#374 - The evolutionary biology of testosterone: how it shapes male development and sex-based behavioral differences, | Carole Hooven, Ph.D.
Release Date: 12/01/2025
#377 ‒ Special episode: Understanding true happiness and the tools to cultivate a meaningful life—insights from past interviews with Arthur Brooks
The Peter Attia Drive
In this special episode of The Drive, Peter presents a curated “best of” conversation with bestselling author and previous guest Arthur Brooks, organized around four core themes: happiness itself, the forces that undermine it, the tools and practices that help cultivate it, and the courage required to live and love well. The episode brings together the most meaningful moments from two past interviews into a single, focused discussion that distills Brooks’ most insightful ideas and offers practical takeaways for building a life that's both successful and deeply happy. We discuss: ...
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#376 - AMA #78: Longevity interventions, exercise, diagnostic screening, and managing high apoB, hypertension, metabolic health, and more
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter tackles a wide-ranging set of listener questions spanning lifespan interventions, exercise, cardiovascular risk reduction, time-restricted eating, blood pressure management, hormone therapy, diagnostics, and more. Peter reveals the single most important lever for extending healthspan and lifespan, and explains how he motivates midlife patients using the Centenarian Decathlon framework. He discusses the importance of addressing high apoB and cholesterol even in metabolically healthy individuals with calcium scores of zero, how to manage high...
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#375 - Ketogenic diet, ketosis & hyperbaric oxygen: metabolic therapies for weight loss, cognition, Alzheimer’s & more | Dom D’Agostino, Ph.D.
The Peter Attia Drive
Dom D'Agostino is a neuroscientist and professor at the forefront of metabolic therapies, including ketogenic diets, exogenous ketones, and hyperbaric oxygen. In this episode, Dom breaks down nutritional versus supplemental ketosis, defines meaningful ketone thresholds, and outlines practical ways to achieve ketosis. He explains how a ketogenic diet can support metabolic health and weight loss, and advises on how to maintain adequate protein and avoid common mistakes. Dom surveys the growing landscape of exogenous ketones—from salts and esters to 1,3-butanediol—and effective pairings...
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#374 - The evolutionary biology of testosterone: how it shapes male development and sex-based behavioral differences, | Carole Hooven, Ph.D.
The Peter Attia Drive
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...
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The impact of gratitude, serving others, embracing mortality, and living intentionally | Walter Green (#288 rebroadcast)
The Peter Attia Drive
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The Peter Attia Drive
Antonio Bianco is a world-renowned physician-scientist and expert in thyroid physiology and metabolism. In this episode, Antonio explores the complex biology of thyroid hormone production, conversion, and regulation—highlighting how deiodinase enzymes modulate hormone activity at the tissue level and why that matters for interpreting lab results. He discusses the shortcomings of relying solely on TSH as a marker of thyroid function, the ongoing debate around combination therapy with T3 and T4 versus standard T4 treatment, and how genetics, tissue sensitivity, and individual variability...
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#372 - AMA #77: Dietary fiber and health outcomes: real benefits, overhyped claims, and practical applications
The Peter Attia Drive
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#371 – Women’s sexual health: desire, arousal, and orgasms, navigating perimenopause, and enhancing satisfaction | Sally Greenwald, M.D., M.P.H.
The Peter Attia Drive
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...
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Longevity 101: a foundational guide to Peter’s frameworks for longevity, and understanding CVD, cancer, neurodegenerative disease, nutrition, exercise, sleep, and more (re-broadcast)
The Peter Attia Drive
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#370 - AMA #76: Peter evaluates longevity drugs, aspirin for CVD, and strategies to improve muscle mass — proven, promising, fuzzy, noise, or nonsense?
The Peter Attia Drive
In this “Ask Me Anything” (AMA) episode, Peter revisits the “proven, promising, fuzzy, noise, nonsense” scale and applies it to a variety of popular topics. He begins with a refresher on what each category represents before classifying a range of interventions based on the strength of their supporting evidence. The conversation spans three main areas: drugs for geroprotection (including GLP-1 receptor agonists, SGLT2 inhibitors, methylene blue, and telomere-lengthening supplements), the use of low-dose aspirin for cardiovascular disease prevention, and strategies to improve muscle...
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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.
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