loader from loading.io

#374 - The evolutionary biology of testosterone: how it shapes male development and sex-based behavioral differences, | Carole Hooven, Ph.D.

The Peter Attia Drive

Release Date: 12/01/2025

#390 ‒ AMA #84: Family health history, preventing heart disease, metabolic health, strength training efficiency, dementia risk reduction, NAD supplements, and hydration show art #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...

info_outline
#389 - Thinking scientifically: why it's hard, why it matters, and a practical toolkit show art #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...

info_outline
#388 — Prostate cancer screening: why current PSA guidelines are failing men and how modern tools improve early detection and save lives show art #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...

info_outline
#387 - AMA #83: Peptides—evaluating the science, safety, and hype in a rapidly growing field show art #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,...

info_outline
#386 - Aging clocks—what they measure, how they work, and their clinical and real-world relevance show art #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...

info_outline
#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 show art #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...

info_outline
#384 - Special episode — Obicetrapib: The CETP inhibitor with cardiovascular benefits and potential Alzheimer's prevention show art #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...

info_outline
#380 ‒ The seed oil debate: are they uniquely harmful relative to other dietary fats? | Layne Norton, Ph.D. show art #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...

info_outline
#379 - AMA #79: A guide to cardiorespiratory training at any fitness level to improve healthspan, lifespan, and long-term independence show art #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...

info_outline
#378 ‒ Women’s health and performance: how training, nutrition, and hormones interact across life stages | Abbie Smith-Ryan, Ph.D. show art #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...

info_outline
 
More Episodes

View the Show Notes Page for This Episode

Become a Member to Receive Exclusive Content

Sign Up to Receive Peter’s Weekly Newsletter

Carole Hooven is a human evolutionary biologist whose research centers on testosterone, sex differences, and behavior. In this episode, she explores how prenatal testosterone orchestrates male development in the body and brain, how early hormonal surges shape lifelong behavioral tendencies, and what rare natural experiments—such as 5-alpha-reductase deficiency—reveal about the biology of sex differentiation. She discusses distinct male and female aggression styles through an evolutionary lens, how modern environments interact with ancient competitive drives, and the implications of attempting to suppress them. The conversation also covers testosterone across the lifespan, the role of hormone therapy in both men and women, and Carole’s own experience after surgical menopause, culminating in a broader discussion of masculinity, cultural narratives, and the consequences of denying biological sex differences.

We discuss:

  • How Carole became interested in exploring the biological and evolutionary roots of sex differences and the role of testosterone [2:30];
  • How testosterone and other hormones influence sex differences in aggression and behavior across species [9:45];
  • How chromosomes, the SRY gene, and early hormones direct embryonic sexual differentiation [12:15];
  • A stark contrast of male social bonding compared to females, and evolutionary parallels in chimpanzees [19:30];
  • How hormones like DHT shape sexual differentiation, and how 5⍺-reductase deficiency reveals the distinct roles of these hormones [22:45];
  • How sex chromosomes and prenatal testosterone shape early brain development and explain sex differences in childhood behavior [31:30];
  • How gamete differences shape reproductive strategies, energetic costs, and sex-specific behavior [42:30];
  • How evolutionary biology shapes sex differences in play, aggression, and conflict resolution (and how modern environments and cultural messaging can disrupt those patterns) [49:00];
  • Why males commit disproportionately more violent crime, and how cultural and environmental forces shape aggression [1:01:00];
  • Why females evolved different behavioral strategies: nurturing, risk aversion, and the cultural norms that override biology [1:04:00];
  • Whether male aggression is still necessary in modern society, why the underlying biological drives persist, and how modern society redirects these drives [1:06:30];
  • How testosterone levels naturally shift to support fatherhood and caregiving [1:13:30];
  • How testosterone shapes male mating strategies, and why long-term pair-bonding persists even when reproduction is no longer at stake [1:18:30];
  • The distinct roles of estrogen in male development, mood, libido, and muscle [1:25:00];
  • How evolution, health, lifestyle, and androgen receptor biology shape modern testosterone replacement therapy (TRT) [1:34:15];
  • Carole’s experience with hormone replacement therapy (HRT), and the risks associated with TRT in younger men [1:45:15];
  • How Carole rebuilt after controversy: leaving academia and recommitting to scientific honesty [1:51:30,];
  • Carole’s next book: examining masculinity, cultural narratives, and the cost of denying biological sex differences [1:57:30]; and
  • More.

Connect With Peter on TwitterInstagramFacebook and YouTube