Clearly Hormonal

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.

Clearly Hormonal is a health podcast hosted by Komal Patil-Sisodia, MD, with 61 episodes on record and a Required Pod Score of 80. PitchCentric scores this show on Booking Probability, Listen Score, and live audience signals refreshed every 24 hours.

Komal Patil-Sisodia, MD hosts Clearly Hormonal, a health show with 61 episodes published.

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  Episode #20

  Lean PMOS: Why the Diagnosis Gets Missed Without Weight Gain

  Sep 9, 202611 minS2

  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 itself The three actual diagnostic criteria: irregular or anovulatory cycles, elevated androgens (DHEAS, testosterone), and polycystic ovarian morphology on ultrasound What 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 exterior The three-part pattern that causes lean PMOS to slip through the cracks in clinical practice Why an undiagnosed lean PMOS patient loses out on cardiometabolic monitoring, not just a menstrual explanation What needs to change: for clinicians, dropping body size as a screening filter; for patients, presenting symptoms as a pattern instead of one at a time Timestamps 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 .

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  Episode #19

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

  Sep 2, 202614 minS2

  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 disease The underlying biology: insulin resistance, visceral fat, and cholesterol changes that often start in the teenage years What worsens at perimenopause: insulin resistance, LDL and triglycerides, and belly fat The missed clinical question that keeps PMOS histories from shaping midlife care Why 20+ years of a less favorable metabolic starting point matters for heart disease risk What changes in practice: trend-based monitoring, shifting treatment goals, and individualized hormone therapy A preview of the rest of the PMOS Awareness Month series Timestamps 00:00 — Welcome to Clearly Hormonal 01:03 — PMOS Beyond Fertility 02:14 — PMOS Is Lifelong 04:05 — Perimenopause Metabolic Shifts 06:17 — The Missed Clinical Question 07:52 — Heart Risk Over Decades 09:38 — What To Do In Practice 11:34 — Key Takeaways & Next Episodes 12:46 — Mini Course Invitation Coming Up in This Series Episode 2 — Lean PMOS (sometimes called "skinny PMOS") and why it gets missed Episode 3 — Where GLP-1s and other weight management tools fit into PMOS care Episode 4 — The long road to diagnosis and its toll on mental health Links Join the email list for the PMOS mini-course: eastsidemm.com/newsletter Thanks for listening. Find more info about Clearly Hormonal on the website or Instagram .

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  Clearly Hormonal

  Equality & the Executive Suite: The Menopause Penalty Revisited

  Aug 26, 202638 min

  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 Stamps 00:00 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 Bio Dr. 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 .

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  Clearly Hormonal

  Same Diagnosis, Different Bodies: The Four PMOS Phenotypes

  Aug 19, 202617 min

  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 risk Why insulin resistance, not BMI, may be the real driver of your risk Why phenotype D ("the mild one") still deserves your attention Three questions to bring to your next appointment to get more personalized care Whether 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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  Episode #16

  Perimenopause or Something Else? Bringing Nuance Back to Midlife Symptoms

  Aug 12, 202626 minS2

  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 @drpatilsisodia Got 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 .

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