You Are Not Broken

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

When Sex Hurts – Dr. Krapf  Dr. Jill Krapf is a gynecologist specializing in vulvovaginal disorders in Tampa, FL  Dr. Krapf is active in research and has published chapters and peer-reviewed articles on vulvodynia, vulvar dermatoses, and hypoactive sexual desire disorder. She is Associate Editor for the Journal of Sexual Medicine, as well as for the textbook Female Sexual Pain Disorders, 2nd Edition.  Love Dr. Krapf? Check out my other episodes #131 – National Lichen Sclerosis Day and #172 – Vulvar Itch Why write a 2nd edition of the book “When Sex Hurts”? How common is pain with sex for women? Often times with pain with sex there is a physical cause, but you can’t always see it. Pelvic pain and pain with sex is very isolating and people feel very alone.  People don’t know how to talk about it.  What happens after the pain is fixed. What does “all in your head” mean and why people don’t like that. “Those who perceive their partners as kind and understanding report more intense pain than women whose partners have responses that promote adaptive coping.” – what!  What is adaptive coping? How to communicate your pain to your partner and your doctor. What if you are a partner of someone with dyspareunia - - “best partner response is having a partner who engages in what researches call facilitative responses – affection and encouragement to cope with the pain in an adaptive way, such as by focusing on pleasure, deep breathing or positive thoughts while experiencing the pain.” We talk about stress, sex and the gut – things like irritable bowel syndrome related to pain with sex? The role of birth control pills and pelvic pain and health. In her book, “When Sex Hurts” they talk about Yaz (drospirenone) and pelvic pain – a prospective study of women’s genitals and sexual function prior to starting Yasmin – and then after three months- decreased clitoris, decreased blood flow, decreased labia minora, decreased libido, fewer orgasms and more dyspareunia. The role of testosterone in pelvic pain – one study showing women with higher androgen levels have less work related neck and shoulder pain then women with low androgen and differing levels of Testosterone may explain some of the gender related differences in pain perception The difficulty in giving testosterone to women and the problem with pellets. Recurrent Yeast Infections – Dr. Krapf helps us 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 The new 2nd edition of “When Sex Hurts ”https://amzn.to/460TP4V https://jillkrapfmd.com/ https://www.instagram.com/jillkrapfmd/   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

The Best Sex Ed You Never Had   We all got a sex education – it just wasn’t accurate.   My Sex Ed course is coming out this Month!  Get on the email list to join when it opens.   This was a talk I gave to medical doctors for a residency program continuing education lecture.   Seasons of sexuality Stress and sexuality The importance of self-care in sexuality Communication and sexuality Sex as a skill that can be improved   Sexuality and gender equality   Stop Should-ing all over your sex life       If you got decent sex ed you were lucky   Sex is Complex – therefore so so interesting Biopsychosocial   Your sexuality is not a fixed asset   Orgasms are good for us   Your biggest sex organ is your brain   Night shifts wreak your sexual function – any gender   Sex is dopamine, and we have cheaper dopamine in our current society which competes with sex.   Defining heteronormativity   What Society tell us about sex (and is wrong about)  Pro tip: desire mismatch is normal Pro tip: Why do you want to have sex?  FEELINGS – list three -       If partnered: do you know theirs?   Orgasmic Inequality is real.   The Heteronormative Theory of Low Desire in Women Partnered with Men   How Freud messed us up in regards to sex.   Do you actually “fall out of love” or does your brain habituate and you are craving newness and dopamine?   Cognitive distractions are bad for good sex.  Mindfulness and meditation can help.   How to improve sex as a skill Relationship between sex and sexuality (sensuality) and ways to improve sex drive How to have a balanced life, not put sexual health on the back burner Stress effects on sexuality Resources -       You are not broken book -       Becoming Cliterate -       Your body is not an apology -       Sex and Sexuality podcast -       How to find a sex therapist o   AAASECT.org   Take one action toward achieving a fulfilled life   Why does sex end when the male ejaculates?   The heteronormative definition of sex is not good for anybody.   What we make lubrication mean.   How does your pelvic know that it is sexy time?  Remember brain and pelvic arousal.   Our lack of ability to communicate to our partner’s about why we want sex hurts us.   So many things about sex are aren’t actually about sex.   How to help post partum people and their partner’s understand what is happening after birthing a baby. The biologic and psychosocial component behind this   Even though we are not taught about sex, we are told things about sex all the time.   Women: men didn’t get any more sex ed than we did….we have to communicate our needs to them.   How to communicate about sex.   What does sensuality mean?   Don’t forget to desire things you already have.   What are your top three feelings you want to have during sex.   If you can’t turn off your frontal lobe you may have trouble with orgasms.   Challenge your limiting beliefs about sex.   Figure out your obstacles to a good sex life – now you have the pathway. The obstacles are the way.   Tips from people who have magnificent sex.   Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK 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

This is my talk I gave at the 2023 Clitoris Summit https://clitoris.io/summit2023   I discuss the bias that women’s sexual health is all in her head.   We can’t neglect the “bio” part of all bodies.   9% of urologists in the United States are female – which is about 1,000 surgeons.   Orgasms are good for us, but so often are considered “bonuses”   Don’t forget the “psychosocial” part of sexuality.   Clitoral Adhesions   Genitourinary Syndrome of Menopause   Persistent Genital Arousal Disorder   What to do about blunted orgasms?  New guidelines on female orgasm coming soon!   Our podcast partner is Firmtech – use code “NOTBROKEN” for 15% off https://myfirmtech.com/?sca_ref=3901627.saeQB3wieI   Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK 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

Adult Sexy Time Sucks – YouSeeLogic to the Rescue! Dr. Uchenna “UC” Ossai is a sex-positive pelvic health physical therapist, sexuality educator and counselor. YouSeeLogic is her platform that focuses on improving the sexual intelligence of adults through innovative content and honest discussion that is free of judgement.   What was Dr. Ossai’s path to get here?   What is intersectionality how does it affect people’s sexuality?   What is Burbon talez? Why did you write: Sexy swagger a guide to reimagining your sex life   So much of her work surrounds the role of confidence in one’s sexuality – She talks about this and gives us some top tips.   Sexual stereotypes hurt all humans – we discuss some stereotypes we might not be aware of and how we can be better informed.   Swagger Tip #99: Diversity and inclusion is basically the foundation of good sex.   How to own your sexy – and confidence isn’t static.   “Confidence is a process” – Dr. Uchenna   Swagger Tip #103 : Take up more space.   How to communicate with your partner about sex.   What does being “erotic” mean?   Embrace pleasure as the antidote to oppression! What ! bring us some news here!   What is your definition of a good lover?   https://www.instagram.com/youseelogic/ https://www.tiktok.com/@youseelogic https://youseelogic.com/   Our podcast partner is Firmtech – use code “NOTBROKEN” for 15% off https://myfirmtech.com/?sca_ref=3901627.saeQB3wieI   Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK 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

Dr. Elliott Justin – founder and CEO of Firmtech Our podcast partner is Firmtech – use code “NOTBROKEN” for 15% off  FirmTech’s rings help improve performance and sexual experience for all men not just those with ED. Award Winning Tech: Most Innovative Sex Toy (XBIZ); RunnerUp in Fitness & Health (CES Showstoppers)  Firm tech focuses on enjoyable sex for men of all ages, while empowering them to better understand their health and the impact of medications, supplements, personal habits, vices and exercise on their sexual wellness. We want to give you the data to make the best decisions for your sex health.    Dr. Justin started out as an emergency medicine doctor (treating ED - amazing story) – how he transitioned to sex tech and founded a company?   The number of nocturnal erections you have is a marker of vascular health. The penis is the canary in the coal mine of vascular disease.   No one knows what is normal in terms of numbers of nocturnal erections for men as they age.   “cock killer” drugs for men – SSRI and hypertension drugs, recreational drugs   Is there a number of times a week a man should have sex to “use it or lose it”?   Alcohol has a profound effect on erections.   Dr. Justin explains venous leak syndrome of the penis and what causes it.   How this Firmtech device actually works.   What is coming in the future for clitoral wearables?   https://www.instagram.com/myfirmtech/ https://myfirmtech.com/ use code “NOTBROKEN” for 15% off https://wefunder.com/firmtech Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK   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

Member question:  Lichen Sclerosis, decreased sensation and libido – I discuss two types of desire – spontaneous and responsive and three options pharmacologically for low desire. A couple options for if you "want to want": testosterone, Addyi and Vyleesi. Pneuma for penile girthiness  - if you want to be a shower. The Orgasm Gap - as written by men Testosterone is not associated with increased cardiovascular risk and associated decreased risk of breast cancer. P Agrawal and others, Testosterone Therapy in Females Is Not Associated with Increased Cardiovascular Risk – A US Claims Database Analysis, The Journal of Sexual Medicine, Volume 20, Issue Supplement_1, May 2023, qdad060.014, https://doi.org/10.1093/jsxmed/qdad060.014   Sexual Boredom in long term relationships contributes to low desire. L De Oliveira and others, (055) Sexual Boredom and Sexual Desire in Men and Women in Long-term Relationships: A Latent Profile Analysis, The Journal of Sexual Medicine, Volume 20, Issue Supplement_1, May 2023, qdad060.053, https://doi.org/10.1093/jsxmed/qdad060.053   An obituary of Jaqueline Gold Our Podcast Sponsor is Firmtech – use code “NOTBROKEN” FirmTech’s rings help improve performance and sexual experience for all men not just those with ED. ⁠https://myfirmtech.com/⁠ Did you get the You Are Not Broken Book Yet? https://amzn.to/3p18DfK   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

You Are More Than Just Your Breast Cancer - Hormones and Breast Cancer   Dr. Corinne Menn is a board certified OBGYN and North American Menopause Society Certified Menopause Practitioner. She has a special interest in areas often neglected in women's health: Perimenopause and menopause, the unique needs of female cancer survivors and those at high risk for breast cancer.    Dr. Menn tells us her story of breast cancer dx at age 28, going through menopause three times and is now a pro-hormone educator.   Dr. Menn discusses taking systemic hormones and her journey and how it has changed her life.   Why are doctors and patients so afraid of hormones?   Doctors are so risk adverse – but let’s talk about the risks of not treating menopause.   The myth that estrogen causes cancer.   How Tamoxifen works.   Breast cancer nomenclature – estrogen positive – this doesn’t mean estrogen caused the cancer – we clarify.   The nuance of being overweight and risk of breast cancer.   The number one killer of women with history of breast cancer is heart disease.   Safety of systemic hormone replacement therapy in breast cancer survivors Article in Breast Cancer Research and Treatment · January 2022 – Dr Bluming -       "Twenty-five studies of HRT after a breast cancer diagnosis, published between 1980 and 2013, are discussed, as are the 20 reviews of those studies published between 1994 and 2021. Only 1 of the 25 studies, the HABITS trial, demonstrated an increased risk of recurrence, which was limited to local or contralateral, and not distant, recurrence. None of the studies, including HABITS, reported increased breast cancer mortality associated with HRT. Even in the HABITS trial, the absolute increase in the number of women who had a recurrence (localized only) associated with HRT administration was 22. It is on the basis of these 22 patients that HRT, with its demonstrated benefits for so many aspects of women's health, is being denied to millions of breast cancer survivors around the world."   The problem with the HABITS trial.   Why are we scaring women so much about breast cancer?   Who is the right breast cancer survivor to start hormones? A good candidate?   Are we overtreating with aromatase inhibitors? Podcast partnership today: Always Discreet https://www.instagram.com/alwaysdiscreet/   Bluming AZ. Hormone Replacement Therapy After Breast Cancer: It Is Time. Cancer J. 2022 May-Jun 01;28(3):183-190.   Young Survival Coalition https://youngsurvival.org/   Vaginal Estrogen for people with a history of breast cancer: 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   Dr. Menn is an Alloy Health Medical Advisor and Prescriber www.myalloy.com http://www.drmenn.com/ https://www.instagram.com/drmennobgyn https://www.tiktok.com/@drmennobgyn https://www.facebook.com/drmenn --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices