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Dr. Rachel Rubin

👤 Person
698 total appearances

Appearances Over Time

Podcast Appearances

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

I will tell patients, you need to do this regularly, and I think it's going to be three, four, even five months before you're going to really wake up and say, wow, this is working. Oh my gosh, someone just walked across the street and I did a cartoon style head turn with my eyes popped out of my head. Oh my gosh, I initiated sex. Wow, that orgasm was easier to have.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

I will tell patients, you need to do this regularly, and I think it's going to be three, four, even five months before you're going to really wake up and say, wow, this is working. Oh my gosh, someone just walked across the street and I did a cartoon style head turn with my eyes popped out of my head. Oh my gosh, I initiated sex. Wow, that orgasm was easier to have.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

These are the things that patients notice. I also get patients telling me their stress incontinence is slightly improved. Why? Because the urethra has testosterone receptors in it. We know that for all genders. These are the kinds of things my patients will report. I don't know. What do you think? I think it takes a while.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

These are the things that patients notice. I also get patients telling me their stress incontinence is slightly improved. Why? Because the urethra has testosterone receptors in it. We know that for all genders. These are the kinds of things my patients will report. I don't know. What do you think? I think it takes a while.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

We have studies on testosterone, which show... Oh, sorry. I mean, within my observation. Got it. I hear you. Yes.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

We have studies on testosterone, which show... Oh, sorry. I mean, within my observation. Got it. I hear you. Yes.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

It's getting harder and harder to find these days. And so I think similarly, we've been interested in it and people have played with it before. This idea, can you do one squirt into your... Nobody likes to squirt things in their nose, it turns out. It's a challenge. Now, any of these topical testosterone formulations, a lot of them have alcohol in them.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

It's getting harder and harder to find these days. And so I think similarly, we've been interested in it and people have played with it before. This idea, can you do one squirt into your... Nobody likes to squirt things in their nose, it turns out. It's a challenge. Now, any of these topical testosterone formulations, a lot of them have alcohol in them.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

So I don't recommend putting them on your genitals directly. But I do think it needs to be studied. It's challenging finding the formulation of testosterone that is low enough, like from the male side, because we have lots of formulations for men that is low enough to kind of give an appropriate dose.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

So I don't recommend putting them on your genitals directly. But I do think it needs to be studied. It's challenging finding the formulation of testosterone that is low enough, like from the male side, because we have lots of formulations for men that is low enough to kind of give an appropriate dose.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

Buckle up, buttercup. So here we go. We had a billion dollars that was put into it. A billion dollars and a five-year study that was done at the FDA. And it showed it was safe. It showed that it was effective. It showed that it was... The TLDR on testosterone is it's not that serious. We want it to be serious. Again, not a feeling. We want it to be like all about aggression. It's not a feeling.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

Buckle up, buttercup. So here we go. We had a billion dollars that was put into it. A billion dollars and a five-year study that was done at the FDA. And it showed it was safe. It showed that it was effective. It showed that it was... The TLDR on testosterone is it's not that serious. We want it to be serious. Again, not a feeling. We want it to be like all about aggression. It's not a feeling.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

It truly isn't. So they did five years of study. A billion dollars went into it. And the FDA came back and they said, ooh, women have breast tissue. So we're going to need five more years of data and another billion-dollar study. And every company was like, I'm out. The benchmark was different for women.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

It truly isn't. So they did five years of study. A billion dollars went into it. And the FDA came back and they said, ooh, women have breast tissue. So we're going to need five more years of data and another billion-dollar study. And every company was like, I'm out. The benchmark was different for women.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

Yeah. They just keep moving the goalpost. Everywhere they move the damn goalpost. Okay, I talked about the labeling on testosterone being removed, that it doesn't worsen cardiovascular disease. Why? Because they did the Traverse study that your listeners know about. That proved it.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

Yeah. They just keep moving the goalpost. Everywhere they move the damn goalpost. Okay, I talked about the labeling on testosterone being removed, that it doesn't worsen cardiovascular disease. Why? Because they did the Traverse study that your listeners know about. That proved it.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

The box labeling on estrogen products, which says that estrogen causes stroke, blood clots, heart attacks, probable dementia, we just got done saying that that study didn't show that. So why is that box labeling still there? We're killing women by trying to protect them.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

The box labeling on estrogen products, which says that estrogen causes stroke, blood clots, heart attacks, probable dementia, we just got done saying that that study didn't show that. So why is that box labeling still there? We're killing women by trying to protect them.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

I think medicine has a humility problem and a deeply ability to say, hey, we didn't know what we didn't know back then. We're learning and we're adjusting. They don't like to say, I don't know. They don't like to evolve in their thinking. And for some reason, women's health comes with so much bias. The amount of money that goes into women's health research is worse than it was 10 years ago.

The Peter Attia Drive
#348 ‒ Women’s sexual health, menopause, and hormone replacement therapy (HRT) | Rachel Rubin, M.D.

I think medicine has a humility problem and a deeply ability to say, hey, we didn't know what we didn't know back then. We're learning and we're adjusting. They don't like to say, I don't know. They don't like to evolve in their thinking. And for some reason, women's health comes with so much bias. The amount of money that goes into women's health research is worse than it was 10 years ago.