#371 – Women’s sexual health: desire, arousal, and orgasms, navigating perimenopause, and enhancing satisfaction | Sally Greenwald, M.D., M.P.H.
Release Date: 11/03/2025
#390 ‒ AMA #84: Family health history, preventing heart disease, metabolic health, strength training efficiency, dementia risk reduction, NAD supplements, and hydration
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter answers listener questions across a wide range of topics, focusing on how to think through real-world trade-offs and apply scientific evidence in practice. He explores how to build and interpret a meaningful family health history, how individual risk tolerance influences decisions around testing and treatment, and why heart disease remains poorly prevented despite available tools. He also examines whether it’s possible to carry excess body fat while remaining metabolically healthy, outlines the minimum effective dose for strength training...
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#389 - Thinking scientifically: why it's hard, why it matters, and a practical toolkit
The Peter Attia Drive
In this episode, Peter explores one of the most foundational topics underlying nearly everything discussed on the podcast: how to think scientifically. Framed as an introspective deep dive, he examines why scientific thinking is inherently difficult for humans, the cognitive biases and tendencies that make it challenging to separate belief from evidence, and why these challenges are even more consequential in today’s environment saturated with misinformation. He also offers a framework for improving our ability to evaluate claims, question assumptions, and identify a personal panel of...
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#388 — Prostate cancer screening: why current PSA guidelines are failing men and how modern tools improve early detection and save lives
The Peter Attia Drive
In this episode, Peter takes a deep dive into prostate cancer screening, explaining why advanced and metastatic diagnoses continue to rise despite the availability of screening tools, and what can be done to reverse this trend. He breaks down what PSA actually measures and why it is far more informative when tracked over time rather than interpreted as a single value, and he explores how tools like MRI, PSA density, PSA velocity, and improved biopsy techniques can both reduce unnecessary procedures and improve the detection of aggressive cancers. Peter also discusses the role of active...
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#387 - AMA #83: Peptides—evaluating the science, safety, and hype in a rapidly growing field
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter explores the topic of gray-market peptides, one of the most requested and most confusing topics he’s covered on The Drive. Peptides sit at the intersection of biological plausibility, clinical promise, and aggressive commercialization, and are often marketed as cutting-edge therapies for everything from muscle repair and longevity to cosmetic enhancement. Rather than promoting or dismissing peptides wholesale, Peter lays out a clear, repeatable framework for evaluating any peptide or drug—covering mechanism, intended effects, safety,...
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#386 - Aging clocks—what they measure, how they work, and their clinical and real-world relevance
The Peter Attia Drive
In this episode, Peter takes a deep dive into the science and application of aging clocks, unpacking what they are, the differences between chronological age, biological age, and the pace of aging, and what epigenetic clocks may actually be measuring. He explores key research in the field, including a randomized controlled trial that tested simple lifestyle interventions against several commonly used aging clocks, as well as a study using brain MRI to assess the pace of aging and its relationship to dementia risk and mortality. Throughout the episode, Peter highlights the promises and...
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#385 - AMA #82: Applying the tools of longevity in the real world: disease prevention, DEXA scans, artificial sweeteners, injury recovery, stability training, habit formation, protein intake and mTOR activation, and more
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter answers listener questions across a wide range of topics, focusing on practical decision-making and real-world application. He explores how health priorities and strategies should evolve across different decades of life, which chronic diseases are most challenging to manage and how to think about risk hierarchies, and which emerging interventions—beyond exercise—show the most promise for dementia prevention. Peter also breaks down the utility of wearables and explains how to use and interpret DEXA scans effectively. He discusses the...
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#384 - Special episode — Obicetrapib: The CETP inhibitor with cardiovascular benefits and potential Alzheimer's prevention
The Peter Attia Drive
In this special episode, Peter takes a deep dive into obicetrapib, an investigational drug that has captured his attention and renewed interest in an entire class of therapies known as CETP inhibitors. He explains what obicetrapib is and how it works, revisits the history of CETP inhibitors and why earlier versions of these drugs failed—sometimes dramatically—and breaks down the key clinical trials designed to evaluate their impact on cardiovascular risk. Peter examines how obicetrapib influences major lipid biomarkers, including LDL cholesterol and lipoprotein(a) [Lp(a)], and discusses...
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#380 ‒ The seed oil debate: are they uniquely harmful relative to other dietary fats? | Layne Norton, Ph.D.
The Peter Attia Drive
Layne Norton is a nutrition scientist and accomplished power athlete,who returns to The Drive for a conversation that departs from the show’s usual format. In this episode, Layne presents the evidence-based case that seed oils are not uniquely harmful under isocaloric conditions, while Peter steelmans the strongest versions of the opposing argument that seed oils are inherently harmful. They examine how scientific bias and evidence are evaluated, revisit the historical randomized controlled trials that shaped the seed oil controversy, and explore the mechanistic biology underlying LDL...
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#379 - AMA #79: A guide to cardiorespiratory training at any fitness level to improve healthspan, lifespan, and long-term independence
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter brings together his most up-to-date thinking on cardiorespiratory fitness into a single, practical guide designed to help listeners structure training for maximal impact on healthspan, lifespan, and long-term independence. He explains why cardiorespiratory fitness is one of the strongest modifiable predictors of longevity, clarifies what zone 2 training actually represents and how it differs from higher-intensity work, and addresses persistent confusion around exercise volume, intensity, and time constraints. The discussion covers how to...
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#378 ‒ Women’s health and performance: how training, nutrition, and hormones interact across life stages | Abbie Smith-Ryan, Ph.D.
The Peter Attia Drive
Abbie Smith-Ryan is a leading researcher in exercise physiology whose work focuses on how training and nutrition influence body composition, metabolism, cardiovascular health, and women’s health across the lifespan, with particular attention on perimenopause and post-menopause. In this episode, Abbie explains how early exercise and play help build the foundation for bone health, muscle development, and cardiorespiratory fitness in girls, as well as how puberty and menstruation shape athletic performance, motivation, and recovery. She also explores how women can tailor training and...
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Sally Greenwald is an OB-GYN who specializes in women’s sexual health from a hormonal and physiologic perspective, with expertise spanning desire, arousal, pelvic floor function, contraception, and menopause care. In this episode, she explains why sexual health is a vital component of overall well-being, exploring topics such as the drivers of desire, the anatomy of sexual function, myths and realities around orgasm, and the role of hormones in perimenopause and menopause. She also covers vaginal and pelvic health, pain with sex, evidence-based therapies for low desire and arousal, how contraception and medications can affect sexual function, and practical strategies for enhancing sexual satisfaction and maintaining intimacy across life stages. This episode offers a comprehensive, evidence-based discussion with immediate real-world relevance for women as well as for men who want to better understand their partners.
We discuss:
- How sexual health influences physical health, emotional well-being, and relationships [3:15];
- Understanding the physiology of the female orgasm, sexual comfort and satisfaction, and the disparity between men and women [12:45];
- Foreplay, the science of desire, and methods to help women cultivate arousal and connection [19:00];
- The physiology and sources of female lubrication, the role of clitoral nerve anatomy in pleasure, and the use of lubricants and vibrators to enhance comfort and sexual health [23:45];
- Understanding female anatomy and what is needed for orgasm [31:15];
- Understanding sexual desire, how to cultivate it, the role of hormones, and testosterone therapy in women [41:15];
- Personalizing perimenopause care: how desire for ovulation guides the choice between contraception and menopausal hormone therapy [49:30];
- Considerations for choosing contraceptives and hormonal therapies during perimenopause [59:45];
- Factors negatively affecting desire, and why female libido persists with age and fluctuates across the menstrual cycle [1:11:00];
- How sexual trauma and physical pain can affect sexual health, and evidence-based strategies for recovery [1:15:15];
- Vaginal care routine: lubricants, moisturizers, topical hormones, and other approaches for vaginal health [1:19:15];
- Tips for sexually satisfying your female partner [1:25:45];
- The pharmacology of arousal: various treatments for low sexual desire in women [1:30:30];
- Sex during and after pregnancy: impact on arousal, safety of sex, and how to manage postpartum recovery and pain [1:37:45];
- How Sally would redesign sex education [1:42:15];
- Sally’s optimism about a new era in women’s sexual health [1:49:00]; and
- More.
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