Carrie Carda, MD, on peptide therapy for PMOS, endometriosis, and fertility

Peptides are signaling molecules—short proteins of fewer than 40 amino acids that instruct cells and body systems rather than build tissue—and their potential role in women's health is generating significant interest, although the evidence base varies widely across specific agents and applications, according to Carrie Carda, MD, MMS, MHS, national medical director for 10X Health.

Carda offered a foundational reframe for clinicians unfamiliar with the category.

"Peptides are like text messages from our brain to our cells, to our body systems, just telling them what to do," she said. The class is not new—insulin, she noted, is a peptide, and peptide-based therapies have been in clinical use for decades. What distinguishes peptides from conventional proteins is function: Rather than structural roles, they perform highly specific signaling tasks, typically targeted to a single receptor or pathway.

"A peptide generally has one job—a signal that it does to one particular body part," Carda said.

The clinical relevance of that specificity increases with age. Endogenous peptide production begins declining around age 35 and continues to fall through the fifth and sixth decades—a trajectory that parallels many of the physiologic changes that drive women's health concerns in perimenopause and beyond. But Carda cautioned against categorical enthusiasm. The evidence base across peptides is heterogeneous: Some have extensive human data, others remain largely experimental.

"You can't say 'do peptides work' because you don't say 'do medications work'—it's too generic of a term," she said. Each peptide must be evaluated on its own data.

In women's health applications, Carda noted that no peptide directly addresses menopause, endometriosis, or PMOS as a disease-specific intervention. The more productive framework is metabolic: Peptides that target insulin resistance—GLP-1 receptor agonists being the most prominent current example—indirectly improve conditions where insulin resistance plays a central pathophysiologic role.

"In an indirect way, peptides can be used very effectively in helping these women's health disease processes," she said.

For fertility specifically, kisspeptin is among the most actively studied investigational peptides. It acts at the hypothalamic level to modulate ovarian signaling and has shown promise in oocyte maturation and infertility management.

"It's still investigational, but it's certainly going to do some good work," Carda said. She framed the clinical responsibility around peptide counseling clearly: "We have to stem evidence-based help with peptides vs just enthusiasm over them. We can't practice social media medicine. We have to practice evidence-based, safe medicine—but on the flip side, we can't stifle innovation."