You Are Not Broken

Sex Med Advocate and ISSWSH President - Sue Goldstein Sue Goldstein is an AASECT certified sexuality educator and certified clinical research coordinator. She serves as clinical research manager and program coordinator for San Diego Sexual Medicine  Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken  Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com  She is current president of ISSWSH (International Society for the Study of Women’s Sexual Health)  Her story of your career in sexual education and sex med.  Pain associated with oral contraceptives.  There should never be pain with sexual activity.  We pick apart “doing menopause naturally”  We discuss PGAD Persistent Genital Arousal Disorder and the role of education for people and providers. Language matters.  We talk about menopause and pain with sex after menopause.  Is low sex drive the “tip of the iceberg” for testosterone?  We discuss testosterone, SHBG and bioavailable testosterone and explain how this works.  What is a vajay-jay?  The importance of using correct words for our anatomy.  Why we love ISSWSH.  Why Sue hates the concept that “women are complicated”   The combo platter of aging PIV intimacy – we need to approach both partners to address the issues.   Sue shares her experience with HSDD  We discuss the issue with delayed ejaculation.   “The educated woman is the empowered woman” – Sue Goldstein   https://www.isswsh.org/ ISSWSH’s Education website https://www.prosayla.com/   Book about vulvas: Petals by Nick Karras   Sue’s Book: When Sex Isn’t Good https://amzn.to/3OKyMMk   Did you get my “You Are Not Broken” Book Yet? https://amzn.to/3p18DfK Listen to my Tedx Talk: Why we need adult sex ed   Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed  Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

GOAT - Dr. Irwin Goldstein He is the director of San Diego Sexual Medicine. Dr. Goldstein has had a long career providing medical help to those with sexual problems, having been involved with sexual dysfunction research since the late 1970′s. Dr Goldstein’s interests include regenerative therapies for men and women, surgery for dyspareunia, physiologic investigation of sexual function in men and women, and diagnosis and treatment of sexual dysfunction in men and women. He has authored more than 360 publications in the field of sexual dysfunction, with 20 consecutive years of funding by the National Institutes of Health   Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken  Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com  You are a urologist. I am a urologist. You are a pioneer and yet I don’t even remember hearing about you during residency training. How do urologists not know who Irwin Goldstein is? He started out in men’s sexual health. Dr. Goldstein tells us his story. Dr. Goldstein published the original paper on Sildenafil (Viagra) – and 90% of the phone calls after were women asking for help for them. He created ISSWSH. https://www.isswsh.org/ He was in the room when the term vulvovaginal atrophy was changed to genitourinary syndrome of menopause (GSM). Thoughts on DHEA vaginally. Women and Sildenafil – oral versus topical and his thoughts on arousal. Orgasm guidelines are coming!! The role of dapoxetine (Priligy) for inability to orgasm – you can’t get this in the USA Other drugs for orgasm The role of testosterone for orgasm issues Sexual side effects of birth control pills Depression side effects of birth control pills Testosterone in women! It is a thing! Estradiol in men – needed for bones and erections. We wrap up with discussing hard flaccid. A hypogastric nerve dysfunction. Any advice for me, for other physicians, for the women and their partners? --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

Mojo and Empowerment with Deborah Kagan Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com  Deborah Kagan helps women conquer self-doubt and indecision to step into their full power, love who they are and live a turned ON life.  She tells us her inspiration and her story. How do we get women to thinking differently?  Our bodies are energy and the concept of male and female energy.  The four pillars of Deborah’s teaching about MOJO.  What is Mojo and how is it different from libido?  How do you know if you are disconnected from your body?  We discuss masculine and feminine energy.  We discuss our thoughts about the Barbie movie.  Feeling feelings and using anger for us.  We discuss your intuition, your gut intuition and where your mojo lives.  We discuss pain and the role of Western medicine and the role of our energy and listening to our body and our relationship with our body.   The Real Undressed Podcast: https://podcasts.apple.com/us/podcast/the-real-undressed-with-deborah-kagan/id1494643770 Order Undressed Now Find her on https://www.facebook.com/mojorecoveryspecialist Instagram (@deborahkagan) Twitter (@deborahkagan) Pinterest (/deborahkagan) and LinkedIn (/in/deborahkagan). And for all things mojolicious, check out www.deborah-kagan.com/blog --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

Sexual Health is an Equality Issue! – A Chat About Sex, Coaching and Menopause This was a live chat that I did with Dr. Ashley Winter. She is the Chief Medical Officer at Odela health! We had a chat about my book and sexual health in general. Is it true that women are “too complicated”? Sexual Health is an Equality Issue The clitoris doesn’t have a place in the traditional medical paradigm – Dr. Winter We don’t teach people medically accurate language – so we can’t communicate with anyone and it ends up hurting you. It is not informed consent if we don’t tell people that medications can cause sexual health issues. Everyone needs to know about menopause. The reason coaching really helps our sex lives. The fallacy of “natural” and challenging the idea that natural is better. We need to stop judging women for their decisions around hormones. We don’t judge men for being on testosterone. The problem with the FDA label on vaginal estrogen. Love Dr. Winter? Go way back to episode 46 https://www.odelahealth.com/ Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK Did you watch the Tedx Talk yet? Why We Need Adult Sex Ed   Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed   Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

Menopause and Hormones in the Modern Era AKA: Why the Boomers Should be Pissed  This is a lecture I gave for the Society of Women in Urology about hormones.  If you like this episode also check out number 197.  Genitourinary syndrome of menopause  Men at age 60 have more estrogen in their bodies then women Why I don’t do a loading dose of vaginal estrogen.  The problem with the vaginal estrogen labeling by the FDA.  How the nation used estrogen prior to the Women’s Health Initiative Scare. I explain why the WHI study was created and what question it was trying to answer. Myth: you have to be a year without a period to be on hormones.  I break down the three concerns about progestin and breast cancer from the WHI 1)  Was the placebo arm flawed 2) Was it the synthetic progestin and now we use bioidentical 3)  Maybe progestin increases risk but it is small and perhaps benefits still outweigh risk as breast cancer is so curable and all the other benefits are worth the small increased risk I discuss the “critical window” hypothesis and “healthy cell” hypothesis and why hormones are recommended to be started “early” in menopause which means less than ten years. Why I think the Boomers should be pissed. Vaginal estrogen for all and get an okay from your  Best practices -  If you have a uterus, with systemic estrogen you need a progestin -  You can continue hormones for life as long as your benefit > risks -  Vaginal bleeding after menopause is never normal -  If there is an FDA approved product use it instead of compounded -  Checking hormones is often not necessary -  One size does not fit all   What about hormones for prevention? On a national level the answer is no. But everyone needs their own analysis.  National guidelines on how to give testosterone to women for low desire. Hormones: are we being equitable to all genders in regards to hormones.   NAMS 2022 guidelines: According to NAMS, “the benefits of hormone therapy outweigh the risks for most healthy symptomatic women who are aged younger than 60 years and within 10 years of menopause onset.” For women with primary ovarian insufficiency and premature or early menopause who are at higher risk of bone loss, heart disease, and cognitive or affective disorders, “hormone therapy can be used until at least the mean age of menopause unless there is a contraindication to its use.”   Where is the black box warning on alcohol?   What about lasers for GSM?   Where are we on removing the FDA black box warning on vaginal estrogen?   My thoughts on online hormone companies.   Estrogen plays a role in the gut microbiome and may affect the risk of osteoporosis.   Our podcast sponsor today is AG1. Use AG1 to build a foundation for better health. FREE ONE YEAR SUPPLY OF VITAMIN D3+K2, 5 TRAVEL PACKS drinkag1.com/youarenotbroken   Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK Did you watch the Tedx Talk yet? Why We Need Adult Sex Ed Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed Join mymembership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

August Podcast Live – the state of sex ed     We are going to talk about Sex ed today in celebration of the Tex talk coming out! https://femtechinsider.com/rescripted-sex-ed-report/  https://pleasurebetter.com/orgasm-statistics/ I answer a listener’s question about being stuck in a sexual script  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035379/   Did you get my “You Are Not Broken” Book Yet? https://amzn.to/3p18DfK Listen to my Tedx Talk: Why we need adult sex ed   Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed   Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

BRCA Gene Previvor, Menopause Activist and Protector Against Corrosion – Monica Molenaar   Our podcast sponsor today is AG1. Use AG1 to build a foundation for better health. FREE ONE YEAR SUPPLY OF VITAMIN D3+K2, 5 TRAVEL PACKS drinkag1.com/youarenotbroken   Monica Molenaar is a serial entrepreneur and an advocate for frank talk and common-sense solutions around women’s health and wellness.  At the age of 40, Monica tested positive for the BRCA gene and elected to remove her ovaries prophylactically to reduce her risk of breast and ovarian cancers, thereby ending her natural production of estrogen and sending her into surgical menopause overnight. This began a multi-year journey trying to make sense of all the misinformation and lack of clarity around this phase of life. It was only after starting to supplement with estrogen and progesterone that Monica found relief from the menopausal symptoms affecting her quality of life and was able to get back to work. She was inspired to start Alloy to make sure that other women entering menopause would have an easier time than she did accessing credible information, doctors expert in menopause and women's health, effective and safe solutions, and a supportive community.   What turned Monica into an estrogen activist? Why do you think it's important that women learn more about their biology in order to take control of how they age? Since when did it become ok to talk about sex the way we are doing it now? Alloy is combo menopause and sexual health – how did that happen? – let’s talk about topical sildenafil The stigma of testosterone in women     https://www.instagram.com/myalloy/ https://www.myalloy.com/ CODE: CASPERSON25 for $25 off your order   Our podcast sponsor today is AG1. Use AG1 to build a foundation for better health. FREE ONE YEAR SUPPLY OF VITAMIN D3+K2, 5 TRAVEL PACKS drinkag1.com/youarenotbroken   Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK Did you watch the Tedx Talk yet? Why We Need Adult Sex Ed Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed   Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

Estrogen Matters with Dr. Avrum Bluming Avrum Bluming received his MD from the Columbia College of Physicians and Surgeons. He spent four years as a senior investigator for the National Cancer Institute. He organized the first study of lumpectomy for the treatment of breast cancer in Southern California in 1978, and for more than two decades he has been studying the benefits and risks of hormone replacement therapy administered to women with a history of breast cancer. Dr. Bluming has served as a clinical professor of medicine at USC and  is the co-author of “Estrogen Matters: why taking hormones in menopause can improve women’s wellbeing and lengthen their lives – without raising the risk of breast cancer” with Dr. Carol Tavris.   Hear his story about how he became the advocate for hormones and hormones after breast cancer.   So many people think correlation = causation – case with E and breast cancer – just poor education in our population?   “we don’t know what causes breast cancer” – can people handle a grey world?   Estrogen receptor positive doesn’t mean estrogen caused the cancer – discuss   Dispel the myth that early puberty and late menopause is a breast cancer risk – dogma – “lifetime exposure” – but women with lots of pregnancies have lower risk.   Should we just work on a re-brand? Go on HRT because if you do get breast cancer you will do better than if you weren’t on it?   How do aromatase inhibitors work? People call them “estrogen blockers” so people think estrogen causes cancer and recurrence.  Why only in post-menopausal women?   What’s with adipose tissue? People always say it is because adipose tissue increases estrogen – is it estrone ?? Or inflammation?   Doctors don’t want to be sued. Do you know of any doctor getting sued for giving hormones in general or after breast cancer?   If estrogen is FDA approved for prevention of osteoporosis – why did the USPSTF say no to prevention and why are we screening for osteoporosis so late (age 65?)   Do you agree with the USPSTF about no for prevention. Your opinion of Progestin causing Breast cancer" Is the placebo arm bad?  Is the risk not actually that high – from 2-4% Is it the synthetic progestin?  Everyone’s talking about dementia now – Dr. Bluming’s take  There are 25 studies showing E is safe after breast cancer  and 20 review studies– and the HABITS trial is the only one that shows local recurrence and is flawed – how many studies are enough?   Advice for younger physicians who care about this work?   Do you think the world is just crazy? How does Dr. Bluming cope?   We discuss the new Danish study in the British Medical Journal and dissect the data to dispel the fear.   http://www.instagram.com/estrogenmatters https://estrogenmatters.com/ Buy Estrogen Matters https://amzn.to/3POsai5     Did you get my “You Are Not Broken” Book Yet? https://amzn.to/3p18DfK   Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed   Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

Genitourinary Syndrome of Menopause 101. This is an interview I did with my friend and co-founder of a menopause clinic Alloy, Monica Molenaar. Why I care about women and sex and hormones The definition of menopause and how we aren’t educated about what menopause actually is and the symptoms that can arise Genitourinary Syndrome of Menopause The types of bladder leakage and how estrogen can help The different types of estrogen – vaginal and systemic Why we need vaginal estrogen even when we are not sexually active Why I have a cream bias with vaginal estrogen, and other options. Vaginal estrogen will not help your hot flashes. Myths about who can and can’t use vaginal estrogen. Biologic changes of the skin of the vulva after menopause      How the clitoris works. Scream Cream – what it is and does it work. Favorite lubes and I explain why I like what I like Gen X is the lowest users of vibrators in America There are many papers showing transdermal estrogen does not increase your clot risk above what it already is. I explain the Women’s Health Initiative study and how it hurt women by creating fear. Vaginal estrogen is equivalent in efficacy to the common overactive bladder medications.  Why not restore function instead of taking the side effects of the overactive bladder medications? When should you stop using your seatbelt, sunscreen and vaginal estrogen? Urinary tract infections put people in the hospital and kill them – this is not a hangnail. Can estrogen alone help all pain with sex? What do they new Menopause guidelines say about the window for starting systemic hormones and how long can you take them. The role of androgens and testosterone in the genitals.   ACOG Position Statement of using vaginal estrogen in breast cancer patients https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2021/12/treatment-of-urogenital-symptoms-in-individuals-with-a-history-of-estrogen-dependent-breast-cancer Vagina Obscura by Rachel Gross https://amzn.to/46XHChX https://www.myalloy.com/ CASPERSON25 for $25 off   https://www.instagram.com/myalloy/   Our podcast sponsor today is AG1. Use AG1 to build a foundation for better health. FREE ONE YEAR SUPPLY OF VITAMIN D3+K2, 5 TRAVEL PACKS drinkag1.com/youarenotbroken   Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK   Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed   Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership   --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

Welcome to July's Live Podcast Orgasmic versus hormonal Use it or lose it Studies on Teen Sex Ed, PRP for ED, HPV jabs, Creating Desire and more! Sex Ed matters:https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-11388-2 Did you get my “You Are Not Broken” Book Yet? https://amzn.to/3p18DfK Get in the Free FB group: https://www.facebook.com/groups/youarenotbroken/   Join my NEW Adult Sex Ed Master Class: https://www.kellycaspersonmd.com/adult-sex-ed   Join my membership to get these episodes ASAP when they are created and without advertisement and even listen live to the interviews and episodes. www.kellycaspersonmd.com/membership --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices