Dr. Peter Attia

So while I appreciate that your breadth of knowledge will cover both sexes, you'll probably notice kind of a bias in what I want to talk about vis-a-vis women specifically. So let's start with perhaps the biggest and most obvious difference between men and women.

So while I appreciate that your breadth of knowledge will cover both sexes, you'll probably notice kind of a bias in what I want to talk about vis-a-vis women specifically. So let's start with perhaps the biggest and most obvious difference between men and women.

And that is from an endocrine perspective, women go through this period called menopause, which is a rather sudden and abrupt loss of their sex hormones. And that's to be contrasted with the way men's sex hormones decline over time a little more slowly.

And that is from an endocrine perspective, women go through this period called menopause, which is a rather sudden and abrupt loss of their sex hormones. And that's to be contrasted with the way men's sex hormones decline over time a little more slowly.

So again, the listeners of this podcast are highly erudite and they won't need the lengthy dissertation, but just give us a quick overview of what the heck is happening in menopause. Why is it happening? And then we can get into maybe what some of the symptoms are before women might really notice them.

So again, the listeners of this podcast are highly erudite and they won't need the lengthy dissertation, but just give us a quick overview of what the heck is happening in menopause. Why is it happening? And then we can get into maybe what some of the symptoms are before women might really notice them.

I love that analogy. I've never heard it before, but it absolutely replicates what, of course, we see clinically, which is in perimenopause, why do we sometimes, when we're measuring a woman's labs, say every three months, see periods where estradiol is through the roof, FSH and LH are low, and three months later it's completely flipped, and of course with it go symptoms.

I love that analogy. I've never heard it before, but it absolutely replicates what, of course, we see clinically, which is in perimenopause, why do we sometimes, when we're measuring a woman's labs, say every three months, see periods where estradiol is through the roof, FSH and LH are low, and three months later it's completely flipped, and of course with it go symptoms.

So can you explain why there's this, if we have hormones running like this during pre-menopause, They're like this during menopause, but this transition is nothing linear.

So can you explain why there's this, if we have hormones running like this during pre-menopause, They're like this during menopause, but this transition is nothing linear.

And what I'd like to do now is make sure that anybody listening who wants a more nuanced overview of this, we're going to link to a video that I made a couple of years ago where I walk through the ovulatory cycle and I draw the graph of estrogen. progesterone, FSH, and LH, according to the nomenclature you're using by days.

And what I'd like to do now is make sure that anybody listening who wants a more nuanced overview of this, we're going to link to a video that I made a couple of years ago where I walk through the ovulatory cycle and I draw the graph of estrogen. progesterone, FSH, and LH, according to the nomenclature you're using by days.

But let's also have you do an explanation now of the role of FSH and LH on the brain, because you've already referred to that, and what the feedback cycle looks like with estrogen. I just want to make sure people are following the physiology you're describing.

But let's also have you do an explanation now of the role of FSH and LH on the brain, because you've already referred to that, and what the feedback cycle looks like with estrogen. I just want to make sure people are following the physiology you're describing.

And again, just to make the obvious statement, it's because most of the time when a woman ovulates, she does not get pregnant.

And again, just to make the obvious statement, it's because most of the time when a woman ovulates, she does not get pregnant.

Yeah, a lot of my patients don't read the book about what their physiology is supposed to do. It's very disappointing.

Yeah, a lot of my patients don't read the book about what their physiology is supposed to do. It's very disappointing.

So let's talk about why. So why is it that in perimenopause, the fluctuations in estradiol level are so dramatic?

So let's talk about why. So why is it that in perimenopause, the fluctuations in estradiol level are so dramatic?