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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 think there's no question that we see worsening. Now, I will say perimenopause, from what I understand of the data, is actually worse on mental health and can actually level out a little bit once there's less erratic hormones. But again, an empty gas tank is still an empty gas tank. And so we see a lot of challenges in this time period.

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

I think there's no question that we see worsening. Now, I will say perimenopause, from what I understand of the data, is actually worse on mental health and can actually level out a little bit once there's less erratic hormones. But again, an empty gas tank is still an empty gas tank. And so we see a lot of challenges in this time period.

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

The fact that this story hasn't been made into a Hollywood biopic mega drama, I don't know. This is a big deal. A billion dollars of our resources went into doing this study. And there are many things that we learned that were helpful and useful and this huge set of data that we're still using today to extrapolate information from. And there was a lot of good that came from it.

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

The fact that this story hasn't been made into a Hollywood biopic mega drama, I don't know. This is a big deal. A billion dollars of our resources went into doing this study. And there are many things that we learned that were helpful and useful and this huge set of data that we're still using today to extrapolate information from. And there was a lot of good that came from it.

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

But there was a lot of misinformation and just really bad marketing or really effective marketing, you could argue. Because what is so wild, Peter, is that when this study came out, they did a press conference. Before the study was published, they did a press conference. Have you ever seen the NIH do a press conference that Matt Lauer talked about or that was made it on Good Morning America?

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

But there was a lot of misinformation and just really bad marketing or really effective marketing, you could argue. Because what is so wild, Peter, is that when this study came out, they did a press conference. Before the study was published, they did a press conference. Have you ever seen the NIH do a press conference that Matt Lauer talked about or that was made it on Good Morning America?

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

They did a press conference. I remember I was in medical school at the time. Like, I remember this happening. And they said, OK, we had to stop the study early. It is increasing the risk of breast cancer and increasing the risk of blood clots and cardiovascular disease. And we have to stop the study.

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

They did a press conference. I remember I was in medical school at the time. Like, I remember this happening. And they said, OK, we had to stop the study early. It is increasing the risk of breast cancer and increasing the risk of blood clots and cardiovascular disease. And we have to stop the study.

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

There's different statistics out there, but people will say about 40% maybe of women were on hormone therapy at the time. Overnight, it crashed to nothing. You're talking billions of dollars of an industry went to nothing. And the people who are prescribing the hormone therapy were like, this doesn't make any sense. I do this. I've been doing this for 20 years, 30 years.

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

There's different statistics out there, but people will say about 40% maybe of women were on hormone therapy at the time. Overnight, it crashed to nothing. You're talking billions of dollars of an industry went to nothing. And the people who are prescribing the hormone therapy were like, this doesn't make any sense. I do this. I've been doing this for 20 years, 30 years.

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

I don't have a clinic full of people who are dying of blood clots or heart attacks or who get breast cancer. Like this is not my clinic. Whose clinic is this?

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

I don't have a clinic full of people who are dying of blood clots or heart attacks or who get breast cancer. Like this is not my clinic. Whose clinic is this?

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

Then they published the paper, and as we talked about before we did this podcast, is that they misinterpreted the data so drastically and scared everybody with so much fear that you actually have an entire generation that has forgotten how to prescribe hormone therapy. And this is the nightmare that we're living in today because now we realize that the data was misinterpreted.

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

Then they published the paper, and as we talked about before we did this podcast, is that they misinterpreted the data so drastically and scared everybody with so much fear that you actually have an entire generation that has forgotten how to prescribe hormone therapy. And this is the nightmare that we're living in today because now we realize that the data was misinterpreted.

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

So the WHI was one medication, one dose. That's it. And it was a sort of birth control pill style kind of hormone therapy. So a synthetic estrogen and progestin. It was not the, what we call more, and we can talk about the marketing term bioidentical, but the FDA approved products that we use today, like estradiol and progesterone, they're different medications that we use today.

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

So the WHI was one medication, one dose. That's it. And it was a sort of birth control pill style kind of hormone therapy. So a synthetic estrogen and progestin. It was not the, what we call more, and we can talk about the marketing term bioidentical, but the FDA approved products that we use today, like estradiol and progesterone, they're different medications that we use today.

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

And so you're talking one medication, one dose, and we're still practicing fear-based medicine 30 years later, whatever it is, saying like, we don't practice any other medicine like this. We're like, Well, there was one study about surgery 30 years ago, and that's the way we practice medicine. We evolve, we learn new things. So what did it show? Let's talk about the good.

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

And so you're talking one medication, one dose, and we're still practicing fear-based medicine 30 years later, whatever it is, saying like, we don't practice any other medicine like this. We're like, Well, there was one study about surgery 30 years ago, and that's the way we practice medicine. We evolve, we learn new things. So what did it show? Let's talk about the good.

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

When you took estrogen and progestin or estrogen alone, you had a decreased risk of colon cancer. You had decreased risk of fractures, like significant decrease of fractures. Decrease of diabetes. Okay, that seems like a good, those seem like all good things. This is in the hormones we don't even really prescribe anymore.

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

When you took estrogen and progestin or estrogen alone, you had a decreased risk of colon cancer. You had decreased risk of fractures, like significant decrease of fractures. Decrease of diabetes. Okay, that seems like a good, those seem like all good things. This is in the hormones we don't even really prescribe anymore.