You Are Not Broken

Menopause in the Workplace and Estrogen After Breast Cancer Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken Go to Addyi.com and use code NOTBROKEN for a $10 telemedicine appointment. Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com -       Female physicians want to back off work secondary tomenopause symptoms -       The huge financial burden and loss to the workforce because of untreated menopause -       One of the largest groups in poverty in America is women over age 80 -       I report on the Evernow survey of menopause in the workforce -       I discuss Avrum Bluming’s article in the May 2022 Cancer Journal – Estrogen After Breast Cancer – is it time? -       I discuss the progression of prostate cancer survivors being given testosterone over my career and how I think breast cancer will be headed this way too. -       The efficacy of estrogen in preventing hip fractures. -       The longevity benefit of taking estrogen The risk of pulmonary embolism with pregnancy, birth control and menopause hormone therapy  -       I discuss three paradigms coming in the future with hormones – hormones after breast cancer, hormones in women greater than 10 years post menopause, and hormones in perimenopause Evernow menopause in the workplace Dr. Avrum Bluming’s article Bluming, Avrum Zvi MD. Hormone Replacement Therapy After Breast Cancer: It Is Time. The Cancer Journal 28(3):p 183-190, 5/6 2022. | DOI: 10.1097/PPO.0000000000000595 Estrogen Matters Book 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

238. Testosterone: An Education  Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken Go to Addyi.com and use code NOTBROKEN for a $10 telemedicine appointment. Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com Dr. Khera lives in Houston, TX practices at Baylor and has dedicated his clinical and research efforts to three main areas:  Men’s Health, sexual medicine, and hormone replacement therapy.   His basic science and clinic experiences have allowed him to thus far give over 250 lectures at scientific meetings throughout the world, publish over 120 articles in peer-reviewed journals, complete 15 book chapters, and edit and write two books, all in the field of sexual medicine and Men’s Health. Why is testosterone so interesting to Dr. Khera? Testosterone and prostate cancer – what do we know. Is a lowering Testosterone in men "natural"? and if it isn’t, what causes low testosterone in men? What do the new weight loss drugs do to testosterone levels and male fertility? We discuss the different ways you can give testosterone to women: topical, pellets and compounded injectable doses of testosterone for women: 50mg/ml and start at 0.1 mg injected a week. The benefits of testosterone for women besides low libido. The role of chronic pain and testosterone and pain meds. The mechanism of how your testosterone goes up when you lose body fat. The four pillars of health for natural testosterone production – diet, exercise, sleep, stress reduction Erectile dysfunction is a harbinger for heart attack and heart disease. “There is not a better barometer of a man’s overall health than his sexual health” – Dr. Khera The role of DHEA (a mild androgen made in the adrenals) in men and women. The link with Peyronies disease and Testosterone. And we discuss penile stretching devices. We discuss a 2013 Finkelstein article – they gave men testosterone and blocked its conversion to estrogen. So are we undertreating men by not addressing their estrogen? Dr. Khera was  part of the NEJM study that came out this summer looking at T in men with low T and high risk CV risk. The Traverse trial. Conclusions: In men with hypogonadism and preexisting or a high risk of cardiovascular disease, testosterone-replacement therapy was non-inferior to placebo with respect to the incidence of major adverse cardiac events.  Barriers to a testosterone prescription include that it is a regulated medication, a physician needs a DEA license to prescribe it – similar to a narcotic. Dr. Khera lends his opinion to safe prescribing of testosterone but thinks the DEA regulation is here to stay. He clarifies the number of men who suffer from hypogonadism and the number of men who are undergoing treatment for this condition? Testosterone levels are dropping because men are getting less healthy. Dr. Khera talks about measuring a baseline testosterone level in men as a marker of overall health and focus on lifestyle changes to naturally get this normal. 50% of men don’t talk to their doctor about their erectile dysfunction, and 44% of those men don’t talk to their partner about it. www.instagram.com/drmohitkhera Dr. Mohit and Dr. Morgentaler’s testosterone course ⁠NEJM article discussed: Gonadal Steroids and Body Composition, Strength, and Sexual Function⁠ ⁠Traverse Trial https://drmohitkhera.com/ 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

237. Libido/Desire Differences in Partners Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com  Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken Go to Addyi.com and use code NOTBROKEN for a $10 telemedicine appointment. Dr. Jennifer Vencill (she/her) is an assistant professor, board certified clinical health psychologist, and AASECT certified sex therapist at the Mayo Clinic in Rochester. Her research focuses on sexual health and health disparities in marginalized sexual and gender communities. Dr. Lauren Fogel Mersy (she/her) is a licensed psychologist and an AASECT certified sex therapist. She received her doctorate in clinical psychology and completed her postdoctoral training at the University of Minnesota’s Institute for Sexual and Gender Health. She has advanced training in Emotionally Focused Couple Therapy and Gottman Method Couple Therapy. She specializes in sexual health and relationships and owns her own private practice in Minnesota.  Why did they needed to write a book about desire? Desire discrepancy should be part of adult sex education "Your desire should match your partner" is a myth. Why do we want to blame someone or make someone be the problem in a relationship for having a low libido. The stereotype is that the low libido person is the female – but that is not always the case. We define responsive desire. Four requirements for responsive desire – consent, pleasure, focus, time When you have sex for your partner or fulfill a duty – if this is the default or only motivator for sex it can really affect your desire. Tips for getting out of this pattern. We talk about shame and sex. Your sexuality does not exist in a bubble. We suss out asexuality versus low desire. Asexuality is a self-identity label and a valid sexual orientation. What to do when not attracted to a partner anymore? Is attraction as fluid as desire is? We talk about “sexual destiny” beliefs versus sexual growth beliefs and how these can hurt and benefit our relationships.   Tips for the high libido partner. Reducing pressure on their partner and managing their rejection and disappointment reactions. Consider what you are longing for when you seek sexual connection or sexual frequency. Tips for “trying to conceive" low libido Is “desire discrepancy” in a relationship a deal breaker? Not usually. What to do when your partner stonewalls you or doesn’t want to work on the relationship.   Dr. Fogel Mersy Instagram, Facebook, and TikTok @drlaurenfogelmersy  Dr. Vencill www.instagram.com/drjennifervencill. Get their desire book onAmazon Desire: An Inclusive Guide to Navigating Libido Differences in Relationships.   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

Dr. Sonya Ephraim, a urogynecologist and founder of Allure Pelvic Wellness, shares her insights on pelvic organ prolapse. She discusses the stigma surrounding this condition and emphasizes the importance of open conversations about women’s health. Topics include the risk factors for prolapse, especially post-menopause, effective treatments like pessaries, and the role of pelvic floor therapy. Dr. Ephraim also addresses common misconceptions about bladder prolapse and explores options for managing intimacy and body image during treatment.

Menopause Society President – Dr. Lisa Larkin. This episode is sponsored by Solv Wellness®, makers of Via™, a vaginal moisturizer that can also be used as a lubricant. To get Via, visit ⁠via4her.com⁠ for 30% off your first purchase. Discount automatically applied at checkout. Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com Dr. Larkin Trained at Yale and the University of Chicago, Dr. Lisa Larkin is a women’s health internist, menopause, sexual medicine, and medical breast expert and a women’s health physician and consumer educator who has been practicing in both academics and private practice for over 30 years. She is Founder and CEO of Ms.Medicine, a national health care organization dedicated to advancing women’s health on a broader scale and Founder and CEO of Concierge Medicine of Cincinnati, an Internal Medicine and Women’s Health practice where she continues to practice clinically. Dr. Larkin is the President of the Menopause Society.   Why did NAMS (North American Menopause Society) rebrand to Menopause Society?   “We can’t pigeon hole women’s health into the Ob/Gyns” – Dr. Casperson   “Women’s health doesn’t belong to any one specialty” – Dr. Larkin   Dr. Larkin shares her story about not being trained in menopause and her career journey and how she understands the WHI study.   We talk about fezolinetant (Veozah) – the new non-hormonal medication for hot flashes.   One of Dr. Larkin’s favorite thing to talk about is breast cancer risk assessment and prevention so we discuss this.   We define dense breasts.   Why alcohol just doesn’t make sense in midlife   Dr. Larkin shares her personal journey with menopause symptoms and sexual dysfunction. And shares non-hormonal options. And what you can do without seeing your doctor.   The role of confidence in midlife - lack of confidence in what to do and how Menopause Society/her clinic/my podcast can help - and what we see when women get confident and educated in midlife. What excites Dr. Larkin about menopause and the women’s health space   https://www.menopause.org/ https://www.instagram.com/drlarkin/ https://www.mymsmedicine.com/dr-lisa-larkin   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

Dr. Sonia Wright interviews me on genitourinary syndrome of menopause - AKA: The Senile Vagina and The Super Penis Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken Go to Addyi.com and use code NOTBROKEN for a $10 telemedicine appointment. Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com The history of getting to the name “genitourinary syndrome of menopause” GSM happens not just in menopause The labia goes away after menopause unless hormones are supplies Recurrent urinary tract infections are in the top 10 reasons women go to the doctor Why you get more urinary tract infections after menopause When we treat erectile dysfunction are we treating the partner? We talk about sex ed for adults and what I would put in a curriculum. The role of vaginal estrogen Where to get cheap vaginal estrogen ACOG statement on vaginal estrogen after breast cancer “estrogen is not trying to kill you” The FDA black box warning on vaginal estrogen is wrong Can I just use lube? Issues with sensitive skin when starting vaginal estrogen Why I don’t use a loading dose with vaginal estrogen When to consider adding testosterone to your vulva or DHEA to your vagina How to talk to your health care provider about genitourinary syndrome of menopause and ask to try a prescription product. Vaginal estrogen can help overactive bladder and urge leakage The myth of needing to finish your periods prior to starting vaginal estrogen https://soniawrightmd.com/ https://www.instagram.com/drsoniawright 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

Booty Play and Butt Stuff I am back with Jenn Mason!  Check out our older episodes on toys and more #45, #49 and #52 Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken Go to Addyi.com and use code NOTBROKEN for a $10 telemedicine appointment. Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com The more people are empowered in their sexuality, hopefully this will decrease the bad things. What is booty play and let’s define what it is and what the body parts are. How do people get started with butt stuff? No one gets extra points for going up in size with booty play. Tips for starting to explore. Consent and doing stuff because my partner wants me to. The importance of communication. Is booty play guaranteed pain? Pain is a sign to slow down or stop. How to people prepare for receptive booty play. How messy is booty play in real life? Lube lube lube Is it okay to ejaculate in the rectum? Rules for booty play Do you need to use condoms? What anuses are supposed to look like. Is there a lube that is specific for booty play? Anal play safety Does booty play make me gay? How to talk to your health care provider about anal sex. If someone wants anal sex does that mean he is weird? Can receptive anal play mess up my body? Does the penis have to be a certain type of hard for penetrative play?   Why does this not go well sometimes?   “No one gets a trophy for getting a penis into a butt” – Jenn Mason https://winkwinkboutique.com/ https://instagram.com/winkwinkboutique 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

I am back with Jenn Mason!  Check out our older episodes with Jenn on toys and more #45, #49 and #52 Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken Go to Addyi.com and use code NOTBROKEN for a $10 telemedicine appointment. Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com What are intimate lubricants and why are they important? When do most people get introduced to lubes? Types of lube Myths about lubes How to incorporate lube into your life How to talk about lube Risks with lubes Novelty lubes What’s coming down the pipeline with lubes Do lubes have expiration dates?  Lubes versus intimate moisturizers – an educated difference.  A discussion about “natural” and “botanical” and “organic” lubes  https://winkwinkboutique.com/ https://instagram.com/winkwinkboutique 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

“Low Libido is Not a Problem to Me” - Caffyn Jesse Caffyn Jesse is a queer elder, sacred intimate, teacher and writer who revels in the power and pleasures of the erotic. They are a renowned teacher of sex, intimacy and healing trauma with pleasure.  Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com   She tells us how she went through her journey at age 40 and found her erotic energy   "You are not broken" is the name and theme of my podcast – She tells us how her work relates to this? In your book, “Science for Sexual Happiness” she says – “Can you imagine a way of being sexual that is energized and playful, passionate and flowing? “ - I think for so many people it is a hell no. How they would work with pain with penetrative sex. How they would work with low libido. We have so much experience consenting to things we don’t really want” – Caffyn Jesse Tips for being stuck in a sexual rut? How can erotic massage change our experience of sex? In your book “Intimacy Educator: teaching through touch” – you have a whole chapter on touching a vulva owner.  Tips. How they deal with erectile dysfunction What do you do on your retreats?   Science for Sexual Happiness by Caffyn Jesse Intimacy Educator: Teaching Through Touch by Caffyn Jesse https://ecstaticbelonging.com/ https://www.facebook.com/caffynjesse/ https://www.instagram.com/caffynjesse/   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

Normalizing Sex - Talking With a Sacred Intimate Practitioner How did he choose this career path – or did it choose him? From the military to tech to surrogate partner.   Thanks to our sponsor Sprout Pharmaceuticals addyi.com/notbroken   Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN  uberlube.com   What is the difference between Surrogate Partner Therapy and Sexological Bodywork? His approach uses the theory that sexual energy manifests in your body, not your mind – tips for people to access and be comfortable with their body. Tips for communicating. He discusses what a sacred intimate is. How he works with trauma. His definition of sex. The top reason men and women seek out his work.  How do people stay intimately connected when life gets busy? So many disempowered people – where do you start?  What is consensual non-monogamy and what does he wish people knew about it?  What he wishes doctors and therapists knew about his job?  www.instagram.com/comingcloserwithandre www.coming-closer.com   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