The Peter Attia Drive

#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

364 snips
May 12, 2025
Dr. Rachel Rubin is a board-certified urologist and a leading expert on sexual health, particularly for women. She discusses the often-ignored complexities of women’s sexual health, hormonal changes during menopause, and the critical need for personalized hormone replacement therapy (HRT). Dr. Rubin clarifies misconceptions surrounding HRT and emphasizes the benefits of local vaginal therapies. She also highlights the significant health risks of menopause, including osteoporosis and cognitive decline, advocating for improved awareness and education in this field.
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INSIGHT

Perimenopause Hormone Fluctuations

  • Perimenopause features extreme hormone fluctuations, notably in estradiol levels.
  • These unpredictable swings cause diverse symptoms akin to an empty and overflowing gas tank.
INSIGHT

Progesterone Sensitivity Variation

  • Women have varying sensitivities to progesterone's effects during menstrual cycle changes.
  • This sensitivity relates to brain receptors and explains the diverse reactions to progesterone therapy.
INSIGHT

Health Risks Post-Menopause Without HRT

  • Postmenopausal women without hormone therapy face risks including osteoporosis, dementia, cardiovascular disease, and recurrent UTIs.
  • Hormonal decline significantly impairs genitourinary and systemic health beyond typical menopausal symptoms.
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