Interview with Lori Harvey, Model & Entrepreneur: The Silent Struggles Behind PCOS & Endometriosis

Dr. Thais Aliabadi and Mary Alice Haney sat down with Lori Harvey and Dr. Thaïs Aliabadi to unpack a topic that too many of us have been taught to accept as “normal” — but shouldn’t: the lived reality of PCOS and endometriosis. Lori shared her personal story of misleading medical encounters, the moment she finally got the right diagnosis, and the treatments and lifestyle shifts that helped her reclaim her body. Dr. Aliabadi, an OBGYN with decades of clinical experience, explained the biology underneath these conditions and the practical, evidence-informed approach she uses to treat them.

Table of Contents

• Why this conversation matters
• Interview
• Practical takeaways we want every reader to keep
• FAQ
• Final thoughts

Why this conversation matters

When symptoms show up in our teens — painful periods, acne, weight fluctuations, unexplained fatigue — many are told to tough it out. That message creates a culture of silence and self-blame. We learned from Lori and Dr. A that early recognition, the right tests, and a joint treatment plan change lives. The deeper point is simple: ignoring symptoms or normalizing severe pain and metabolic changes does not protect anyone. Education does.

Interview

How did you finally get diagnosed with PCOS and endometriosis?

Lori: We got to the diagnosis because of persistence and the right clinician. I had been seeing doctors for years and constantly being told, “you’re fine.” I knew something was off — the pain, the cycles, the hormonal symptoms — and my mom suggested seeing Dr. A. From that first appointment, the difference was immediate. Dr. A listened, ran the right tests, and told me I had both PCOS and endometriosis. It changed my life.

Dr. A: Listening is the single most important diagnostic tool. Too often, women are told their pain is normal. When we actually ask targeted questions, run appropriate blood work and imaging, and listen to the clinical story, the diagnosis becomes clear. That was the case here: ultrasound confirmed an endometrioma, lab tests and history pointed to PCOS, and clinical correlation tied everything together.

What were the symptoms you noticed first, and when did they start?

Lori: My symptoms began in my teens, around 16. I had excruciating cramps that could have landed me in the hospital, acne that never seemed to improve, mood fluctuation, and confusing weight changes. I was dieting and working out hard, and still would gain significant weight after a short break. I also had occasional long coarse hairs that made me question what was happening hormonally.

Dr. A: This pattern is common. Many patients report symptoms beginning in adolescence — painful periods, acne, irregular cycles, weight swings, hair changes. Those early years are critical because the teen is trying to understand her body and is most vulnerable to developing disordered eating and unhealthy relationships with exercise when symptoms are dismissed.

What is PCOS? Can you explain the core systems involved?

Dr. A: PCOS is not one single problem; it is a syndrome that emerges from interacting systems. We describe four core systems that commonly interact in PCOS:

• The brain-ovary axis: This is the hormonal signaling between the brain and the ovaries. In many people with PCOS, the brain secretes more luteinizing hormone (LH) relative to follicle-stimulating hormone (FSH). That imbalance nudges the ovaries to produce more androgens such as testosterone, which impacts periods, acne, and hair growth.
• Insulin resistance: At its core, many people with PCOS do not handle carbohydrates the same way as others. When insulin rises, and receptors are less responsive, the body stores more sugar as fat, and the high insulin environment stimulates ovarian androgen production. That contributes to weight gain, hair and skin changes, and irregular cycles.
• Chronic inflammation: PCOS is associated with a low-grade inflammatory state. Inflammation itself drives more androgen production and makes metabolic control harder. Reducing inflammation is a pillar of treatment.
• Gut dysbiosis: Imbalances in the gut microbiome and increased intestinal permeability — often called “leaky gut” — are common. When the gut barrier weakens, harmful substances can enter circulation, provoke inflammation, and worsen insulin resistance.

All four systems interact. For example, gut dysbiosis can increase inflammation, which worsens insulin resistance, which then fuels ovarian androgen output. That explains why patients with similar diagnoses have different dominant symptoms.

How does insulin resistance actually cause so many of the symptoms people with PCOS experience?

Dr. A: The mechanism is straightforward to understand. When you eat carbohydrates, they are digested into glucose. In response, the pancreas releases insulin. Insulin signals cells to open receptors, take up glucose, and convert it to energy. In insulin resistance, those receptors become less responsive. The sugar stays in the blood, and insulin levels rise to compensate.

High insulin levels do two things that matter in PCOS:

1. They tell the body to store energy as fat, which helps explain weight gain and difficulty losing weight even with diet and exercise.
2. They stimulate the ovaries to produce more androgens such as testosterone, which causes irregular periods, acne, body and facial hair, and even hair loss on the scalp.

So insulin resistance is central. That is why treatments that improve insulin sensitivity often have dramatic effects — metabolic balance improves, and the overproduction of androgens eases.

Metformin is often prescribed. What does it do for PCOS, and is it safe?

Dr. A: Metformin helps reverse insulin resistance. Think of it as flipping a metabolic switch back toward energy burning rather than fat storage. It helps move glucose into cells, similar to the effect of exercise, and can lower appetite in some patients. For many people with PCOS, it produces a striking improvement in energy, metabolic control, and the downstream hormonal symptoms. Clinically, many patients call it “oxygen on their face” because they notice improvement quickly.

It is generally safe and well-studied. Side effects — mainly gastrointestinal — can happen on initiation, which is why patient education, gradual titration, and understanding the “why” increases adherence. Metformin also modestly affects the gut microbiome, which can be helpful, but it is not a stand-alone solution. We pair it with diet, exercise, and targeted therapies for inflammation or gut issues when needed.

What other medical and non-medical treatments are effective?

Dr. A: Effective care for PCOS is multimodal. The treatments we commonly use include:

• Combined hormonal strategies: Birth control pills regulate the brain-ovary axis, reduce androgen effects, and help control abnormal bleeding and pain for many patients. They are symptomatic treatment for the hormonal imbalance.
• Insulin-sensitizing agents: Metformin is the most common. In some cases, other agents or lifestyle approaches emphasizing carbohydrate timing and quality can help.
• Anti-inflammatory strategies: Both systemic and targeted approaches. Diets rich in anti-inflammatory foods, supplements with evidence for reducing inflammation, and certain medications, when indicated, are all tools we use. Dr. A developed OV to include specific ingredients aimed at inflammation, metabolic health, and hormone balance.
• Gut-directed treatments: If bloating or GI symptoms exist, we test for small intestinal bacterial overgrowth (SIBO). When SIBO is present, targeted antibiotics such as rifaximin sometimes in combination with other agents, plus a low-FODMAP approach initially, can reduce bacterial overgrowth and systemic inflammation.
• Surgical care when needed: For endometriosis, laparoscopy remains the gold standard to identify and remove implants. But surgery must be paired with suppression strategies to avoid recurrence.
• Lifestyle and therapeutic exercise: Not all exercise is equal. While vigorous exercise has benefits, high-intensity, high-volume training can increase inflammation for some patients. Low-impact, consistent routines like Pilates can reduce inflammatory load while improving tone and metabolic health. Sleep, stress reduction, and targeted nutrition matter just as much.

What is endometriosis and how does it relate to PCOS?

Dr. A: Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus — commonly on the ovaries, fallopian tubes, the pelvic lining, and sometimes on bowel or other pelvic organs. These implants respond to hormonal cycles; every menstrual cycle they can bleed and create local inflammation. When an implant grows inside the ovary, it can form a cyst called an endometrioma, often described as a “chocolate cyst” because the old blood looks like melted chocolate when removed.

Endometriosis and PCOS can coexist. In fact, literature suggests a large overlap — and in our experience the prevalence of endometriosis is higher than many standard estimates. Endometriosis creates pelvic inflammation, which worsens gut function and systemic inflammation, which in turn worsens insulin resistance. That vicious cycle explains how the two conditions can amplify infertility risk and decline ovarian health when untreated.

How is an endometrioma diagnosed and treated?

Dr. A: When endometriosis is inside the ovary, it often has a distinct appearance on ultrasound. A skilled ultrasonographer can identify these cysts reliably. If an endometrioma is detected, especially in a young patient, early surgical removal is often recommended because these cysts can damage ovarian tissue over time.

Laparoscopic surgery allows us to remove implants, free adhesions, and preserve normal ovarian tissue where possible. Importantly, surgery is only the first step. If a patient is sent home without a suppression strategy, recurrence within months to a few years is common. For that reason, we combine surgery with hormonal suppression, metabolic control, and inflammation-targeted therapy to reduce recurrence and preserve fertility.

How does endometriosis affect fertility differently than PCOS?

Dr. A: They impair fertility through different, sometimes overlapping, mechanisms. PCOS often presents with many eggs but lower egg quality related to the hormonal and metabolic milieu. Endometriosis can physically damage ovarian tissue and the fallopian tubes, scar tissues, and obstruct ovum pickup — all structural threats to fertility. If endometriosis has destroyed ovarian tissue — as we’ve seen in women in their late 30s — egg numbers and quality can decline dramatically.

The good news is when endometriosis is controlled, and PCOS hormonal imbalances are addressed, many patients conceive naturally. For those planning for future family-building, egg freezing is an important insurance policy, especially for younger patients who want to delay pregnancy. However, egg freezing is expensive and often out of reach for many people when their eggs are healthiest. That gap is a public health and equity issue we all feel strongly about.

Should people with endometriosis get their ovaries removed at menopause?

Dr. A: This requires individualized discussion. After menopause the ovaries no longer function in the reproductive sense. Endometriosis feeds on estrogen, so removing ovaries after menopause can reduce the small risk that endometriosis-related ovarian pathology could later transform into certain ovarian cancers, particularly the clear cell and endometrioid subtypes. In my practice I often recommend removing ovaries after natural menopause in patients with a significant history of endometriosis. If we do remove ovaries and the patient needs hormone replacement for menopausal symptoms, we use estrogen combined with progesterone carefully because unopposed estrogen can stimulate endometriosis implants.

What does real, everyday self-care look like for someone managing PCOS and endometriosis?

Lori: For me the non-negotiables are reducing inflammation and supporting my gut. I get lymphatic drainage regularly to help reduce swelling, I follow an anti-inflammatory diet — bone broth in the mornings is something I do for gut repair — and I do low-impact workouts like Pilates. That saved me. After years of high-impact, heavy training that left me inflamed, the shift to Pilates made me leaner and less reactive.

Dr. A: Those practical steps align perfectly with the core targets we want to address: reduce inflammation, restore metabolic function, improve gut health, and balance hormones. We also emphasize regular monitoring, clear communication about medication side effects, and understanding the “why” behind each treatment so patients are more likely to stay consistent.

How do we change the culture of dismissal and make diagnosis more equitable?

Dr. A: First, we must teach clinicians to listen and to suspect these conditions rather than normalize pain. Second, we need screening tools in primary care and adolescent medicine so symptoms get evaluated early. Third, we must expand access to fertility preservation and ensure people get information about their reproductive lifespan in their 20s and 30s. Finally, public education and advocacy — celebrities and patients talking openly — destigmatize these conditions and make people seek help sooner.

Lori: We have responsibility as public figures and as women to use our platforms to normalize these conversations. If one young person recognizes she isn’t alone and gets care earlier, this whole system of silence breaks down. We all deserve to feel at home in our bodies.

Practical takeaways we want every reader to keep

• Severe period pain is not something you must accept. If you are consistently debilitated by cramps, ask for evaluation for endometriosis and other causes. Push for an ultrasound when appropriate.
• PCOS often begins in the teens. When acne, irregular cycles, weight changes, and new hair growth appear together, consider hormonal evaluation.
• Insulin resistance is central. Addressing carbohydrate handling through medication, diet, and exercise can dramatically improve symptoms.
• Gut health matters. Gut dysbiosis and SIBO worsen inflammation and metabolic dysfunction. If you have bloating or GI symptoms, ask your clinician about testing.
• Treatment is multimodal. Surgery, medication, diet, lifestyle, and sometimes targeted antibiotics all play roles. One single therapy rarely fixes everything.
• Be your own health advocate. Understand why a treatment is recommended, track how you feel, and keep pursuing answers if symptoms persist.
• Consider fertility planning early. If family-building timing is uncertain, discuss egg freezing and other options while egg quality is higher. We acknowledge the barriers and costs; advocacy for broader access is critical.

FAQs

What are the most common symptoms of PCOS?

Common symptoms include irregular or absent periods, heavy periods in some cases, acne, increased facial or body hair, hair thinning on the scalp, weight gain or difficulty losing weight, fatigue, and mood changes. Symptoms often begin in adolescence and vary widely by person.

Can you have PCOS and endometriosis at the same time?

Yes. Coexistence is common. PCOS and endometriosis can interact through systemic inflammation and gut dysbiosis, making symptom burden higher. Each condition requires targeted care, and when both are present we intentionally treat metabolic, hormonal, inflammatory, and structural issues.

How useful is ultrasound for diagnosing endometriosis?

Ultrasound is very useful when endometriosis forms visible cysts in the ovary (endometriomas). A skilled ultrasonographer will detect these reliably. However, small implants on the pelvic lining or bowel may not show on ultrasound; clinical judgment and sometimes diagnostic laparoscopy remain important.

What is SIBO and why is it tested in PCOS patients?

SIBO stands for small intestinal bacterial overgrowth. It occurs when bacteria proliferate in the small intestine where they do not normally dominate. Symptoms include bloating, gas, irregular bowel habits, and nutrient malabsorption. SIBO increases systemic inflammation and worsens insulin resistance. In patients with bloating or GI symptoms, testing and treating SIBO can improve overall PCOS symptoms.

Is metformin appropriate for everyone with PCOS?

Metformin is a common, generally safe treatment for insulin resistance and is widely used in PCOS care. It is particularly helpful when metabolic dysfunction or glucose intolerance is present. However, individual tolerability and medical history determine suitability. Always discuss with a clinician to review benefits, side effects, and monitoring plans.

When should I consider egg freezing?

Egg freezing is an individual decision influenced by age, ovarian reserve, medical history (including PCOS or endometriosis), relationship status, career plans, and financial considerations. For those with PCOS and preserved ovarian reserve, freezing earlier preserves higher-quality eggs. Speak with a fertility specialist to review ovarian reserve testing and timing. We also advocate for broader access and clearer public information so people can make informed choices long before urgent decisions are required.

How can I advocate for myself when a clinician dismisses my symptoms?

Document your symptoms: frequency, severity, and how they interfere with daily life. Ask specific questions about possible causes, request targeted labs (hormone levels, metabolic markers) and imaging when appropriate, and seek a second opinion if you feel dismissed. Bringing a trusted person to appointments, using patient portals to share concerns in writing, and preparing a focused list of questions can all help ensure you are heard.

Final thoughts

We are committed to breaking the silence around reproductive health conditions that disproportionately affect women. Lori’s story is a reminder that a right diagnosis, compassionate care, and a comprehensive treatment plan can restore confidence and function. Dr. Aliabadi’s clinical framework — target the brain-ovary axis, reverse insulin resistance, reduce inflammation, and restore gut health — gives us a practical roadmap.

When symptoms appear, especially in adolescence, we must listen. When clinicians fail to listen, we must persist. And as a community we must advocate for better education, earlier screening, and equitable access to fertility preservation. These are not just medical issues. They are human ones.

We hope this interview arms you with knowledge, practical steps, and the courage to demand the care you deserve.

This article was created from the video Lori Harvey Shares the Silent Struggles Behind PCOS & Endometriosis | SHE MD for Dr. Thais Aliabadi’s website.