Could hormone replacement therapy play a much greater role in women's mental health than previously recognized?

In this episode of *The Longevity Protocol — Longevity Brief*, Dr. John Robinson and Dr. Cristina Bosch explore a compelling 2026 study published in *BJPsych International* involving 957 women undergoing menopause hormone therapy. Researchers reported a remarkable 92% reduction in suicidal ideation scores among women initially experiencing suicidal thoughts, alongside approximately 46% improvements in depressive symptoms.

Discover how estrogen, progesterone, and testosterone influence brain chemistry, emotional resilience, motivation, and psychological well-being—and why perimenopause may be one of the most overlooked periods of vulnerability in women's mental health.

The doctors discuss what these findings mean for comprehensive menopause care and why emotional well-being is essential to **Experienced Longevity**.

In this episode of The Longevity Protocol, Drs. John Robinson and Cristina Romero-Bosch welcome pelvic floor physical therapists Dr. Krista Zelizney and Dr. Jake Lape of Streamline Performance Physical Therapy to explore the surprising connections between pelvic health, sexual pleasure, athletic performance, and longevity. From erectile dysfunction and orgasm quality to urinary incontinence, core strength, and hormonal changes, we uncover how the pelvic floor influences far more than most people realize. Discover why Kegels aren't always the answer, what actually happens during pelvic floor physical therapy, and how improving pelvic function can enhance intimacy, physical performance, and quality of life at every age. Your takeaway: You'll learn how to recognize common signs of pelvic floor dysfunction, understand whether your pelvic floor needs strengthening or relaxation, and discover practical strategies to improve sexual function, core stability, and pelvic health—starting today.

What if one of the most important organs for longevity isn't your heart or brain—but your muscle? Dr. John A. Robinson and Dr. Cristina Romero-Bosch reveal why skeletal muscle is far more than strength and appearance. From metabolic health and myokines to sarcopenia, protein, creatine, and resistance training, discover how preserving muscle may protect your independence, vitality, and quality of life as you age. Because longevity isn't simply about living longer. It's about remaining capable of living fully.

What if sex is actually a vital sign? In this episode of The Longevity Protocol, Dr. John A. Robinson and Dr. Cristina Romero-Bosch explore sexual longevity and why changes in libido, erections, arousal, lubrication, sensation and orgasm can reveal much more about our overall health than we realize. We examine the connections between sexual function and cardiovascular health, nitric oxide, hormones, metabolism, the nervous system, menopause, genital tissue health and the pelvic floor, while also exploring the equally important roles of desire, pleasure, intimacy and connection. From erectile dysfunction as a potential cardiovascular clue to new discoveries about clitoral anatomy and innervation, we make the case that sexual health deserves a place alongside the other markers we routinely discuss in longevity medicine. Because longevity isn't simply about living longer—it's about preserving our capacity to desire, connect, experience pleasure and remain fully alive. This is the art and science of living the well lived life.

In this episode of The Longevity Protocol, Dr. John A. Robinson and Dr. Cristina Romero-Bosch make the case that sexual health should be considered a vital sign of healthy aging. Sexual function depends on the coordinated health of the brain, hormones, nervous system, cardiovascular system, metabolism, genital tissues, pelvic floor, and relationships—meaning changes in libido, erections, lubrication, sensation, or orgasm may be telling us something important about the health of the whole person. We explore erectile dysfunction as a potential early cardiovascular warning sign, nitric oxide and endothelial health, testosterone and menopause, the remarkable anatomy and innervation of the clitoris, pelvic floor function, and the neurobiology of desire and orgasm. But sexual longevity isn't about trying to be 25 again; it's about preserving our capacity for desire, arousal, sensation, pleasure, intimacy, and connection as we age. Because longevity isn't simply about accumulating more years—it is about remaining fully alive within those years, and sexuality is an important part of the art and science of living the well lived life.

A. What France made us think about

B. Art de vivre

C. The central question

1. Have we become so focused on optimizing life that we've forgotten how to experience it?
2. The science protects our ability to live; it shouldn't replace living.

II. THE LONGEVITY PARADOX: WHEN HEALTH BECOMES ANOTHER JOB

A. We can measure almost everything

B. When optimization becomes stress

III. THE FRENCH MEAL: SLOWING DOWN MAY CHANGE HOW MUCH WE EAT

A. Dinner is the activity

B. Eating speed and weight

C. Why the physiology makes sense

IV. WHY DOES BREAD SEEM DIFFERENT IN FRANCE?

A. First, a misconception

B. Traditional French bread

C. The 1993 Décret Pain

D. Pesticides and sourcing

E. Bread as culture

V. REAL FOOD: FOOD THAT STILL LOOKS LIKE FOOD

A. Nutrition has become tribal

B. The French-market lesson

VI. TERROIR: THE FOOD SHOULD BELONG TO THE PLACE

A. There isn't one French diet

B. Terroir

C. UNESCO and the French gastronomic meal

VII. WALKING: EXERCISE THAT DOESN'T FEEL LIKE EXERCISE

A. Movement built into life

B. The metabolic science

C. Art meets science

VIII. THE DINNER TABLE MAY BE LONGEVITY MEDICINE

A. More than food

IX. WINE: PLEASURE WITHOUT TURNING IT INTO MEDICINE

A. The French paradox

B. The more interesting question

X. BEAUTY: THE FORGOTTEN COMPONENT OF WELLNESS

B. Beauty creates presence

XI. STOP RUSHING THROUGH YOUR LIFE

A. Modern life rewards speed

B. The question

XII. PLEASURE IS NOT THE ENEMY OF HEALTH

A. Sustainable longevity

B. The objective is capacity

XIII. PRACTICAL EXPERIMENT: BRING ART DE VIVRE HOME

A. Change one dinner

B. Look at what you accomplished

XIV. THE QUESTION WE BROUGHT HOME FROM FRANCE

A. Science still matters

B. Stop postponing life

XV. CLOSING: THE ART AND SCIENCE OF THE WELL-LIVED LIFE

The science tells us how to protect the body.

The art tells us what the body is for.

What if we’ve been asking the wrong question about longevity?

We spend enormous amounts of time asking how to live longer—tracking biomarkers, optimizing hormones, building muscle, protecting our brains, and trying to slow biological aging. But eventually, another question has to be asked:

What are we trying to live longer for?

This episode launches Season 3 of The Longevity Protocol Podcast, and with it, a new season-long theme: The Art and Science of the Well-Lived Life.

Throughout this season, Dr. Bosch and I are going to try to answer a question we’re asking in our own lives: What does it actually mean to live a well-lived life? Not just as physicians, but as a married couple, parents, friends, travelers, business owners, and two people getting older ourselves.

Inspired by our recent travels through France and the idea of l’art de vivre—the art of living—we begin by exploring what modern longevity sometimes forgets. Medicine, movement, nutrition, hormones, and optimization matter, but so do love, intimacy, purpose, friendship, great food, beauty, adventure, pleasure, and being present enough to actually experience your life.

The science of longevity helps preserve the instrument—your body and brain. But the science exists to make the art possible.

We don’t have the well-lived life figured out. That’s the point of Season 3. We’re going to explore the question together.

Because perhaps longevity isn't simply about putting more time into life. It's about putting more life into our time.