Gyno Gurus Podcast

Alexandra MacLean, WHNP-BC, and Peter Mandel, MD, FACOG, are women’s health clinicians and co-hosts dedicated to translating medical evidence into clear, practical guidance. Their conversations help listeners understand their bodies, ask better questions, and make confident decisions—without the jargon.  

Episodes

PCOS IS EXTINCT!!!

May 27, 2026

May 27, 2026

21 min

In this episode of the Gyno Gurus Podcast, we break down the emerging concept of PMOS (Polyendocrine Metabolic Ovarian Syndrome) and why many experts believe the term “PCOS” may no longer fully capture what’s really happening in the body. We explore how genetics, epigenetics, insulin resistance, brain signaling, ovarian dysfunction, and androgen excess may all converge through different pathways to create the same clinical syndrome. From LH dysfunction and theca cell overstimulation to fasting insulin, AMH, and lipid abnormalities, this episode takes a deeper look into the true pathophysiology behind “PMOS.” Whether you’re struggling with irregular cycles, infertility, or metabolic dysfunction — understanding the why behind the condition changes everything.
 
Chapters:
00:00 PCOS is No More
05:52 Pathophysiology of PMOS
10:09 Understanding the Underlying Causes
12:13 PCOS vs PMOS, Does it Really Matter?
14:09 Markers of PMOS: LH/FSH Ratio, AMH, Fasting Insulin Levels, Dyslipidemia
19:58 Final Thoughts
 
In this episode we discuss:
• Epigenetics and fetal programming
• How PMOS may begin in the womb and brain
• LH dysregulation and ovarian signaling
• Theca cells and androgen overload
• Insulin resistance and hyperinsulinemia
• The “ovary-first” theory
• LH vs FSH ratios
• AMH and metabolic markers
• Different pathways leading to the same syndrome
 
If you enjoyed this episode, make sure to like, subscribe, and share with someone navigating PCOS/PMOS.
 
#PCOS #PMOS #InsulinResistance #Hormones #Fertility #WomensHealth #Endocrinology #Infertility #HormonalHealth #MetabolicHealth #GynoGurusPodcast

May 27, 2026

21 min

Mar 28, 2026

21 min

If you’ve ever been told you have PCOS—or think you might—you’re not alone… but you may not have gotten the full picture.
 
In Part 1 of this PCOS series, we break down what PCOS actually is (and what it isn’t), why it’s called a syndrome, and how it’s diagnosed in real clinical practice. We also dive into common symptoms, ultrasound criteria, and the metabolic connections that are often overlooked.
 
This episode is designed to give you a clear, evidence-based foundation—so you can better understand your body and advocate for the care you deserve.
 
🧠 What we cover:
What PCOS (Polycystic Ovarian Syndrome) really means
The difference between a disease vs a syndrome (and why it matters) Diagnostic criteria (including Rotterdam criteria)
How ultrasound findings factor into diagnosis
Common symptoms of PCOS
The link between Vitamin D & metabolic dysfunction
What may actually cause PCOS
The critical role of your provider in making the diagnosis
 
Chapters:
00:00 Introduction
01:30 PCOS = Polycystic Ovarian Syndrome
01:50 Disease vs Syndrome
04:33 How do we Diagnose PCOS?
05:22 Ultrasound Criteria for Diagnosis
08:15 PCOS Symptoms
10:02 Vitamin D Levels and Metabolic Dysfunction
12:12 What Causes PCOS?
16:02 Provider Role in Diagnosis
20:50 Next Week's Episode
 
📌 Who this is for:
Women diagnosed with PCOS
Anyone struggling with irregular cycles, acne, or hormonal symptoms
Clinicians who want a clearer framework for diagnosing PCOS
 
🔔 Don’t forget:
Subscribe for Part 2 + more evidence-based women’s health content from the Gyno Gurus Podcast
 
🧬 Disclaimer:
This content is for educational purposes only and is not medical advice. Always consult your healthcare provider for personalized care.

Mar 28, 2026

21 min

Jan 28, 2026

14 min

Is PMS really “all in your head”? 🤔
 
In this Fact or Fiction episode of the Gyno Gurus Women’s Health Podcast, we break down one of the most dismissive myths in women’s health—and replace it with actual physiology.
 
We dive into what’s really driving PMS and PMDD, from hormonal signaling and progesterone sensitivity to neurotransmitters like serotonin. We also explore evidence-based treatments (including SSRIs) and emerging options like low-dose naltrexone (LDN)—what’s backed by science, what’s overstated, and what deserves more research. If you’ve ever been told PMS is “just stress” or “in your head,” this episode is for you.
 
👇 Chapters below so you can jump right to what matters most to you.
Chapters:
00:00 Intro
00:34 PMS - It's All in Your Head?!
02:18 - Causes & Treatments of PMS & PMDD
06:44 - Progesterone & PMS
09:50 - SSRIs as a Treatment for PMS
10:58 - Our Final Assessment on PMS & PMDD
11:28 - Low Dose Naltrexone for PMS
 
🎧 Listen on Spotify & Apple Podcasts
📺 Watch on YouTube
📌 Subscribe for evidence-based women’s health, minus the myths Educational purposes only. Not medical advice.

Jan 28, 2026

14 min

Jan 12, 2026

25 min

Can you get pregnant on your period? Is Natural Family Planning only for women with “perfect” cycles? Does birth control protect—or harm—future fertility?
In this Fact or Fiction episode of the Gyno Gurus Podcast, we break down three of the most common fertility myths. We’ll walk through how the menstrual cycle actually works, why cervical mucus matters more than most people realize, how LH surge tracking fits into Natural Family Planning (NFP), and what the science really says about hormonal birth control and fertility. Whether you’re trying to conceive, avoiding pregnancy naturally, or just want to better understand your body—this episode is for you.
 
Chapters:
00:00 Intro
00:59 Fact or Fiction: You Can’t Get Pregnant on Your Period
02:19 What a Period Actual Is
04:10 Fact or Fiction: NFP is Only for Women with Regular Cycles
07:51 Physiology of Cervical Mucous 09:46 LH Surge Monitoring
10:46: More on Natural Family Planning
16:34: Factor or Fiction: Birth Control Makes You Infertile
19:59 Does “the Pill” Protect Fertility?
24:10 Final Thoughts and Next Episode
 
💡 Key topics covered:
Menstrual cycle physiology (without the fluff)
Fertile vs infertile windows
Cervical mucus as a biomarker
LH surge testing & ovulation timing
Natural Family Planning myths vs reality
Hormonal birth control and future fertility
 
📌 Subscribe for evidence-based women’s health education
🎧 Available on podcast platforms
💬 Drop your questions or future Fact or Fiction ideas in the comments

Jan 12, 2026

25 min

Dec 13, 2025

27 min

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections—but there’s a lot of confusion, fear, and misinformation surrounding it. In this episode of The Gyno Gurus Podcast, we break down HPV in a clear, evidence-based, and patient-centered way.
 
We cover what HPV actually is, how it’s tested, how it relates (and doesn’t always relate) to cervical cancer, and what prevention and treatment options currently exist—including the HPV vaccine (Gardasil) and commonly discussed supplements. We also answer the most common patient questions we hear in clinic and talk through how to navigate difficult conversations with partners.
 
Whether you’re a patient, clinician, or just want accurate information without the panic, this episode is for you.
 
Chapters:00:00 Intro00:57 What is Human Papillomavirus (HPV)?02:52 Pap Smear - How Do We Test?05:51 Primary Prevention and Gardasil07:17 Who Can Benefit from Gardasil?09:44 Safety Profile and Efficacy of Gardasil13:05 HPV Treatments - Pervistop, Vitamin D, & Papillex18:13 Patient Questions - Can You Get Rid of HPV?21:17 Patient Questions - Do I Need to Tell My Partner?22:05 Patient Questions - Does HPV Mean I Have Cervical Cancer?22:29 Patient Questions - Can I Test Positive for HPV After the Vaccine?23:31 Best Method of Prevention & Difficult Conversations25:33 Final Thoughts
 
Study Referenced in the Podcast:
https://www.mdpi.com/1422-0067/26/11/5251
 
🎧 Listen to The Gyno Gurus Podcast on YouTube, Spotify, and Apple Podcasts
📚 Educational content only – always talk with your healthcare provider about your individual situation
👍 If this episode helped you, like, subscribe, and share with someone who might benefit
 
#HPV #Gardasil #WomensHealth #PapSmear #CervicalHealth #Gynecology #HPVVaccine #STIeducation #TheGynoGurus

Dec 13, 2025

27 min

Dec 6, 2025

26 min

Unlock the essentials of hypothyroidism, thyroid optimization, Hashimoto’s, and evidence-based treatment options in this deep-dive episode. Whether you're a clinician, patient, or someone trying to understand thyroid health, this video breaks everything down in a clear, practical way.
 
We cover the anatomy & physiology of thyroid regulation, the differences between TSH, T4, T3, and Reverse T3, and how treatment varies between T4-only therapy vs. combination T3/T4 therapy.
 
We also discuss supplements like Thyrommune, the proper role of iodine, and the controversial topic of baby aspirin in autoimmune disease.
 
Chapters:00:00 Intro00:57 What is Hypothyroidism?01:52 Importance of Optimal Thyroid Function05:05 Thyroid Function Regulation A&P11:29 Thyroid Testing: TSH, T4, T3, & Reverse T3 13:43 Hypothyroidism Treatments: Levothyroxine (T4) & T316:30 Hashimoto's Disease18:41 Supplements: Thyrommune & Iodine23:21: Autoimmune Disease & Baby Aspirin25:45 Closing Thoughts
 
Want to learn more? Check out this article on the role of Inositol in treating hypothyroidism:
https://pubmed.ncbi.nlm.nih.gov/34040582/
 
If you found this video helpful, like, subscribe, and share to help others learn about thyroid health!

Dec 6, 2025

26 min

Nov 15, 2025

28 min

The FDA has officially begun removing the long-standing Black Box warnings from Hormone Replacement Therapy (HRT) products — a major shift after more than two decades of confusion, fear, and misinformation. In this video, we break down what this change means, why it’s happening now, and how it impacts women using HRT for menopause symptom relief and long-term health.
 
We walk through the history, evidence, and the landmark Women’s Health Initiative (WHI) study, plus the crucial differences between types of estrogen, progesterone, and delivery routes (oral vs transdermal). If you want a clear, evidence-based understanding of this FDA update, this episode covers everything.
 
Chapters:
00:00 Intro
01:29 Historical Context of Hormone Replacement Therapy (HRT)
02:10 FDA Update on Black Box Warning
05:42 Benefits of HRT
14:23 Types of Estrogen and Progesterone
16:41 Women's Health Initiative Study
21:10 Importance of Medication Route
26:30 Closing Thoughts
 
🔍 What You’ll Learn
- Why the FDA is reversing course after 20+ years
- What the original Black Box warning meant
- How the WHI study was misinterpreted
- Differences between bioidentical vs synthetic hormones
- Why transdermal estrogen carries different risk profiles
- Evidence-based benefits of HRT for symptom relief, bone density, cardiovascular health, and more
- What this policy change means for women and clinicians moving forward
 
Links:
FDA Press Release:
https://www.fda.gov/news-events/press-announcements/hhs-advances-womens-health-removes-misleading-fda-warnings-hormone-replacement-therapy?utm_source=chatgpt.com
 
FDA Fact Sheet:
https://www.hhs.gov/press-room/fact-sheet-fda-initiates-removal-of-black-box-warnings-from-menopausal-hormone-replacement-therapy-products.html
 
#HRT #HormoneReplacementTherapy #FDAUpdate #MenopauseRelief #WomensHealth #BlackBoxWarning

Nov 15, 2025

28 min

Nov 2, 2025

43 min

In this episode, we break down three of the most talked-about tools in metabolic health — Allulose, Metformin, and GLP-1 agonists (like Ozempic) — and explore how each impacts insulin resistance, glucose regulation, and metabolic health. We start with a clear overview of insulin resistance, then dive deep into the science of Allulose, how Metformin improves mitochondrial and hepatic function, and why GLP-1s can be both revolutionary and risky for long-term weight management and glucose control.
Whether you're a clinician, patient, or health enthusiast, this video will help you understand how these interventions work individually — and when each might be the right choice.
 
Chapters:
00:00 Intro
01:07 Summary of Insulin Resistance
02:59 Allulose Explained
17:05 How Metformin Works
22:57 Ideal Patients for Metformin vs GLP-1
26:25 What is a GLP-1 (Ozempic)?
30:28 Benefits and Risks of GLP-1s
38:47 Summary of GLP-1s
 
Key Topics Covered:
How insulin resistance develops and why it matters
Allulose’s role in lowering blood sugar and supporting fat metabolism
Metformin’s cellular mechanisms and benefits
GLP-1 agonists like Ozempic, Wegovy, and Mounjaro — how they work and potential long-term effects
Personalized medicine: choosing between Metformin and GLP-1s
 
#InsulinResistance #Metabolism #BloodSugar #Diabetes #Allulose #Metformin #GLP1 #Ozempic #WeightLoss #GlucoseControl #MetabolicHealth #Hormones #Nutrition #HealthEducation #Type2Diabetes

Nov 2, 2025

43 min

Oct 19, 2025

24 min

🧠 Insulin Resistance: Exercise, Lifestyle, and Supplements (Myo-Inositol & Berberine)
 
In this episode, we break down how exercise, nutrition, and evidence-based supplements can improve insulin sensitivity and metabolic health. Learn how muscle mass, time-restricted feeding, and protein intake all play key roles — plus how myo-inositol, berberine, and allulose may support glucose control through real biological mechanisms. We also explore supplement quality control, cost considerations, and the long-term vision for sustainable metabolic health — beyond just blood sugar numbers. Whether you're an athlete, clinician, or just trying to reverse early insulin resistance, this deep-dive will give you actionable, science-based insights.
 
Chapters:
00:00 Intro
00:35 Muscle Mass and Insulin Sensitivity
02:24 Time Restricted Feeding
04:21 Importance of Protein & Exercise
08:39 Supplements - Myo-inositol, Berberine, & Allulose
11:23 Quality Control & Cost
16:09 Myo-inositol & Berberine Mechanism of Action
19:57 The Long Term Picture of Health
 
Check us out on Spotify & Instagram!
 
Keywords / Tags #InsulinResistance #MyoInositol #Berberine #MetabolicHealth #BloodSugar #PCOS #Exercise #Nutrition #Supplements #Fasting #Allulose #Longevity

Oct 19, 2025

24 min

Oct 11, 2025

17 min

In this Clinical Conversations episode, we bring insulin resistance to life through a real patient story — showing how disrupted blood sugar balance can ripple through a woman’s hormonal cycle.
We walk through her cycle charts, hormone patterns, and lab results, including fasting insulin, glucose, and OGTT with insulin response — uncovering how insulin resistance was silently affecting ovulation, progesterone, and overall menstrual health.
You’ll see how targeted treatment improved her symptoms, normalized her cycle, and restored hormonal balance — illustrating how metabolic health and reproductive health are deeply connected.
 
💡 In This Episode:
How insulin resistance shows up in menstrual cycles
What happens hormonally when cells stop responding to insulin
Key labs: fasting insulin, glucose, OGTTi, and more Real-world improvement after lifestyle and medical intervention
 
Chapters:
00:00 Intro
01:15 Patient Background
03:52 Baseline Menstrual Cycle Hormone Curves
04:55 Cycle #1
07:57 Cycle #2
08:41 Cycle #3
09:29 Patient Labs (Glucose & Insulin)
11:21 Oral Glucose Tolerance Test with Insulin Response (OGTTi)
13:23 Treatment
14:33 Post Treatment Cycle Tracking Results & Symptom Resolution
16:30 Final Thoughts
 
🎧 Listen to More Clinical Conversations:
Spotify: https://open.spotify.com/show/6Vr4aqUja6gyXH9vN515wA
Podbean: https://gynoguruspodcast.podbean.com/
YouTube: https://www.youtube.com/@GynoGurusPodcast
Apple Podcasts: https://podcasts.apple.com/us/podcast/gyno-gurus-podcast/id1842175238
 
📌 About Clinical Conversations:
This series connects real patient cases to the topics we’ve discussed on The Gyno Gurus Podcast — bridging the gap between medical science and real-life experiences. Each episode breaks down symptoms, labs, and treatment outcomes to help you see the physiology in action.
 
#InsulinResistance #HormoneHealth #MetabolicHealth #WomenHealth #BloodSugar #PCOS #ReproductiveHealth #ClinicalConversations #GynoGurus

Oct 11, 2025

17 min

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