You Are Not Broken

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

I went to the 2023 American Urologic Association's National Conference. Here are some top takeaways and thoughts. So much on this week’s podcast! Low hormones in men and women — can increase risk for cardiovascular disease Women have a decreased risk of heart attack and stroke when started on hormones in the safety window of menopause (first 10 years) The Traverse study paper coming out in two months - can’t wait! Testosterone is not a gendered hormone All bones need testosterone Women in early menopause should be on hormones at least until natural age of menopause to decrease risk of cardiovascular disease, osteoporosis (NAMS guidelines and this indication has FDA approval). Equality in healthcare Three new oral testosterone pills on the market for men, not for women We need to focus on brains and bones health in women just as much as we do for men Treat women the same in healthcare Did you know the UK is requiring doctors to talk to their patients at age 50 about menopause? Amazing! If hormones are so dangerous, why don’t we stop estrogen in trans women after the age of 50 - a thought exercise on how we think about giving hormones to all bodies - Is staying on hormones during menopause gender affirming care? Oral DHEA supplements — what’s the deal? Bulkamid — urethral filler for stress incontinence ECoin training Prolapse repair in premenopausal women Should we offer it or no? Male infertility is associated with shorter life expectancy Marijuana affect sperm Using testosterone for maintenance of vaginal health Michael Pearlman balance scale of desire More about Addyi (filbanserin) Importance of elastin and collagen Very small percentage of women have cervical orgasms - but it matters. New technology that @mysteryvibe is releasing to help with period cramps --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

Feeling Broken In The Bedroom? What You Need To Know About Your Sexual Health - With Dr. Kelly Casperson This is an interview I did with Lesley McShane for her podcast “Redesigning Midlife” and it was just such a good interview I asked her if I could share it again.  1. Basics:  a. Menopause means it’s been one year and one day since your last period. b. The average age of menopause is around 51. and c. for ten years prior to menopause, women go through peri-menopause, where hormones are doing a reverse puberty. 2.  A lot of women stop or have pain during penetrative intercourse during this time due to a decrease in natural lubricant and collagen, but this can be easily treated. 3. Even if you don't have menopause symptoms, if you are over the age of approximately 51, you have gone through it. 4. The most sexually satisfied people aren’t young people, it is people in their 50s, 60s, 70s. 5. Great sex is not a passive thing. It’s an active process, just like someone that is physically fit. It has to be prioritized. 6. Use of lube increases your success of orgasm by 70-80%. Silicone based lube is best because you don’t absorb it like you do the water based. 7. There is no “how long” should I use Vaginal Estrogen cream. The use of it is like using sunscreen or wearing a seat belt. 8. You don’t need a “sex drive”. We do things because they are awesome.  If you aren’t having awesome sex, don’t wonder why you don’t desire it. 9. We feel entitled to a spontaneous sex drive that has been sold to us by media. And when we don’t achieve that, we end up feeling broken. 10. Putting something in the vagina only leads to female orgasm 30% of the time so special focus need to be paid to the female body. Your largest sex organ is your brain. 11. Don’t sit passively by waiting for spontaneous desire to happen. Get dressed up and go to the party even if you don’t think you want to. Chances are you’ll have a good time once you get there. 12. Control of stress and cortisol levels in our bodies will help us desire more intimacy. 13. If there is a desire mis-match in your relationship, normalize it by talking about it. 14. Communication with our partner about menopausal symptoms and what we are going through is important to our relationship. 15. Get educated on hormone replacement therapy as an option. When women start thinking about how they want to live as they get older and get educated, then they see how beneficial HRT could be for them. 16. Women between the age of 50-60 that are on hormone therapy live 3-4 years longer than women in the same age group not on hormone therapy. 17. For our young adult children that are starting their own sexual lives, the biggest thing they need to know from the start is about consent. 18. They need to be aware of is orgasmic equality. 19.We have to educate our girls that pleasure is for everybody.  Lesley McShane's podcast: https://podcasts.apple.com/us/podcast/redesigning-midlife-workout-motivation-over-50-weight/id1549596974 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

Better Sex Through Mindfulness – Dr. Lori Brotto  Dr. Lori Brotto is a psychologist and Director, UBC Sexual Health Laboratory Canada Research Chair in Women’s Sexual Health Professor, Department of Obstetrics & Gynaecology, UBC Executive Director, Women’s Health Research Institute  “Sex is not just a deficiency in a hormone” – KJC Dr. Brotto tells us how she started her sex research career by studying rats. Do stressed out rats want sex? “Stress is antisexual” – Dr. Brotto “So many people don’t even know that they are stressed.” - KJC Dr. Casperson tells her story about finding mindfulness How Dr. Brotto discovered mindfulness for helping manage pain, anxiety, and desire Mindfulness During sex. How anxiety and depression affects our sexuality. And mindfulness can help! We talk about medications for low desire in women. Filbanserin specifically. Beliefs are key!  We discuss the role of beliefs on our sex life. Mindfulness helps us “see” our beliefs more. Anorgasmia – how common it is and what is the most common cause. How to suss out asexuality versus low desire.  Obligatory sex – how to navigate discrepant desire. The myth of penis and vagina sex and why it excludes so many people. Mindfulness for sexuality after prostate cancer. The role of communication with your partner. Do they even want your erect penis? https://www.loribrotto.com/ Better Sex Through Mindfulness https://amzn.to/42bchpj Better Sex Through Mindfulness Workbook: https://amzn.to/42abTYc https://www.instagram.com/drloribrotto/ https://www.cancersexnetwork.org/ https://www.drannekatz.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