Podbit · The Peter Attia Drive
Two hundred years ago women had roughly 100 lifetime ovulatory cycles; today the number is closer to 400. Later menarche, earlier menarche now, fewer pregnancies, less breastfeeding — the modern reproductive pattern was never anticipated by evolution, and endometriosis prevalence is rising as a result.
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To understand endometriosis, Tomioka begins with the architecture of the uterus: the outer serosa, the muscular myometrium, and the inner endometrium where embryos implant. Endometriosis, he explains, is a chronic disease in which tissue resembling the endometrium migrates outside the uterus — onto the ovaries, fallopian tubes, bladder, bowel, appendix, and even the diaphragm. The scale is striking: approximately 10% of reproductive-aged women, 200 million globally. [1] — Renato Tomioka "10% of reproductive-age women: Endometriosis affects approximately 10% of reproductive-aged women, equating to roughly 200 million women gl…" 03:48 Among infertile women, 30 to 50% have endometriosis, and the relationship is causal — if a woman has endometriosis, she faces roughly a 40% chance of infertility. [2] — Renato Tomioka "30–50% infertility in endometriosis: Among women struggling with infertility, 30 to 50% have endometriosis, and if a woman has endometriosi…" 04:30 Tomioka notes the strong genetic signal: approximately 50% heritability and a sevenfold elevated risk for women with an affected first-degree relative. The mechanism he considers most important is retrograde menstruation — menstrual blood flowing backward through the fallopian tubes into the pelvis — which occurs in roughly 90% of all women, yet only 10% develop endometriosis, implicating immune dysregulation (particularly macrophage dysfunction) as the difference-maker.
Endometriosis affects approximately 10% of reproductive-aged women, equating to roughly 200 million women globally.
Among women struggling with infertility, 30 to 50% have endometriosis, and if a woman has endometriosis, she faces roughly a 40% chance of being infertile.
Endometriosis has approximately 50% heritability, and women with a first-degree relative with the disease have about 7 times the normal risk.
Approximately 90% of women experience retrograde menstruation — menstrual flow traveling backwards through the fallopian tubes — yet only about 10% develop endometriosis.
AI nailed Andrew Huberman's vertigo-vs-low-blood-pressure diagnosis because that pattern has been reported millions of times. But every patient's liver is different and data on liver surgeries is scarce worldwide — making solo robot surgery dangerous. The rule is simple: data abundance means AI can help; data scarcity means keep the human in the loop.
Fei-Fei Li's father had liver surgery performed by a da Vinci robot guided by a surgeon. The result: 10 times less blood loss than a typical procedure. This isn't replacement — it's the gold standard of human-machine collaboration, where the human's judgment and the robot's precision combine.
US drug overdose deaths fell from 110,000 to roughly 70,000 — the biggest CDC-recorded single-year drop ever. Men's rates fell 27% in one year, and the steepest decline of all was among 15–24-year-olds, down 37%. The crisis narrative around young men needs to make room for signs of genuine progress.
Kessler thought his grief expertise would protect him. It didn't. When his son David died unexpectedly, he found himself on the floor — and eventually realized that acceptance alone wasn't enough. That unmet need became the sixth stage: finding meaning.
Grief isn't just death — it's any unwanted change. Kessler lectured at Coca-Cola and General Mills not because they had lots of funerals, but because change management is grief management. People who grieve well live well.
Witnessing someone's grief isn't just emotional support — it's an essential act of healing. Kessler argues grief is a severance and connection heals it. But real witnessing has two steps: seeing the pain AND affirming the person's capacity to recover.
Avoiding grief isn't free — it's exhausting. Kessler's beach ball metaphor nails it: pushing a small balloon down is easy, but holding a massive beach ball underwater takes constant, draining energy. Unattended feelings don't disappear; they just consume you.
Most people try to control their environment to avoid triggers. Kessler flips this entirely: triggers aren't problems to manage around — they're a detailed map to your pain and your healing. Every trigger points directly to what needs attention.
Running from pain doesn't leave it behind — it accelerates the chase. Whatever we run from pursues us, and whatever we face transforms us. Both Kessler and Lewis Howes testify to knowing both roads firsthand.
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