOS Care

    📱 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 continues the PMOS Awareness Month series by walking through where GLP-1 medications, like semaglutide and tirzepatide, fit into PMOS treatment. She explains what GLP-1s actually do in the body, who is likely to benefit, who they are not built for, and why they are never a stand-alone treatment plan for PMOS. In This Episode What a GLP-1 is and the three main effects these medications have on the bodyWhy insulin resistance sits at the center of PMOS for so many patients, and how that connects to androgen levels and symptoms like acne and excess hair growthWho is the clearest fit for a GLP-1: patients with insulin resistance or higher body weight, and those who haven't seen enough improvement from metformin or lifestyle changes aloneWho GLP-1s are not built for: lean PMOS patients without insulin resistance, and anyone trying to conceive soonWhy GLP-1s only work well alongside lifestyle change, and the real risks of low protein and fiber intake while on these medicationsWhat a GLP-1 does not replace: ongoing metabolic monitoring, fertility treatment, and androgen-targeted treatments like birth control pills or spironolactoneThe four questions Dr. Patil-Sisodia asks herself before recommending a GLP-1 for a PMOS patient Timestamps 00:00 Podcast Intro01:01 Series Setup02:13 GLP-1 Basics02:45 Why It Matters03:28 Who Benefits04:32 Who Should Avoid05:27 Lifestyle and Safety06:15 What GLP-1s Don't Replace07:40 How I Decide08:29 Wrap Up and Next Week09:36 Mini Course Promo Links Mentioned Newsletter sign-up: eastsidemm.com/newsletterFollow Dr. Patil-Sisodia: @drpatilsisodia on Instagram and TikTokThanks for listening. Find more info about Clearly Hormonal on the website or Instagram.

  5. Sep 9

    Lean PMOS: Why the Diagnosis Gets Missed Without Weight Gain

    📱 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. Many people picture PMOS (polyendocrine metabolic ovarian syndrome, formerly known as PCOS) as a condition tied to weight gain. But the diagnostic criteria never mention body size at all, and a significant number of people with PMOS have a completely normal BMI. In part two of our PMOS Awareness series, Dr. Patil-Sisodia breaks down “lean PMOS”: what it looks like, why it is so often missed, and why the metabolic risk is just as real even when the outside doesn't show it. In This Episode Why PMOS became associated with a specific body type, and why that picture was never the diagnosis itselfThe three actual diagnostic criteria: irregular or anovulatory cycles, elevated androgens (DHEAS, testosterone), and polycystic ovarian morphology on ultrasoundWhat lean PMOS symptoms look like: irregular periods, acne, facial and body hair growth, scalp thinning“Normal weight obesity”: how insulin resistance and visceral fat can hide behind a normal-looking exteriorThe three-part pattern that causes lean PMOS to slip through the cracks in clinical practiceWhy an undiagnosed lean PMOS patient loses out on cardiometabolic monitoring, not just a menstrual explanationWhat needs to change: for clinicians, dropping body size as a screening filter; for patients, presenting symptoms as a pattern instead of one at a timeTimestamps 00:00 | Welcome to Clearly Hormonal 01:01 | Series Setup: Lean PMOS 02:09 | Why PMOS Has a Body Type 02:42 | Diagnosis Criteria, Not Weight 03:39 | Lean PMOS Symptoms 04:05 | Hidden Insulin Resistance 05:01 | Why Lean PMOS Gets Missed 06:51 | Why Diagnosis Matters 08:05 | What Should Change 09:24 | Wrap Up and Next Week 10:03 | Mini Course Announcement Coming up next week: Episode three of the series looks at treatment, including where GLP-1 medications and other weight management tools fit into PMOS care, and who they actually make sense for. Sign up for the newsletter at eastsidemm.com/newsletter, and follow along on Instagram or TikTok @drpatilsisodia. This podcast is for education, 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.

  6. Sep 2

    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.

  7. Aug 26

    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.

  8. Aug 19

    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.

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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.

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