#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
#404 ‒ Mental health beyond neurotransmitters: the role of hormones in psychiatry, why symptom reduction isn't enough, and the future of psychedelic therapies | Linus Abrams, M.D.
The Peter Attia Drive
In this episode, Peter sits down with Dr. Linus Abrams, a psychiatrist with nearly 35 years of clinical experience specializing in mood disorders and psychopharmacology, to explore how our understanding of mental health is evolving beyond the traditional neurotransmitter model. After decades in practice, Linus began questioning many of the assumptions underlying modern psychiatry, leading him to investigate how hormones, metabolism, inflammation, circadian biology, and the endocrine system shape mood and cognition. Together, Peter and Linus examine why psychiatric care should aim not only...
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#403 ‒ Peptides: separating scientific promise from marketing hype
The Peter Attia Drive
In this episode, Peter returns to the topic of peptides, offering a clear and accessible guide to a field surrounded by both genuine scientific promise and widespread misinformation. Peptides are increasingly marketed for everything from injury recovery and muscle growth to longevity and improved appearance, often with claims that extend far beyond the available evidence. Rather than promoting or dismissing peptides as a category, Peter presents a practical framework for evaluating any peptide: what it is, how it is supposed to work, and where the science is strong, weak, or simply absent....
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#402 ‒ NMR blood analysis: how heart disease risk, insulin resistance, inflammation, and mortality risk can be assessed from a single blood sample | Jim Otvos, Ph.D.
The Peter Attia Drive
Jim Otvos is a biophysical chemist who pioneered the use of nuclear magnetic resonance (NMR) spectroscopy to measure lipoprotein particles and developed the first FDA-cleared method for directly quantifying LDL particle number (LDL-P), a technology that has since expanded to provide broader insights into metabolic health, inflammation, insulin resistance, and mortality risk. In this episode, Jim recounts the unlikely story of transforming a flawed cancer test into a new way of measuring lipoproteins, explains what standard cholesterol tests can miss and why LDL-P and apoB can inform...
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#401 ‒ How curiosity transforms medicine: extraordinary discoveries that changed modern healthcare
The Peter Attia Drive
In this episode of The Drive, Peter explores how seemingly obscure basic science discoveries have laid the foundation for some of the most important medical breakthroughs of the past half century. Rather than focusing on the clinical applications of modern therapies, he traces the fascinating stories behind the scientists, experiments, and unexpected discoveries that ultimately led to transformative drug classes, revealing how groundbreaking advances often emerge from research with no obvious clinical goal. Through these historical case studies, Peter provides a new perspective on the...
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#400 ‒ AMA #87: Environmental pollution and longevity: air pollution, noise, light, EMFs, and practical strategies to mitigate health risks
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter explores the evidence behind environmental pollution and its impact on long-term health, separating well-supported risks from less substantiated claims while providing a practical framework for deciding which exposures deserve attention. He explains what environmental pollution encompasses, where it fits within the broader hierarchy of longevity interventions, and why studying its health effects is uniquely challenging. Peter examines the evidence linking air pollution to disease and shares actionable strategies for improving indoor and...
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#399 ‒ The evolution of Alzheimer's disease and dementia care: how early detection, personalized treatment, new therapies, and a multimodal approach are changing the landscape | Gayatri Devi, M.D.
The Peter Attia Drive
Gayatri Devi is a nationally recognized neurologist specializing in memory disorders, including Alzheimer’s disease and related dementias. In this episode, Gayatri explains how to think about dementia as a spectrum—including Alzheimer’s disease, vascular dementia, Lewy body dementia, and mixed presentations—while exploring the evolving biology of amyloid, tau, and neuroinflammation and why brain pathology does not always correlate with symptoms. She discusses her approach to detecting subtle cognitive decline in high-functioning individuals, the role of biomarkers and APOE4 testing...
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Building strength and muscle mass: how to optimize training, nutrition, and more for longevity (AMA #71 rebroadcast)
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter dives deep into the topic of muscle mass and strength, examining their essential roles in both lifespan and healthspan. Drawing from over 30 hours of prior discussions with experts including Layne Norton, Andy Galpin, and Mike Israetel, this episode distills the most important insights into one comprehensive and up-to-date conversation. Peter explores why muscle matters for longevity, metabolic health, and injury prevention, and clarifies the differences between muscle mass and strength, including which is more vital for aging well. He...
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#398 ‒ AMA #86: GLP-1 RAs and muscle loss: new data, better questions, and how to preserve muscle during weight loss
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter explores the effects of GLP-1 receptor agonists—including drugs such as Ozempic, Wegovy, and Zepbound—with a particular focus on their impact on muscle. He examines how much lean mass people actually lose during treatment and how those changes compare to weight loss achieved through other methods, while explaining why measurements of lean mass on DEXA scans can sometimes be misleading. Peter discusses the effects of these medications on bone mass, fracture risk, strength, and physical function, highlighting why functional outcomes may...
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#397 ‒ Endometriosis and adenomyosis: diagnosis, fertility, reproductive aging, and emerging treatments | Renato Tomioka, M.D., Ph.D.
The Peter Attia Drive
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#396 ‒ Breast cancer screening: understanding risk, deciding when to start and how often to screen, and choosing the right imaging strategy
The Peter Attia Drive
In this episode, Peter explores the critical topic of breast cancer screening, examining why thousands of women continue to die from breast cancer each year despite the availability of effective screening tools. He explains the strengths and limitations of current screening strategies, reviews the recommendations from major medical organizations, and discusses why screening guidance can often seem confusing or contradictory. Peter outlines a practical framework for understanding breast cancer risk and personalizing screening decisions, including when to begin screening, how frequently to...
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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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