Decoding Women's Health with Dr. Elizabeth Poynor

Sex is supposed to be fun and feel good. So why are pain, low desire and changes in arousal so often treated as something women should simply live with? 

Dr. Poynor is joined by urologist and sexual medicine specialist Dr. Rachel Rubin for a candid, joyful conversation about women’s sexual health. They unpack what’s behind common sexual concerns, available treatments, and why these issues deserve the same curiosity and care as any other part of our health. Along the way, Dr. Rubin makes the case for talking about sex more openly – and for expecting more from the care we receive. 

Links to resources mentioned in this episode:

For more information on the treatment options for vulvar pain: https://journals.lww.com/greenjournal/fulltext/10.1097/aog.0000000000001645~committee-opinion-no-673-persistent-vulvar-pain

The American Urological Association’s clinical guideline on genitourinary syndrome of menopause: https://www.auanet.org/guidelines-and-quality/guidelines/genitourinary-syndrome-of-menopause

Dr. Rubin offers continuing medical education courses for clinicians, as well as free educational sexual health resources: https://www.rachelrubinmd.com/education

Learn more about Dr. Rubin’s Sexual Medicine Research Team: https://www.rachelrubinmd.com/research

Read the FDA’s update on estradiol transdermal patch availability: https://www.fda.gov/drugs/drug-alerts-and-statements/fda-update-estradiol-transdermal-patch-availability

Research on erectile dysfunction and its relationship to cardiovascular health: https://pmc.ncbi.nlm.nih.gov/articles/PMC10353735/

Research on hormonal contraception and sexual function: https://www.sciencedirect.com/science/article/abs/pii/S1743609515312881

More information on the FDA approval of flibanserin for hypoactive sexual desire in postmenopausal women: https://www.urologytimes.com/view/fda-approves-flibanserin-for-hypoactive-sexual-desire-disorder-in-postmenopausal-women

Information about testosterone treatment available for women in New Zealand: https://www.androfeme.nz/

Research on vibrator use among women: https://pubmed.ncbi.nlm.nih.gov/19453881/

Prosayla, a resource from the International Society for the Study of Women’s Sexual Health (ISSWSH), can help you find clinicians who specialize in women’s sexual health: prosayla.com

Dr. Rachel Rubin website: https://www.rachelrubinmd.com/

Dr. Rachel Rubin on YouTube: https://www.youtube.com/@DrRachelRubin

Dr. Rachel Rubin LinkedIn page: https://www.linkedin.com/in/rachel-rubin-7433b0134/

Dr. Rachel Rubin on Instagram: https://www.instagram.com/drrachelrubin

Dr. Rachel Rubin newsletter: https://www.rachelrubinmd.com/newsletter

Dr. Elizabeth Poynor substack: https://poynorhealth.substack.com/

Dr. Elizabeth Poynor on Instagram: https://www.instagram.com/poynorhealth

Atria Health Library: content.atria.org

Note: In this show, we use “women” as shorthand for people with XX chromosomes. We understand sex and gender are more complex, and acknowledge the experiences we describe reach beyond that word.

See omnystudio.com/listener for privacy information.

Heart disease is the number one killer of women, but unlike many other major diseases, there’s no single screening test that can tell you if you’re at risk. So how do you know where you stand? Dr. Poynor is joined by cardiologist Dr. Anuradha (Anu) Lala-Trindade (Lala), the program director for the Advanced Heart Failure and Transplant Fellowship at Mount Sinai and a professor of cardiology, population health, and obstetrics and gynecology.

Together, they unpack the many factors that can shape a woman’s cardiovascular risk and break down why midlife is an especially important time to start paying attention to them.

Resources mentioned during this episode:

Dr. Anu Lala’s 14-part framework for an initial cardiology assessment:

1. Family history

2. Gynecologic history — pregnancy journey, fertility journey, and gynecologic surgeries, including fibroid surgeries

3. Laboratory results  — genetic risk markers plus microalbuminuria (protein in the urine, as an early marker of cardiovascular-relevant kidney health)

4. History of high blood pressure — personal history, in-office reading, and family history

5. Cholesterol panel

6. Insulin resistance and inflammation biomarkers

7. History of autoimmune disease or inflammatory conditions

8. An EKG to check for any abnormalities

9. Weight and weight redistribution

10. Sleep

11. Movement (her preferred term over "exercise")

12. Diet — specifically processed food intake, alcohol, and food timing

13. Tobacco use and cessation

14. Mindfulness and well-being, or mind-body medicine

Here are the numbers Dr. Lala wants women to know.

1. Blood pressure

2. Cholesterol panel

3. Lp(a) — a genetic marker of atherosclerosis, checked at least once

4. Hemoglobin A1c — a marker of insulin resistance, metabolic risk, or diabetes

5. Microalbuminuria 

For some women, she also recommends:

1. ApoB — not for everyone; informative specifically when LDL is elevated

2. Coronary artery calcium score — not for everyone; useful for those at intermediate-to-high risk, with high LDL, or with a relevant family history

About Dr. Lala: https://profiles.mountsinai.org/anuradha-lala-trindade#about

CDC overview of women and heart disease: https://www.cdc.gov/heart-disease/about/women-and-heart-disease.html

National Heart, Lung, and Blood Institute resources for women and heart disease: https://www.nhlbi.nih.gov/health/coronary-heart-disease/women#How-do-symptoms-differ-for-women? 

A Harvard Health article on the heart attack gender gap: https://www.health.harvard.edu/blog/understanding-heart-attack-gender-gap-201604159495

Systolic Blood Pressure Intervention Trial (SPRINT) Study: https://www.nhlbi.nih.gov/science/systolic-blood-pressure-intervention-trial-sprint-study 

Hypertensive disorders of pregnancy and peripartum cardiomyopathy: A nationwide cohort study: https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0211857

Increased risk of cardiovascular disease in women with endometriosis: A systematic review and meta-analysis: https://www.sciencedirect.com/science/article/pii/S0301211525003574 

The 2022 hormone therapy position statement of The North American Menopause Society: https://menopause.org/wp-content/uploads/professional/nams-2022-hormone-therapy-position-statement.pdf 

If you're interested in using a risk calculator you can toggle to the left on the American Heart Association tool: https://professional.heart.org/en/guidelines-and-statements/prevent-calculator 

Auditory stimuli and heart rate variability: the role of music in cardiovascular regulation: https://pmc.ncbi.nlm.nih.gov/articles/PMC13229774/ 

Adjuvant music therapy for patients with hypertension: a meta-analysis and systematic review: https://link.springer.com/article/10.1186/s12906-023-03929-6 

Effects of music in exercise and sport: A meta-analytic review: https://pubmed.ncbi.nlm.nih.gov/31804098/ 

Association between spirituality/religiousness and quality of life among healthy adults: a systematic review: https://pmc.ncbi.nlm.nih.gov/articles/PMC8529786/

Spirituality in Serious Illness and Health: https://jamanetwork.com/journals/jama/article-abstract/2794049 

Acupuncture in persons with an increased stress level—Results from a randomized-controlled pilot trial: https://pmc.ncbi.nlm.nih.gov/articles/PMC7377446/ 

Effects of sleep deprivation and 4‐7‐8 breathing control on heart rate variability, blood pressure, blood glucose, and endothelial function in healthy young adults: https://pmc.ncbi.nlm.nih.gov/articles/PMC9277512/ 

Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis: https://pubmed.ncbi.nlm.nih.gov/35623448/ 

Note: In this show, we use “women” as shorthand for people with XX chromosomes. We understand sex and gender are more complex, and acknowledge the experiences we describe reach beyond that word.

See omnystudio.com/listener for privacy information.

How can the research behind intermittent fasting help us rethink the way we approach our nutrition and our daily habits? Dr. Chris Rhodes has spent much of his career studying the science of fasting. He joins the show to unpack how fasting works in the body and what the research tells us about its potential benefits.

Dr. Rhodes earned his PhD in Nutritional Biochemistry at UC Davis and is also the co-founder of Mimio. We discuss why someone might try intermittent fasting - from longevity to weight loss - as well as the importance of strength training and personalized nutrition. 

Links to resources mentioned in this episode:

For more studies on autophagy, check out: https://physoc.onlinelibrary.wiley.com/doi/full/10.1113/JP287938

and https://pubmed.ncbi.nlm.nih.gov/41372565/

Here's a meta-analysis looking at the effects of time restricted eating: https://pubmed.ncbi.nlm.nih.gov/41586347/

Note: the glycine data we mention is only in mice: https://pmc.ncbi.nlm.nih.gov/articles/PMC6516426/

Important caveat for this episode: the evidence is strongest in animal studies and human markers of aging. No intermittent fasting regimen has been shown to extend human lifespan or reduce mortality in humans.

Note: In this show, we use “women” as shorthand for people with XX chromosomes. We understand sex and gender are more complex, and acknowledge the experiences we describe reach beyond that word.

See omnystudio.com/listener for privacy information.

What can you do to make the most of your annual medical visit? Dr. Poynor is joined by Dr. Jennifer McGugins Hill, an internal medicine specialist at the Atria Health and Research Institute, to discuss how preventive care can help identify health concerns early. Plus, we unpack which labs and screenings are worth discussing with your primary care physician, why it's important to know your calcium score, and how to advocate for the care you need. 

Links to resources mentioned in this episode:

Boston Heart Diagnostics offers specialty labs that your doctor can order for you, usually at a cost. They are not available as direct to consumer products, so if you're interested in them, talk with your care team. https://bostonheartdiagnostics.com/

For expert advice on how to properly log your blood pressure at home, please see this helpful article: https://content.atria.org/article/blood-pressure-cuffs-for-home-monitoring/

You can see the product she mentions here (no affiliate link): https://omronhealthcare.com/blood-pressure-monitors

An ECG or EKG stands for an electrocardiogram, which is a quick, safe, and painless medical test that records the electrical activity of your heart.

DEXA stands for dual-energy X-ray absorptiometry. It is an imaging test that uses low-dose X-rays to measure bone mineral density and body composition. They can be ordered by a physician in an academic medicine system and are also offered at standalone centers.

Cologuard is a stool test that looks for existing cancer. Colonoscopies look for cancer as well as polyps, which can be pre-cancerous and are removed during the colonoscopy procedure.

Note: In this show, we use “women” as shorthand for people with XX chromosomes. We understand sex and gender are more complex, and acknowledge the experiences we describe reach beyond that word.

See omnystudio.com/listener for privacy information.

Many women are turning to cannabis to help with sleep, anxiety, chronic pain, and other major health concerns. But figuring out what actually works for your individual needs can be surprisingly complicated. 

Dr. Poynor speaks with neuroscientist and world-renowned medical cannabis expert Dr. Staci Ann Gruber about the science behind THC, CBD, and other cannabinoids. Together, they break down the potential benefits of cannabis for women’s health, how to navigate different products safely, and best practices for first-time users.

Links to resources mentioned in this episode:

Marijuana Investigations for Neuroscientific Discovery (MIND) Program at McLean Hospital

Women’s Health Initiative at Mind (WHIM)

Medicinal Cannabis: History, Pharmacology, And Implications for the Acute Care Setting

The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research

Marijuana impacts mood in bipolar disorder: a pilot study

Note: In this show, we use “women” as shorthand for people with XX chromosomes. We understand sex and gender are more complex, and acknowledge the experiences we describe reach beyond that word.

See omnystudio.com/listener for privacy information.

What if aging isn't something that simply happens to us, but something we can actually influence? Dr. Poynor is joined by Dr. Eric Verdin - the President and CEO of the Buck Institute for Research on Aging, the world's first institution dedicated solely to understanding why we age and how to do it better.

We break down the science behind why we age, the role of NAD in cellular energy and repair, how inflammation quietly accelerates decline, and what metabolism has to do with how long and how well we live. 

Dr. Verdin also walks us through what the latest research says about what we can actually do today—from how we eat and exercise, to the emerging interventions that may one day change the trajectory of aging altogether. He also shares which interventions he’s tried himself and what he’s chosen to skip altogether. 

Links to resources mentioned in this episode:

Although epigenetics has been studied for decades, a major breakthrough came in 2013, when geneticist Steve Horvath, PhD, developed the first widely applicable epigenetic clock—a DNA methylation-based biomarker that estimates biological age across multiple human tissues. https://link.springer.com/article/10.1186/gb-2013-14-10-r115

A landmark 2026 Science study found that human lifespan heritability is roughly 50%, more than double earlier estimates — once researchers separated deaths from external causes (accidents, infections) from deaths driven by intrinsic aging biology. https://www.science.org/doi/10.1126/science.adz1187

Senescent cells promote tissue NAD+ decline during ageing via the activation of CD38+ macrophages: https://www.nature.com/articles/s42255-020-00328-w

CD38 inhibitor 78c increases mice lifespan and healthspan in a model of chronological aging: https://pubmed.ncbi.nlm.nih.gov/35263032/

CD38 Inhibition Ameliorates Age-Related CognitiveDecline via a Choroid Plexus-Cerebrospinal Fluid-Hippocampus Axis: (This refers to preclinical (meaning animal model) research that was published as a pre-print and has not yet been peer reviewed.) https://pubmed.ncbi.nlm.nih.gov/41542058/

Healthy aging and muscle function are positively associated with NAD+ abundance in humans: https://www.nature.com/articles/s43587-022-00174-3

Pilot Study Evaluates Weekly Pill to Slow Ovarian Aging, Delay Menopause: https://www.nyp.org/advances/article/womens-health/pilot-study-evaluates-weekly-pill-to-slow-ovarian-aging-delay-menopause

Dr. Yousin Suh at the Department of Genetics and Development at Columbia University - you can read more about Dr. Suh’s work here: https://www.crs.northwestern.edu/about/news/2025/nbs-2025.html

Ageing in Drosophila: The role of the insulin/Igf and TOR signalling network: https://pmc.ncbi.nlm.nih.gov/articles/PMC3087113/

NIA Interventions Testing Program: Investigating Putative Aging Intervention Agents in a Genetically Heterogeneous Mouse Model: https://pmc.ncbi.nlm.nih.gov/articles/PMC5514387/

Publications from the NIA Interventions Testing Program: https://www.nia.nih.gov/research/dab/interventions-testing-program-itp/publications

The use of semaglutide medicines and risk of non-arteritic anterior ischemic optic neuropathy (NAION): https://www.who.int/news/item/27-06-2025-27-06-2025-semaglutide-medicines-naion

Dr. Eric Verdin LinkedIn page: https://www.linkedin.com/in/eric-verdin-490212

Dr. Eric Verdin on Substack: https://substack.com/@verdinlabbuck

Dr. Eric Verdin on Instagram: @ericverdinmd 

Dr. Elizabeth Poynor substack: https://poynorhealth.substack.com/

Dr. Elizabeth Poynor on Instagram: @poynorhealth 

Atria Health Library: content.atria.org

Note: In this show, we use “women” as shorthand for people with XX chromosomes. We understand sex and gender are more complex, and acknowledge the experiences we describe reach beyond that word.

See omnystudio.com/listener for privacy information.

What happens to a woman's mental health when she experiences a major hormonal shift and what can she actually do about it? Dr. Ruta Nonacs is a reproductive psychiatrist at Massachusetts General Hospital and a faculty member at Harvard Medical School. Her work sits at the intersection of hormonal health and women's mental well being. 

We break down how changes across a woman's reproductive life—from PMS and PMDD to perimenopause and beyond—can affect mood, anxiety, and emotional health. Dr. Nonacs also walks us through treatment options, and when to seek help.

Links to resources mentioned in this episode:

Dr. Ruta Nonacs: https://researchers.mgh.harvard.edu/profile/14143654/Ruta-Nonacs

So Glad You Asked with Dr. Ruta Nonacs and Allie Hales: https://podcasts.apple.com/us/podcast/so-glad-you-asked-with-dr-ruta-nonacs-and-allie-hales/id1802653992

Essential Reads:  Ovarian Suppression for the Treatment of Severe PMDD: https://womensmentalhealth.org/posts/essential-reads-ovarian-suppression-for-the-treatment-of-severe-pmdd/

Chasteberry: https://www.nccih.nih.gov/health/chasteberry

Co-administration of St. John's wort and hormonal contraceptives: a systematic review: https://www.contraceptionjournal.org/article/S0010-7824(16)30164-0/abstract

Note: In this show, we use “women” as shorthand for people with XX chromosomes. We understand sex and gender are more complex, and acknowledge the experiences we describe reach beyond that word.

See omnystudio.com/listener for privacy information.

Dr. Poynor answers listener questions about HPV, UTIs, hormone support, self breast exams, pelvic floor therapy, and GLP-1s. Plus we address several questions about the condition, PCOS, recently renamed PMOS. Joining Dr. Poynor for this discussion is Atria Health Institute’s Chief Content Officer Siobhan O’Connor. 

Links to resources mentioned in this episode:

HPV Vaccination: https://www.cdc.gov/hpv/vaccines/index.html

Women’s Perspective on Self-Breast Examination https://pmc.ncbi.nlm.nih.gov/articles/PMC11069221/

Decoding Dementia Prevention with Dr. Richard Isaacson: https://www.pushkin.fm/podcasts/decoding-womens-health-with-dr-elizabeth-poynor/decoding-dementia-prevention-with-dr-richard-isaacson

The Tyrer-Cuzick Model: Understanding the Assessment and Your Breast Cancer Risk: https://www.nationalbreastcancer.org/blog/tyrer-cuzick-model/

Note: In this show, we use “women” as shorthand for people with XX chromosomes. We understand sex and gender are more complex, and acknowledge the experiences we describe reach beyond that word.

See omnystudio.com/listener for privacy information.

Could the secret to better health be hiding in your gut? Today, we’re exploring the powerful role the gut microbiome plays in overall well-being with Dr. Megan Rossi. 

Dr. Rossi is a researcher and clinician at King's College London and founder of The Gut Health Clinic. She translates cutting-edge research into practical, everyday advice—including what to eat, what to avoid, and why your gut affects much more than digestion.

To meet your weekly plant-eating goals, try incorporating a variety of items from these "Super Six" essential groups:

• Whole Grains: Quinoa, oats, barley, and wholegrain variations of rice or rye
• Nuts and Seeds: Walnuts, chia seeds, almonds, pumpkin seeds, and flaxseeds
• Vegetables: Leafy greens, carrots, aubergine, broccoli, and tomatoes
• Fruits: Berries, apples, pears, and peaches
• Legumes: Chickpeas, lentils, butter beans, and edamame
• Herbs and Spices: Basil, garlic, and dried mixed Italian herbs

Links to resources mentioned in this episode:

The Gut Health Clinic: https://theguthealthdoctor.com/clinic

Is My Gut Healthy? Quiz - This is from Eat Yourself Healthy, published 2019 (UK). You can take the quiz online here: https://theguthealthdoctor.com/gut-health-quiz

The influence of demographic characteristics on constipation symptoms: a detailed overview: https://pmc.ncbi.nlm.nih.gov/articles/PMC7268616/

In one study women on a low-fat vegan diet that included soybeans had fewer symptoms than those on other diets - The Women's Study for the Alleviation of Vasomotor Symptoms (WAVS): a randomized, controlled trial of a plant-based diet and whole soybeans for postmenopausal women: https://pmc.ncbi.nlm.nih.gov/articles/PMC8462449/

You can see some common causes of bloating documented in this paper from 2021 - Management of Chronic Abdominal Distension and Bloating: https://www.cghjournal.org/article/S1542-3565(20)30433-X/fulltext

Plenty of research has supported the idea that plant-based and plant-heavy diets reduce menopausal symptoms, such as: https://pmc.ncbi.nlm.nih.gov/articles/PMC9812421/ and https://pmc.ncbi.nlm.nih.gov/articles/PMC9812421/

A randomized controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial) - Study summary is here: https://link.springer.com/article/10.1186/s12916-017-0791-y

Eczema-protective probiotic alters infant gut microbiome functional capacity but not composition: sub-sample analysis from a RCT: https://pubmed.ncbi.nlm.nih.gov/30574802/

The Prevalence of Autoimmune Disorders in Women: A Narrative Review: https://pmc.ncbi.nlm.nih.gov/articles/PMC7292717/

Fermented-food diet increases microbiome diversity, decreases inflammatory proteins, study finds: https://med.stanford.edu/news/all-news/2021/07/fermented-food-diet-increases-microbiome-diversity-lowers-inflammation.html

New research presented at ECCO Congress on low emulsifier diet and Crohn's disease: https://www.kcl.ac.uk/news/new-research-presented-at-ecco-congress-on-low-emulsifier-diet-and-crohns-disease

The therapeutic efficacy of Bifidobacterium animalis subsp. lactis BB‐12® in infant colic: A randomised, double blind, placebo‐controlled trial: https://pmc.ncbi.nlm.nih.gov/articles/PMC6973258/

Chrononutrition and Gut Health: Exploring the Relationship Between Meal Timing and the Gut Microbiome: https://link.springer.com/article/10.1007/s13668-025-00670-z

Note: In this show, we use “women” as shorthand for people with XX chromosomes. We understand sex and gender are more complex, and acknowledge the experiences we describe reach beyond that word.

See omnystudio.com/listener for privacy information.

Have you considered getting plastic surgery? We’re separating the social media hype from the surgical reality with board-certified plastic surgeon Dr. Troy Pittman.  He walks us through some of the most common procedures he performs, including his specialty: aesthetic and reconstructive surgery of the breast. 

We also discuss how to spot red flags when looking for qualified surgeons and what he wishes every patient knew before sitting down for their initial consultation. Plus, he’ll weigh in on AI tools and the latest trends reshaping the industry.

Links to resources mentioned in this episode:

Hormonal therapies and venous thrombosis: Considerations for prevention and management: https://pmc.ncbi.nlm.nih.gov/articles/PMC9399360/

The American Board of Plastic Surgery, Inc.: https://www.abplasticsurgery.org/

American Academy of Facial Plastic and Reconstructive Surgery, Inc.: https://www.aafprs.org/

Note: In this show, we use “women” as shorthand for people with XX chromosomes. We understand sex and gender are more complex, and acknowledge the experiences we describe reach beyond that word.

See omnystudio.com/listener for privacy information.