You Are Not Broken

Latest Episodes:

242. Modern Sex Challenges with Dr. Marianne Brandon Dec 17, 2023

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242. Modern Sex Challenges with Dr. Marianne Brandon Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN uberlube.com Check out my retreat March 2024! https://ascendretreats.com/ Dr. Marianne Brandon is a clinical psychologist and Diplomate in sex therapy. Dr. Brandon is the author of “Monogamy: The Untold Story” and the ebook “Unlocking the Sexy in Surrender: Using the Neuroscience of Power to Recharge Your Sex Life”. She is co-author of the book “Reclaiming Desire: 4 Keys to Finding Your Lost Libido.” Dr. Brandon makes cutting edge research on relationships and intimacy accessible for the general public — advice that the people are clearly starving for. Consider the stats: Over 50% of marriages end in divorce Over 40% of women and 30% of men report a sexual concern 20% of marriages are “sexless” Over 20% of women report “marked distress” about their sexual relationships Approximately 30% of spouses have had an affair Dr. Marion Brandon highlights the challenges of sex in society, the lack of comprehensive sex education, and the nuances of pornography. Dr. Brandon also explores the complexities of monogamy, the impact of AI and sex tech, and the role of power dynamics in relationships. She emphasizes the importance of treating couples, not just individuals, and the benefits of having a biopsychosocial perspective. The conversation explores the importance of hormone changes in midlife and the impact it has on sexual health. It highlights the lack of awareness and treatment of genital urinary syndrome, which can significantly affect relationship dynamics. The discussion also addresses the lack of knowledge among physicians regarding available treatments. The impact of intimate connection on overall well-being is emphasized, and Marianne Brandon's Psychology Today blog is recommended as a valuable resource. Comprehensive sex education is lacking, particularly in the digital age. Pornography can be a complex topic, with both positive and negative aspects. Monogamy can be challenging and requires effort, communication, and mindfulness. The rise of AI and sex tech presents both opportunities and concerns. Power dynamics can play a role in sexual relationships and can be explored in a healthy way. Understanding hormone changes and desire discrepancy is important in addressing sexual issues. Treating couples as a unit is crucial for addressing sexual concerns. Taking a biopsychosocial perspective can provide a more comprehensive understanding of sex and relationships. Midlife hormone changes can have a significant impact on sexual health and overall well-being. What to do when the man has a low libido. Genitourinary syndrome is often under-treated and can lead to changes in relationship dynamics. Physicians may lack knowledge about available treatments for sexual health issues. A satisfying intimate connection has a profound impact on relationships and overall life satisfaction. Marianne Brandon's Psychology Today blog is a valuable resource for information on sexual health. The testosterone conference for clinicians is an important event for learning about biopsychosocial and hormonal aspects of sexual health. She asks her clients about their best sex ever because I can learn a lot about them from this memory. https://www.drbrandon.net/ https://www.psychologytoday.com/us/blog/the-future-intimacy twitter @drbrandon https://www.instagram.com/drmbrandon/ Harvard Testosterone Course https://hmstestosteronecourse.com/ Check out details for my retreat: https://ascendretreats.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

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241. Myths and Truths - GSM and Pelvic Hormones Dec 10, 2023

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241. Myths and Truths - GSM and Pelvic Hormones Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN uberlube.com Check out my retreat March 2024! https://ascendretreats.com/ Myths about vaginal estrogen What is GSM - genitourinary syndrome of menopause? The original “use it or lose it” paper. Communication in adult sex ed is very important. Non-hormonal options for GSM We discuss vaginal DHEA My opinion about loading doses for vaginal estrogen Hacks to get cheaper vaginal estrogen – Cost Plus Drugs, Good Rx, Amazon Pharmacy Medication options for GSM and why I have a cream bias Access issues for vaginal estrogen When vaginal estrogen doesn’t work Why vaginal estrogen is a life long medicine Women post menopause have less estrogen in their bodies than men. Vaginal Estrogen is a preventative medicine. It’s role in preventing genitourinary syndrome of menopause. My opinion on the applicator for vaginal estrogen cream. How vaginal estrogen helps overactive bladder symptoms. When our understanding of estrogen is minimal, we don’t understand how it affects our overall health. Should we be treating the female partner when we give men Viagra? I discuss the gender bias in treating humans in medicine with aging issues. How can the medical community do better? The problem with the FDA black box warning on the vaginal estrogen product. Is it okay to put estrogen cream on the penis? How to help our kids and the next generation. https://uronurse.com/ Check out details for my retreat: https://ascendretreats.com https://marcella-hill.mystagingwebsite.com/wake-her-up-retreat/ 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

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240. Sex After Cancer Dec 03, 2023

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240. Sex After Cancer

What are possible sexual issues after cancer?

What are treatment options?

How can we do better talking about it?

Thanks to our sponsor Uber Lube 10% off, Code NOTBROKEN uberlube.com

Dr. Laila Agrawal is a medical oncologist specializing in breast cancer in a community setting at Norton Cancer Institute in Louisville, KY. She is a fellow of the International Society for the Study of Women’s Sexual Health and has a sexual health clinic for women with cancer.

How she went from oncology into sexual health after cancer?

The importance of vaginal health after cancer treatment.

Why does no one talk about breasts as sexual organs? How does this affect the breast cancer conversation? We discuss options.

Things to know about sexual health after cancer diagnosis: It is biopsychosocial

The role of body image in impacting sexual health

The role of prevention of sexual dysfunction after radiation – vaginal dilators.

The ACOG statement supporting the safety of vaginal estrogen after cancer.

We discuss different vaginal estrogen products and vaginal DHEA.

The role of testosterone when you are on aromatase inhibitor after breast cancer.

Use of non hormonal FDA approved products for low sexual desire.

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

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https://www.instagram.com/drlailaagrawal/

@drlailaagrawal on X

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239. Menopause in the Workplace and Estrogen After Breast Cancer Nov 26, 2023

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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

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238. Testosterone - An Education Nov 19, 2023

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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

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237. Libido/Desire Differences in Partners Nov 12, 2023

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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

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236. Prolapse - Surgical and Non Surgical Options Nov 05, 2023

Show notes

236 – Prolapse – Surgical and Non-Surgical Options

This podcast is sponsored by Femselect

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Dr. Sonya Ephraim, MD, FACOG, FPMRS, is a urogynecologist and the founder of Allure Pelvic Wellness and Aesthetic Gynecology in Deer Park, Illinois, outside of Chicago. She talks about how she decided to go back to do a fellowship in female pelvic medicine.

In this episode, we talk a lot about prolapse and touch on-

· What is pelvic organ prolapse?

· Why prolapse needs a rebranding – so much shame

· Risk factors for prolapse

· What are the signs and symptoms?

· Our tips for treating constipation

· Prolapse risk goes up after menopause – we discuss the likely role of hormones and decreased muscle strength.

· The impact of prolapse on those suffering

· Why we hate calling it “bladder prolapse”

· How the bladder can be affected by vaginal prolapse and what may and may not improve

· How do we know if we have prolapse

· How do we know if we should treat prolapse

· Risk of de novo stress urinary incontinence when prolapse is fixed, either with pessary or surgery

· What is a pessary and what are the risks of a pessary.

· Can you be sexually active with prolapse?

· The role of pelvic floor physical therapy and prolapse.

· Surgical treatment options:

o One size does not fit all.

o Obliterative surgery – colpocliesis

o Hysteropexy vs. hysterectomy

o Minimally invasive options – suture or mesh based (sacrocolpopexy) procedures

o New treatment options (EnPlace) benefits and data

o The cervix as a sexual organ for some people and the consideration of cervix/uterine preservation in prolapse surgery.

· Modern prolapse repair is safe, effective and recovery is not too stressful for most women.

· Post surgery instructions and rehab – vaginal estrogen and pelvic floor physical therapy

· The risk of recurrent prolapse

· When to consider adding a sling to your prolapse procedure

· Just because someone or something said you have prolapse, doesn’t mean you need surgery

Instagram.com/allurebydrsonya

https://allurepelvicwellness.com/

#EnPlace, #PelvicOrganProlapse, #WomensHealth #PelvicHealth

My previous Prolapse episodes

21 – pelvic organ prolapse master class

138 – February Live – Hormones, prolapse, pelvic floor PT and more

161 – “I Just need to put something in my vagina”, Prolapse, and how PT helps

Did you get my “You Are Not Broken” Book Yet? https://amzn.to/3p18DfK

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235. Menopause Society President – Dr. Lisa Larkin Oct 29, 2023

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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

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234. The Senile Vagina and The Super Penis Oct 22, 2023

Show notes

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

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233. Booty Play and Butt Stuff Oct 15, 2023

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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

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