We're bringing back one of our most talked-about episodes — a powerful, candid conversation you’ll want to hear again (or for the first time).
In this episode, we sit down with Dr. Kelly Casperson, a renowned female urologist, to explore everything about vaginal health and sexual pleasure during midlife and beyond. Dr. Casperson brings a fresh, open, and engaging perspective to these important topics, offering insights into how women’s bodies change and how to maintain intimacy and pleasure throughout life. This conversation is both informative and hilarious, packed with advice on navigating vaginal health and feeling confident at any age. Buckle up for a candid, emotional, and empowering chat with one of the best in the field!
In this episode, we sit down with Dr. Kelly Casperson, a renowned female urologist, to explore everything about vaginal health and sexual pleasure during midlife and beyond. Dr. Casperson brings a fresh, open, and engaging perspective to these important topics, offering insights into how women’s bodies change and how to maintain intimacy and pleasure throughout life. This conversation is both informative and hilarious, packed with advice on navigating vaginal health and feeling confident at any age. Buckle up for a candid, emotional, and empowering chat with one of the best in the field!
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Transcript
Episode Transcript
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Speaker 1 (00:00):
Today on the Body Pod, we are rerunning doctor Kelly
Casperson's episode which is all about vaginal health and pleasure. Now,
Kelly is not only an incredible physician, but she is
also one of my favorite menopausal specialists in the space.
She is funny, she is vibrant, and this episode will
(00:23):
not only educate you, but keep you in stitches most
of the time. Enjoy this episode with doctor Kelly Casperson. Hi. Everyone,
my name is Haley and this is Laura and welcome
to the body Pod. Today on the Body Pod, we
(00:45):
have a super special treat interviewing urologist doctor Kelly Casperson.
If you are not familiar with her, you need to be.
She is the ted X speaker for why we need
adult sex education. It is fabulous, it is short, and
(01:05):
it packs a punch, so you will want to watch
that if you haven't. She's also the podcaster for You
Are Not Broken, as well as the author of a
book that's launching this fall that is the redo of
her original book, You Are Not Broken. You can now
pre sell that on Amazon. This podcast is spicy and
(01:31):
it will tap into every emotion that you have. Let's
get into the show, all right, Welcome back to the
Body Pod. Everyone. We are so excited we have doctor
Kelly Casperson here. We've already done her intro, so we
(01:51):
are so excited to just get into all of these
questions that we have and any questions that you have
sent in for us. So welcome doctor Casperson.
Speaker 2 (01:59):
Thanks for having having me.
Speaker 1 (02:01):
Okay, first of all, we were just saying this offline,
but you are so funny. And I when I was
watching your Ted Talk, I'm like, this person. I need
to live next door to Kelly because.
Speaker 3 (02:09):
The same we're like, why is she not our best friend?
Speaker 1 (02:12):
Yes?
Speaker 2 (02:13):
Thank you? Where do you guys live? Maybe we're close,
maybe we don't even know what older.
Speaker 3 (02:17):
I'm in Park City.
Speaker 2 (02:20):
I lived in Denver for six years. See missed opportunity.
Speaker 1 (02:23):
Well where are you now? You're in Washington.
Speaker 2 (02:26):
I'm in Washington State now. Oh yeah, yeah, Well that's
great to Denver for the first time last spring and
I was like, you, guys, hasn't always been this brown?
And they're like yeah, and I'm like, I forgot I
forgot right.
Speaker 1 (02:38):
And it's funny because every time I drive out of
state and you're just like you're leaving colorful Colorado. I'm like, no,
the fuck who came up with that tagline? They needed
they need to do.
Speaker 2 (02:53):
So my first date with my husband was in Boulder.
Speaker 1 (02:56):
Oh I love that.
Speaker 2 (03:00):
So it's special. There's two kids because of Boulder, Colorado.
I'll have you no, yeah, I love it.
Speaker 1 (03:09):
Well, okay, so Doctor Casperson, here we go. Let's talk
about Well, first of all, your Ted Talk, because I
just was blown away. I've watched it multiple times.
Speaker 2 (03:24):
And I'm always like, nobody ever talks about the Ted Talk.
Speaker 3 (03:27):
Oh my gosh. That was the first thing we wanted
to talk about.
Speaker 1 (03:30):
Yeah, talking about that Ted Talk. Why we need adult
sex ed I mean, we just had a sex therapist
on and she was like, adults need to be you know,
they need to be teaching their kids about sex ed better.
And then I'm like, we don't even know if we're.
Speaker 2 (03:45):
Talking about teach them what what Hollywood taught you? Like
it's a disaster.
Speaker 1 (03:49):
Yeah, so can we talk about that? For anyone who hasn't, well,
first of all, you need to go watch it right now.
But if you haven't, I.
Speaker 2 (03:57):
Watched the Ted Talk. If you type in Ted ex
Caspersus and it'll on Google or it'll pop up or
on YouTube, it'll anyways it pops up. Yeah.
Speaker 1 (04:06):
I love that.
Speaker 2 (04:07):
It's by like twelve minute. Baby. You know, you spend
like a half a year working on a TED Talk,
so I'm super glad I did it. The Ted Talk
started out so I like, I really started out diving
into female sexual health. And so the TED Talk started
out with female It was like going to be female education.
And because women have way less orgasms than men do,
(04:29):
and it's not because their body can't do it. Lesbians
have same amount of orgasms as men do. You literally
put a penis in the room and a woman's orgasms
go down. They did an amazing bisexuality study looking at that,
which is just like sweet research. But so it started
out female sex ed and then I was like, yeah, no,
well the other fifty percent aren't any better on this, right,
(04:52):
So the TED Talk really did open up to all
adults and being like, you won't think you're so broken
if you just get some basic information. Yeah.
Speaker 3 (05:02):
Yeah, OK.
Speaker 4 (05:03):
I love when you say in the podcast, when you
ask the question are you completely confident in the bedroom
and do you talk to your partner about it? I
just thought that was such a profound question. Because I
all of a sudden, I found myself asking myself like,
well am I I feel like I am, but then
it's like, well am I too? And I think it's
(05:25):
such a good question.
Speaker 2 (05:28):
Right, And then if you're not, be like, oh my god,
I've probably lived my whole life this way, yeah, or
what got me? What got me? Not what happened right,
like if I was, which I would say is the
more unique one. I think. I think we fumble around
in secrecy as teenagers learn something good, bad, neutral from
that first experience, and then we just take that forward.
Speaker 1 (05:48):
Yeah yeah, yeah, well I have to tell you I
this is these are the exact words that I've spoken forever.
Was like, I don't know, maybe I'm just broken exact words.
I'm just like I don't know what to say. And
so this was really enlightening.
Speaker 2 (06:05):
But that's what makes so easy to name my podcast,
because like when I started talking to women about sex,
like that's what they just kept saying. I'm broken, I'm broken,
I'm broken, I'm broken, and I'm like, well, actually, most
women don't have an orgasm from putting something in their vagina,
Like you're not broken, you just don't know that fact right,
and then like another woman if she had never had
an orgasm, and I'm like, well, ten percent of women
(06:26):
have never had an orgasm, so it's not, as I am,
isn't it wild? And like the sex researchers say, it's
not because it's it's rare, that it's actually because it's
a body problem. It's really And then you know, going
back to the ted talk of like sex is biopsychosocial.
It's not just our bodies, it's not just our hormones.
(06:47):
It is you know, the religion and beliefs your parents
gave you and your first experience and dude, the power
differentials and heterosexual relationships. I'm telling you, nobody talks about
this and it profoundly affects people sex lives.
Speaker 1 (07:01):
Oh my gosh. Okay, let's dig into that a little bit,
the biopsychosocial because I'd love that. And I'm sure a
lot of women are like, Okay, that sounds cool, but
let's let's dig into it.
Speaker 2 (07:13):
Probably like this sounds really complicated, because that's how I thought, like,
I'm like, that is a long word. So and I
actually like I hated that word because I'm like, I
think it sounds super clinical. It sounds like somebody knows
something that you don't know, Like do you have to
go to a to like grad school to figure out
what biopsychosocial means? And as I was writing the Ted talk,
Ted talks, you know, they're kind of formulaic, like three
(07:34):
important points blah blah blah, right for a Ted talk,
And I was like, oh crap, bio psycho social. It
makes sense, and it lends itself to a nice Ted
talk because then you can break down all the pieces.
But basically the word just means that, like everything's affected
by what's around you and how you were raised and
(07:55):
your body, right, which you could also say like are
eating styles and choices are biopsychosocial? You know, it's like
what does your body tolerate? What foods did you grow
up with? What does society tell you about the foods?
Speaker 1 (08:09):
Right?
Speaker 2 (08:09):
Like seeing is biopsychosocial. So once you kind of break
it down and be like, oh, right, yeah, that's just
like humans don't exist in a bubble. Your sexuality doesn't
exist in a bubble. It's influenced, whether it's probably not
consciously influenced, but you have been watching Hollywood movies. Your
whole life. You have been influenced about sex roles, gender roles,
(08:32):
who initiates how fast people orgasm? You know that the
glitterist is non existent? Right, Like you have been influenced
by that, because like what other good sex and do
we have in the United States? The data says our
sex and now is worse than it was in the nineties.
Speaker 1 (08:52):
Oh come on, I know.
Speaker 4 (08:53):
Why though, because of everything that's online that got political.
Speaker 2 (08:58):
It kind of got political. So like, but to me,
I'm like, you know, I'm a I'm a victim of
the ninety sex education. But I'm like, dude, you know
when I think of the female body parts that I
was taught, like, well, I think of like what was
on the screen, it was uterous and ovaries. That's the female.
That's like, although important body parts, not responsible for pleasure.
Speaker 1 (09:22):
Yeah, oh so what Okay, this is going off topic
of where I was gonna go, But how do you
think the kids growing up now with the porn industry,
let alone Hollywood but that are just like coming into
this and they're just like, oh, this is going to
be the sexual experience. This is amazing. Yeah, and then
(09:43):
they're like, uh no.
Speaker 2 (09:45):
So there's a profound disappointment between reality, their reality and
what they've been watching. So, I mean poor used to
be like so rare. You had to like go over
to your friend's house, sneak into their dad's claw find
the magazines that were in the brown paper bag, like legit,
because that was like my first experience with like male
(10:07):
gay porn in seventh grade at my friend's house. So
like it was like very hard to access. Now it's
I mean, it's in your it's in your pocket all
the time, right, So, like porn has profoundly influenced people's
perception of not only what women want, but how men
are supposed to perform. And so now that you know,
(10:29):
talking to my friends who do the sex set in
colleges and stuff and the health just the health centers,
guys coming in thinking their bodies are perfund profoundly broken
because they don't last two hours, or they think they
you know, ejaculated too soon, or and then they're coming
in super confused because they're like, I don't think the
women are liking what we're what we're doing because what
we're watching, right, So it's a profound disconnect. And part
(10:52):
of sex education is that a lot of audio visual
is performative. And this is a movie. I love the analogy.
This is not mine, but it's like learning to drive
by watching the Fast and the Furious franchise. Yes, that's
such a good end, like not reality, but we know
that right. We don't know that with sex egg because
we never got a good sex head to be like, oh,
(11:14):
these people are faking it.
Speaker 1 (11:16):
Yeah, oh so true. So do you see more male
or female clients or is it just pretty much a mix?
Speaker 2 (11:25):
I see you about seventy percent female, but I mean
I still see a lot of guys. Well, it's been
very interesting because I really deep dove into caring about
the female now in the like the last five years.
Is when a guy comes in for a rectile dysfunction
and you know, viaguer prescription whatever, you know, we talk
about their health because again, penises are biopsychosocial. Like if
(11:46):
the heart health that you have is not good, the
penis doesn't function, right, we'd never talk about a rectile dysfunction.
But so they're coming in for that, we're talking about
their heart, like you know all these things, and I'm like,
what's your plan with this? I thought these guys would
have a plan, like profoundly interesting that like nine out
of ten are like, I don't know. I was just gonna,
(12:09):
you know, go home and maybe have sex with my wife.
And I'm like, okay, so you haven't had sex in
five years? Does she know you're here? Does she consent
to you coming home with a super dick?
Speaker 4 (12:21):
Like?
Speaker 2 (12:22):
Have you had this conversation? And they're like, ten times
out of ten they're like, no, haven't had this conversation,
which is which is enlightening. I'm like, dude, people don't
talk about their sex lives. They've lived together for decades
and do not talk about their sex life. I gotta
tell you, things get so much better when you start
talking about it. And nobody's died so far. I've never
(12:44):
read a report of somebody dying from talking to their
partner about sex.
Speaker 4 (12:47):
That's so true. It's the lack of communication. But speaking
of the ED, that was a statistic that you shared
I think on Instagram that forty percent of me. Yeah,
those a lot of were Oh was that on the
TED talk forty percent of men? Oh yeah, forty percent
(13:08):
of men by the age of forty have a rectile dysfunction.
Speaker 3 (13:12):
Is that correct?
Speaker 2 (13:13):
Yeah? At least a little bit.
Speaker 4 (13:14):
Which that's what But to me, I'm like, if I
was a man, I would want to know that because
I love how you talk about the shaming and the shoulting,
because I think I would feel that as a man,
because obviously we have as women our own set of
shame and shooting.
Speaker 3 (13:34):
But that's a pretty powerful piece of information.
Speaker 2 (13:39):
Yeah, I mean, I think it really normalizes that our
bodies age. I think it normalizes that, like what you
choose to do with your health, whether it be drinking smoking,
by the way, drinkings horrific for erections, but yeah, exercise,
but like that is profound. Like, you know, I've got
guys in their eighties who have perfectly fine erections. It
(13:59):
does not I mean, everybody's going to have problems, but
I think it's you know, when women enter perimenopause menopause
and we start needing lubrication, by the way, we should
just start lubrication at like age eighteen. But lubrication, vaginal estrogen,
all the things is like normalizing it of like, dude,
guys have changes in their bodies too, right, Like none
(14:19):
of us are immune from the powers of aging, and
it's okay to do something about it and get it treated.
Speaker 1 (14:25):
Okay, I'm so happy because I always feel like we
get the shit the babies, menopause, men can go after
like younger girl, like we're aging up every I mean,
it's literally like I didn't even think that that many
men had to struggle with it, and of course they're
not as comfortable talking about it. No.
Speaker 2 (14:49):
Yeah, I just read this one study about like the
actual amount of a rectile dysfunction compared to like how
many people actually go to the doctor about it, right,
And Viger's over the counter in a lot of kundry,
so like in a lot of countries, guys don't have
to go And now we have all these online pharmacies,
so we're really opening access to people, kind of reducing
the challenge that it is to go see a doctor.
(15:12):
But it's super common for them. And you know, the
directions guys really tie erections to the definition of manlihood,
the definition of a man that you're fully capable, that
you can you know. But again, going back to the
sex ed, like good sex ed will tell you it's
(15:32):
okay to lose an erection in the middle of sexual activity.
It's normal and it happens, and it doesn't mean you're broken,
but guys don't know that. And then they watch the
movies and these guys are like obviously enhanced many times
and taking perform performance enhancing medications, right, so they don't
know that. And just like, erections are not reliable, but
(15:55):
good sex ed will will teach you that, and people
don't know that, so they just feel profoundly broke can
ashamed less like a man. Uh, you know. And the
more anxious and stressed you are about your erection, the
more you're gonna not sustain an erection because when the
body's stressed, erections are like now's not the time he's stressed, right,
so it actually can compound and make it worse.
Speaker 3 (16:17):
Oh, that performance anxiety, I'm sure totally.
Speaker 2 (16:21):
Yeah.
Speaker 1 (16:23):
I have to say the the vaginal dryness, which you
had the best podcast on that, the menopause symptom no
one talks about. I mean, come on, so let's move
on to the vaginal dryness and calling it the When
you said the volva vaginal atrophy, I'm like, nobody wants that.
Speaker 2 (16:45):
No, it gets worse, my friend, in the eighties it
was called the senile vagina. Stop it stop right, Well,
so it keeps at least it keeps kind of getting better.
I don't know, but yeah, because you're really nobody likes
vaginal atrophy, so we call it GSM or genital urinary
syndrome of menopause, right, which is a mouthful, but it's
(17:07):
a better term. And I'm like, well, nobody liked Bobbo
vaginal atrophy. That was an improvement just from senile vagina.
Speaker 1 (17:15):
So bad terrible.
Speaker 2 (17:17):
I was actually I was pulling The reason I know
this is I was pulling up that my guy at
the medical library was helping me. I was pulling up
an old study. Actually had to like take it off
of a shelf and xerox it for me, and it
was the study from which the user er lose it
myth comes from, because I'm like, where does this come from?
Let's go back and dig and find the thing that
(17:38):
like everybody kind of cites and in it they talk
about senile vaginas and I was like, whoa, that was
a gem I hadn't planned on discovering.
Speaker 1 (17:47):
God.
Speaker 2 (17:49):
Yeah, but getting back to like it, people don't know,
like you got it. It goes back to education again, like
people think menopause is a hot flesh menopause is not
a hot flesh and menopauseist is when you can no
longer get pregnant, But it's not that's not what it is.
Those are just like signs and consequences of what it is.
(18:10):
And what it is is a profound hormone change another
way of saying that is a profound enrochronology change, right,
Like you are outliving your ovaries, which is a whole
nother podcast of Like if you outlive your eyes, you
get glasses, If you outlive your hips, you get a
hip replacement. If you outlive your teeth, you get teeth.
Why are we so afraid of replacing what our ovaries are?
(18:32):
We're outliving, right, But so with that, your hormones go down,
including testosterone, and the pelvis is profoundly active and lovely
and healthy because of your hormones. So when your hormones
go down, your labia can disappear. Inner labia disappears. Nobody
knows that you can get more recurrent urinary tract infections,
(18:54):
pain with sex, more yeast infections, more burning when you
pee getting up at nightmare to pee frequency urgency. All
of those things are under the umbrella of genital urinary
syndrome of menopause or GSM, and explains that both the
genitals and the urinary system change because of menopause. Now
two more things and then I'll stop talking. This can
(19:15):
happen before your periods are done, because your hormones start
fluctuating before your peers. So people are like, my doctor
said I was too young because I was forty two. Like, no,
your estrogen can go low. Certainly, your testosterone is low
often by that age, and you can I saw a
woman shoes in her mid forties profound vaginal atrophy. And
what this means is you can't penetrate. Tampons are painful,
(19:38):
it burns when you pee. This is not just sex.
For the people who think sex is extra, I would
say it's an important quality of life piece. But can
happen certainly before menopause, and for a lot of people,
it happens eight years after menopause. So they come into
my office and they're like, but menopause was years ago,
and I'm like, well, yeah, but you still have low
hormones and now it's caught up to you and that departarment.
(20:00):
But because we don't have any education about what menopause
is people disconnect that what's going on in their pelvis
is because of a change in hormones.
Speaker 4 (20:10):
So is the best way to correct that or help
is through hormones.
Speaker 2 (20:19):
One hundred percent. Now, the medical the medical literature will
say try non hormonal treatments first. What that means is
lubricants and moisturizers. Lubricants and moisturizers are band aids. They
make skin feel better, but it doesn't actually like you
could you can put on glasses or you can just
print everything in twenty point font Right, you're like, well,
(20:42):
glasses actually like just make it all all better?
Speaker 3 (20:45):
Right.
Speaker 2 (20:48):
I think this is my opinion after being being into
this for a while, is I think vaginal estrogen what
other people call it local estrogen or pelvic estrogen. If
you're on Instagram, you don't want to save a jack
too much because they'll kick you off, and it's true,
So I call it pelvic or local estrogen. Okay, that's
just like skincare. It's skincare for down there. And I
(21:11):
think at a certain age women should just because what
do you want to do? Do you want to come
in to see me once your labia are gone? You
don't want to have sex anymore, and you're on your
fourth urinary traction fection. Perfectly reasonable if you want to
wait for that. Or you could be like, how can
I just like have good skincare so I don't have
that happen.
Speaker 3 (21:32):
Oh, it's like, gosh, do you.
Speaker 2 (21:33):
Want to come in once your face is skin down sinscreen?
I am it.
Speaker 1 (21:39):
I'm up skincare for the badge. I'm usided, dude.
Speaker 2 (21:42):
Skincare is like a twenty six billion dollar industry. Like
women care profoundly about their skincare, and this is just
vulvar vaginal bladder. It's generally urinary skincare very safe, incredibly safe,
so safe, it's over the counter in multiple cut, so
safe that breast cancer survivors can take it, so safe
(22:06):
that breast cancer patients who are currently treating their breast
cancer can take it. Vaginal estrogen just is in the pelvis.
It won't prevent your bones, right, it won't prevent usteoporosis,
It won't protect your brain, it won't protect your heart,
like all the amazing things that systemic estrogen will do. Right,
all it does is help GSM. And my argument is
(22:28):
it should be a preventative medicine, like H fifty five,
pick a number, like, here's your mammogram, here's your colonoscopy,
here's your vaginal estrogen.
Speaker 1 (22:37):
Okay, you need to be everyone's dog.
Speaker 3 (22:39):
Found.
Speaker 2 (22:44):
Don't ask me about anybody's ear problems.
Speaker 1 (22:46):
I cannot help. Yeah, well, okay, so I'm gonna I
always like throw myself under the bus on every podcast.
I'm like, well, here's my problem.
Speaker 3 (22:54):
I know both of us are like dragging our.
Speaker 2 (22:57):
Our podcast just created for the for the host, like
help themselves. I mean, come on, that's what we're all doing.
Speaker 1 (23:04):
So okay, the overactive bladder, I did not know that
was a symptom of perimenopause. And let me tell you,
I've gone to the urologist and I he had me
on the anti what are the called the anticol energics.
Speaker 2 (23:20):
Those are nasty drugs. Yes, by the way, I'm so annoyed.
Speaker 1 (23:24):
I was on it for like three years, and then
my new urrolis because this guy like bounced. He was like,
oh no, you can't be on that, like you don't
go on that long term. And I had no idea.
So now I'm like, well, why am I peeing all
the time?
Speaker 2 (23:37):
Freaking vaginal estrogen. What's wrong with your urologists. I'm allowed
to say that because I'm a urologist, Yes, exactly. And
I'm also allowed to say that because I was literally
in Denver, Colorado last spring, looking at how brown it was,
telling the Rocky Mountain Neurologic Society that vaginal estrogen is
equivalent to anti cool energics. Like, we literally have that
published data. The problem with that data is it's hiding
(23:59):
in the menopause drone and urologists besides me don't read that.
But I was literally in Denver last year telling the
Colorado urologists that vaginal estrogen is equivalent to the nasty
medications they put you on.
Speaker 1 (24:11):
My he's fired, he's he is.
Speaker 2 (24:14):
I have an amazing urologist, and you're boulder. Who's a
female that you can go see. Her name is doctor
Carolyn Phronsia. Go see her. She's amazing.
Speaker 1 (24:22):
Oh I'm seeing her as soon as I get off
this call. This is.
Speaker 2 (24:28):
Help me, help you.
Speaker 4 (24:29):
So overactive bladder and incontinent incontinence.
Speaker 2 (24:36):
Means bladder leakage.
Speaker 3 (24:37):
Okay, that's what I wanted to know the difference.
Speaker 4 (24:39):
So so many women always complain about if they sneeze,
if they jog, they're running, they're you know anything that
your he just comes out. What.
Speaker 2 (24:51):
Yeah, let's talk about that because that's super important and
very common. So leaking, when you cough, sneeze, laugh, trampoline,
double under exercise. Right, it's called stress in continence. People
think that means it's because you're stressed. It's not because
you're stressed. Stress means a force. So it's a force
on the bladder, force on the pelvis. Right, So running, jumping, coughing, sneezing,
(25:13):
all of that will push urine out of the pelvis.
Happens with aging, decrease, collagen decrease, hormones decrease, muscle strength. Also,
putting any sort of baby through a vagina once or
multiple times can increase. So there's many reasons that it happens.
Baginal estrogen may or may not help. Doesn't help everybody
(25:37):
with that. I've seen some women on systemic testosterone get
helped with that. I'm not saying that's why we should
use systemic tstosterone. It's another podcast episode, but sometimes systemic
hormones do help. Pelvic floor physical therapy can help greatly.
They're awesome and the traditional surgery was a sling. It's
called a midirethral sling. It's been around for twenty years,
(26:00):
done plenty of them. It's a great surgery, but I'm
giving you a three percent risk of mesh complications for
your life because I'm putting a permanent piece of mesh
in there. I will now offer you the best new
things in slice bread, which I went in very skeptical
and cynical because I'm not the youngest urologist anymore. It's
called bulkamid b U l K M I D. You
(26:22):
know how women get fillers for their face, yes, to
make their cheeks and their lips more full. It's filler
for your urethra.
Speaker 3 (26:31):
Oh my gosh.
Speaker 2 (26:32):
And it decreases strength and continents by like fifty to
eighty percent. It's a three minute procedure. There's no downtime.
I'm like a walking billboard. It's like you can exercise
the next day, you can have sex the next If
you have a sling, you can't have put anything in
your vagina for six weeks and you can't exercise Like
Downtime's a big deal for busy women. Bulkamid no downtime,
(26:54):
just the day you're having the procedure, I have you
pee before you leave my surgery center because I want
to make sure you're not haven't blocked, and it's not
permanent like a meshling is. But the benefit is you
don't have any risks of things being permanent in your body.
And so you just call me and you just tell
me when it wears off, and we give you more
insurance covers it. This is no brainer it's a no brainer.
(27:18):
Nobody knows about Bulkaman yet. It's been in Europe for
over seven years. It's been in America for about two
to three years. I went, I'm telling you, believe me.
I went in cynical and like, slings are pretty awesome.
Why am I gonna do something that's not maybe doesn't
let like I went in fit with a scientist mind.
I'm like, I don't know about this. If women tell
(27:39):
me they don't like it, I'm not gonna do it.
Like that's how I went in, And now I'm like,
these are the happiest freakin' women. They like bring me
house plants as thank you gifts. One woman came in
with no underwear on to just to show me she
can wear no underwear elk. She has like a love it,
like these are happy women because it's like it's hardly
(28:01):
a surgery. I give you a little ivy a aesesia
because if you're going to put a needle in myurethra,
I'd like a little ivan asesia, like no breathing tube,
no incisions, no stitches, like this is filler for your urethra,
for stress and contents and insurance covers it.
Speaker 3 (28:19):
I can't take it.
Speaker 4 (28:20):
And I feel like women don't care about going and
getting something done again because they're used to getting the
botox or getting you know, you go and get your
teeth cleaned.
Speaker 3 (28:30):
How often? I don't know. I just feel like that's
I agree.
Speaker 2 (28:35):
When I was starting to do this procedure, I had
a woman come back at a year. She's like, yeah,
more off, And I'm like, let listen, let me ask you.
Would you rather come back and see me once a
year for this or would you rather me give you
a sling?
Speaker 1 (28:47):
Right yeah?
Speaker 2 (28:49):
And she's like this once a year, hands down, keep
the mesh out of my body. And I'm like, the
women are speaking, man, they know what they want. We've
got options, they know they want the bulkamen. It's like
very rare that I see a woman and do a sling. Now,
it's usually like do a balkamid if it's what if
(29:09):
it didn't meet your expectations, let's do it again. So
you get two bulkamids before you've bought yourself a sling.
And I've probably done two hundred to two hundred and
fifty bulcamed in the last like two and a half years,
and I've put slings in four of those people.
Speaker 3 (29:23):
It's a great, oh.
Speaker 1 (29:24):
Come, this is amazing. And so it doesn't always come
down to like not having a strong pelvic floor.
Speaker 2 (29:32):
Not always. No, the the control of urine is actually
quite complicated, right, So it's like the integrity of your urethra,
how you integrity of the urethra, collagen and hormones. Right,
Estrogen really helps the mucosa, the collagen, the blood blood
just keeps things plump. So it does an atrophy. So
(29:55):
estrogen hormones also the descent of the urethra where it
rides underneath your pubic bone. It can get pushed down
a little bit by having a baby age all that stuff,
and then the muscles of the pelvic floor. So it's
not just you know, I agree with the pelvic floor.
Physical therapists try it. It's not invasive, they can help.
It makes a world a difference.
Speaker 1 (30:14):
But if it.
Speaker 2 (30:15):
Helped everybody, I would be out of a job in
that department. And I'm telling you, I'm not Yeah.
Speaker 4 (30:21):
Do you do vaginal reconstruction surgery Yeah, for prolabse yeah, yeah,
or just anything woman I don't do.
Speaker 2 (30:31):
I cringe. I get very I'm very I'm a protective person.
I get very protective of my women, and I get
very cringy anytime people are like tightening rejuvenation, Like those
words mean nothing, and you're playing on the insecurities of
women because they don't know if their vulva and vagina's normal.
And like, I think there's a huge market for preying
(30:52):
on women's insecurities about their genitals. So I do nothing
like that.
Speaker 4 (30:56):
Yeah.
Speaker 2 (30:57):
For me, it's like, dude, I had a baby, I
haven't bet on my hormones, the tennis balls falling out,
and I can't exercise. I'm like, fix it if you
want to fix it. Absolutely, So I do a lot
of pelvic surgeries, a lot of vaginal surgeries. But anybody
who's got a website about rejuvenation and tightening. What the
fuck is tightening? Okay, well we so we To me,
(31:18):
I'm like you people come to see me because sex
is painful, because it's too tight because they don't have estrogen.
So to me, I'm like anybody who's branding vaginal tightening
is I don't know a predator.
Speaker 4 (31:31):
Okay, well we read how you said there are three
things that you should never do, and I have done
two of them.
Speaker 1 (31:43):
R the vaginal kitness and the overactive bladder, which I've
done that. So I guess that.
Speaker 2 (31:51):
Anticke a energics for overactive bad.
Speaker 1 (31:52):
Yeah.
Speaker 4 (31:53):
So between Haley and I we have covered them all,
but her and I both have done pr P in
the dress.
Speaker 3 (32:00):
You please tell us why we shouldn't do either of them.
Speaker 2 (32:04):
Listen, if women want to spend their women can spend
their money however they want to spend their money, Like,
I'm not here to tell people not to. They can
dazzle their armpits for as much as I care. But
where I have a problem is when women are sold something,
yes for something for something that doesn't either solve their problem,
(32:28):
right yep. That's my big issue of like, you know,
take sexual desire. For example, sexual desire is quite complicated.
It's biopsychosocial. There's a great TED talk on it. But
it's like desires complex, right, Like it's your relationship, it's
how you view your body image, it's your hormones, it's
(32:49):
how good the sex is to begin with, Like, desires
really complex. And when a woman is sold like come
get these proprietary injections to improve disease desire. I know
that's bullshit because it will not affect everybody's desire because
desires complex. Yeah right, and by the way, it's thousands
(33:10):
of dollars. Insurance doesn't cover it, and you have to
keep doing it if it does work.
Speaker 3 (33:15):
Yeah, so believe it.
Speaker 2 (33:16):
For a woman who's like it were great, it's like, okay,
well just wait for it, Like it's just have you
budgeted for this plan?
Speaker 1 (33:23):
Right?
Speaker 2 (33:23):
Like totally. I always joke like women shouldn't have to
re mortgage their house to take care of their health.
Speaker 1 (33:29):
No.
Speaker 4 (33:29):
Yeah, that's such a good point though about the desire.
It is like we're missing that point. And in your
TED talk, I feel like one of the most important
things you said too is your biggest sex organ is
your brain and it's isn't that what you said?
Speaker 3 (33:46):
Did? I? I want to repeat it correctly, and I
just think, how you're exactly right.
Speaker 2 (33:54):
Totally. I mean if I think if I think my
body's a disaster, it's failed me. I'm worried about leaking.
I'm checking in on my thighs all the time. Like,
my experience of my sexual life is going to be
very different than if I came in being like this
is what I'm showing up with today and let's try
to have a good time, which is even different than fuck, yeah,
(34:15):
look at me. Yeah, this is awesome. I am hot, okay, right,
because I think we're always trying to get to neutral. Yeah,
And it's like, what if we were profoundly radical and
tried to get to freakin' awesome. There's a book on
that there, book called.
Speaker 1 (34:32):
This is our best podcast already.
Speaker 2 (34:36):
There's for people who are interested in at work to
get like, there's this book called The Body is Not
an Apology. I think Sonya Renee Taylor, if I'm getting
it right, it's like over on my bookshelf. But she's like,
why the hell are we striving for neutral?
Speaker 3 (34:51):
So good?
Speaker 2 (34:51):
And it's like as soon as she says, You're like,
oh right, we've put the bar real low.
Speaker 1 (34:56):
Yeah yeah, well, okay, this is like since I'm sharing everything,
Like when I see these things advertised, You're right, Like
I go down and book and I'm like, I don't
know if if I'm normal, Like how do you know?
Speaker 2 (35:13):
Because your body parts have been banned on the internet,
Like the only body parts we see are photoshopped or
video shopped or surgically augmented. It's very hard for people
to go and to see if they if like how
does my chin compare? Like you can go see a
(35:34):
whole bunch of different chints, right, yeah, but like it's
profoundly important to know that people sit within the Bell
curve and if they don't that, you know, we can
do something about it. And even if you don't sit
within the Bell curve, you can have an amazing sex
life anyways, if it's not, you know, a broken thing.
I saw this woman, older woman. She came in with
her I think he was her husband. We're doing a
(35:57):
pelvic exam for like I don't even remember what it
was for. And she was like, I'm so sorry, I'm
so sorry, I'm so ashamed, and I'm like, oh, you know,
tell me about that. And she's like my earlier husband,
like before, the before husband had told her that she
had a profoundly abnormal labia in volva, and I think
(36:18):
it was a little more derogatory of a term. I
made it medical, but like derogatory term about how horrific
her external genitalia were. And I was like, listen, I'm
gonna do you a favor. I look at like fifteen
volvas a day. I have a lot of volva knowledge
in my brain. I'm just gonna tell you where you
are on the bell curve.
Speaker 1 (36:36):
Yeah.
Speaker 2 (36:37):
She's like okay, Like I wanted to keep it like
super neutral. I'm like, I'm just going to tell you
how average you are. It did her exam and I'm like,
you're like so average, you're unforgettable. Like I can't actually
remember her vulva now right, I'm like, you're just like average,
normal bell curve, nothing remarkable. And her husband looked at
her and he's like, see, honey, I told you. And
(36:59):
I'm like, you get to release this asshole from your
brain now. But again, going back to sex ed, like
she took that one guy's advice. He wasn't he how
many involvements. Had that guy looked at right and taken
him as what her body was.
Speaker 3 (37:18):
That is so sad.
Speaker 2 (37:19):
Anyways, I don't remember the point of that story, but
like women are hiding in shame because they don't know
if they're normal or not. That's yes, that's the point.
Speaker 4 (37:31):
Well, all of you know, we're at this age where
when we are with our friends we're talking, we end
up talking about all of these different things. And a
lot of my friends have said that they feel like
their vagina has aged, like it's not looking the same
and they and sometimes functioning the same, and they do
(37:53):
want it to function like it did, but also look young.
And I never even thought about that until I started
having conversations about it, and I'm at an older age.
But what do you think is the best advice for
people that feel that way?
Speaker 2 (38:13):
Yeah? So, I mean again, this whole thing is biopsychosocial, right, Yeah,
it's like, why do you want to change your body part? Oh?
Because society told you youngers better? Okay, interesting, so there
might not actually be anything wrong with the body part
you're just coming to And by the way, we wear clothes,
like ninety nine percent of the time, like Society's literally
(38:36):
not like I understand the face so much more because
it's your billboard, right, But it's like, dude, literally, maybe
a couple of people are looking at your volva and
ideally they're having a hell of a good time with
it and not trying to judge your like your anatomical
age by it.
Speaker 1 (38:52):
Yeah.
Speaker 2 (38:53):
Right, But that's why I love these conversations, because like
you just take somebody's concern and you just freaking blow
it out of the water by being like, is anybody
asking how old you are? And you're like, hold on,
let me check my volva.
Speaker 4 (39:05):
Yeah, And what's funny is all, yeah, we'll save Well
did your husband seeming like are there any complaints? It's
like no, he'd be all over it every day. Yeah.
Speaker 2 (39:16):
So I'm like, okay, this is my advice. Number One,
nothing prevents us from aging except for death. Yeah, so true,
you like nothing is stopping the clock. And do you
spend spend your whole life wishing you were a different
age or your body look different at the on your deathbed,
you kind of wish you didn't do that, Like, enjoy
(39:36):
the time you had, right. Number two, save your money,
go get yourself some phenomenal good hormone healthcare because our
I would agree, our volvas do change with age. We
lose volume, we lose elasticity, and a twenty dollars bottle
of vaginal estrogen does a world of difference, and we
(39:59):
should be putting it on our clitterists. We should put
putting it on our labia minora. And that six o'clock
entrance to the vagina is nasty. It gets tight, and
that's the first part that starts hurting when people start
complaining of dryness or pain with sex. So when I
see people being like get tighter, I'm like, dude, just
give it. Give yourself five years with no hormones and
you'll be tight to the point that you hate sex.
(40:21):
So like, I don't think that tightness should be a
branding thing at all. It makes no sense to me.
If you want to work on tightness, like get a
good pelvic floor physical therapist, get your muscles toned right. Yeah,
so pelvic floor physical therapy and then vaginal estrogen. But
don't remortgage the house or brain, like go out to
dinner or go on vacation. With the amount of money
(40:42):
that people are taking from women praying on their insecurity
that their vulva doesn't look twenty like your partner doesn't care.
They probably just want more sex. Yeah, what are we try?
But when all you see online is like the plastic
surgery images of this is how I can change a volva,
you start thinking that's necessary. It is completely not necessary
(41:05):
to a great sex life. So true, Well spend your
money on.
Speaker 1 (41:08):
Good vibrators, for sure. That's what I thought you were
going to say. When you said hormut it on hormone.
Speaker 2 (41:15):
I was like, we're having the vibrate vibrary conversation. Wow,
we invest in some good vibrators, Like a twenty dollars
vibrator is kind of a piece of crap.
Speaker 1 (41:25):
Yeah, in my opinion, this is this is the best. Okay,
the pelvic floor physical therapist. I went because I had
a lot of issues with my my last my third
child birth. I didn't know that entelled and when I
went in there, I was like, well.
Speaker 2 (41:43):
That was spir is personal and for people, I want
to address that right because I see a lot of
women say I don't want to go because I'm worried
about an internal exam stuff like that, and I'm like,
you need to communicate that to them. You need to
tell them you're boues, whether you've had a history of trauma.
You don't have to tell the details. But I fully
(42:04):
respect if a woman is not ready to get naked
and have some fingers in her for, you know, checking
out her hip joint on the first date, I get it.
Speaker 1 (42:12):
Yeah.
Speaker 2 (42:13):
And physical therapists can do a lot without going inside
of you. They're very talented people. They're better than doctors
are at assessing pelvic floor muscles and inside the vagina
is the way to do that. But they can do
a lot without doing that, and you can also get
to know them. Is this a good fit? Are we
(42:34):
aligned in what the plan is? Do I feel good
showing up here right? Like you don't have to rush
into the internal exam, but you got to communicate it.
You can't be like, well here I go and then
be like I wish I didn't I wish we didn't
do that. Like address that, bring that up on the
front end, is would be my advice.
Speaker 3 (42:51):
That's good advice.
Speaker 1 (42:52):
Oh, I just didn't know what I was getting into.
I mean, like, the lady was amazing, but I was
just like she's like, okay, so this is what's happening.
I was like, ah, well, I thought I was coming
in here for a hamstring something. Where are we going
with this?
Speaker 2 (43:09):
You learned a lot. But with I mean, they're incredibly talented.
There is like not a pelvic floor physical therapist that
I haven't liked yet. They're invaluable people. I mean, it's
so silly our healthcare system, right, Like I'm a surgeon.
People come to me first of all not wanting surgery,
and then I'm like, you know, I'm a surgeon and
They're like no, I didn't know that. And I'm like, okay,
(43:30):
well Google. But but I'm like, you can go to
physical therapy first. The surgeon doesn't have to be your
first stop, right, And so many good pelvic floor physical
therapists will tell you though. They'll be like, go see
a doctor, get on vaginal estrogen, like they know the
importance of hormones in pelvic health. So we're all it's
all just kind of like a mutual love fest that
(43:50):
like we love them, they love us because we all
do a different part to help help a woman.
Speaker 4 (43:58):
So besides the estrogen, what is another essential hormone that
you feel like is really helpful for women?
Speaker 3 (44:10):
Testosterone and progosta.
Speaker 2 (44:12):
Yeah, so there's three. I mean, there's three hormones that
we can buy, right, like that, we have pharmacies that
we've created our bodies. Well, I mean besides the other
hormones of like insulin, thyroid, you know all tho sick.
But we're talking like perimenopause menopause hormones. And to call
these sex hormones is a complete misnomer, Like, yes, our
(44:34):
gonads make most of them, but like they work in
your brain, they work in your heart, they help with
insulin resistance. Like the fact that we've labeled them sex
hormones is actually like a dismissal of their importance. They're
vitally important for our entire body. But again we didn't
get taught that. But so there we have many hormones
(44:54):
within the like there's many types of estrogen. There's several
types of androgens, like all of these different things. But
we have three that like money can buy, money can
buy testosterone, progesterone, estrogen. Our ovaries make testosterone which then
gets converted into estrogen. So it's actually wrong to say
(45:18):
ovaries make estrogen because you're missing out. You're missing out
the fact that like we actually have more testosterone in
our bodies than estrogen because we make testosterone to make
some estrogen, which is I didn't even get taught that
in medical school. Like it's insulting how little we know
about our bodies. But so to me, in perimenopause and menopause,
(45:39):
those are the three options on the table, and I
think they're all important and they all do different things.
And if you see somebody for hormones and they don't
talk about all three of those things, then I wouldn't
say they're comprehensive if they're only would. I like put
this on Instagram the other day and like, if your
only option for a woman is a pellet of one type,
(46:01):
you're a one trick pony. You're not actually a hormone expert.
Speaker 3 (46:05):
I loved when you said that.
Speaker 1 (46:07):
Oh, I loved when you said the pharmacists or assholes quote.
I was like, yeah, so let's talk about that. The
testosterone and the lack of you know how hard it
is to get from it.
Speaker 2 (46:23):
It's embarrassing. And the reason why it's embarrassing is because
I know, I trust and I believe that in the
future it's going to be better. Like I know that
I know there is a world where we have good
access to this, and so I'm like, oh my god,
I'm part of the generation where it's embarrassing, but like
(46:44):
we have to help get it there. Right. So ovaries
make testosterone. All people have testosterone. Men just have more
of it, right, Like people need to know that because
otherwise I come in looking like this crazy person who's
like testosterone for women, and they're like what right, So
(47:04):
you got to like go back to the education first.
But the FDA has about twenty different products for testosterone
for men. We have zero for women. The FDA has
said we want five more years of safety data for
testosterone for women, more safety data than we have for men.
The additional problem, because of the Olympic doping scandals of
(47:28):
the seventies and eighties, our legislature got a little pissed
that people were doping, so they put in the FED
a federal act that all of these synthetic androgens are
now banned substances, and on that list was one naturally
occurring hormone called testosterone. People do not overdose testosterone like
(47:49):
they do not do it. They might become they might
have gros some more hair and get angry, like there's
side effects, but like too much disosterone doesn't kill a person.
But it's on this list of banned subst stances, including
fentanyl and oxycodone. What that does is it prevents access
because now we've labeled it as unsafe instead of something
your body naturally makes. Right, So we've got two problems.
(48:11):
We do not have a female dosed product approved by
the FDA. That means insurance won't cover it, and you
have to dose it appropriately and it's actually difficult to do.
The other problem is now it's on the DEA list.
Your name goes on a register of being somebody who
has a controlled substance it legit. Yeah, California has its
(48:33):
own list because they wanted today want to know everybody
who's taken oxycodone and fentanyl and ope tiestosterones on that list,
and you have to see a doctor every six months
for your prescription instead of every year because it's on
that list. And it also carries the stigma of doctors
being like that's unsafe. That's a steroid. Of like, course
it's a steroid, so but so it's cholesterol, like something
(48:55):
being a steroid means nothing. So yeah, we've got a lot,
a lot of barriers to testosterone. But let me tell you,
there is nothing like testosterone appropriately dosed in a woman
made midlife where she comes back to see me and
she says, I'm back.
Speaker 3 (49:15):
Oh, I just got the chills.
Speaker 2 (49:18):
I feel more like myself. And I'm like, at the
end of the day, if my job as a doctor
isn't to make you feel more like yourself, what are
we doing? You know? Like, there is something profoundly better
about women when they are on testosterone. They come back
and they're like, I can think faster, I'm quicker, I
(49:39):
have more energy, I can recover better from the gym more.
I just had a woman She's like, I'm more interested
in the world. Again, You're never going to get an
FDA approval for something that makes you more interested in
the world, right, Like, it's these these stories that come back.
The other bullshit about testosterone for women is that the
main global consensus it is for low desire. Why is
(50:04):
the only legitimate reason for you to be on a
hormone for you to sleep with somebody else?
Speaker 1 (50:09):
Good point, Well, messed up.
Speaker 2 (50:12):
It's so messed up. I didn't even think about that.
Like my male brother pointed that out to me. He's like, Kelly,
isn't it kind of weird that, like the only reason
for women to take testosterone is to like sleep with dudes?
And I'm like, yes, bro, Yes, yes, bro, thanks for
putting that out to me.
Speaker 1 (50:28):
Gosh, and I don't want to be on any anyone's list,
any government.
Speaker 2 (50:34):
Get as you are if you take testosterone.
Speaker 1 (50:37):
Or like America's most wanted.
Speaker 2 (50:39):
It makes it sound like you're doing something dangerous. And
so in a woman's body, the testosterone she has in
her twenties is about forty to fifty percent higher than
the testosterone she has in her forties. Wow, testosterone starts
going down much early. We kind of think of menopause
as like and on Tuesday, the ovaries stopped and then
(50:59):
everything fell off a cliff. Right, That's not how it
works for testosterone. It's a very much slower decline, but
it starts earlier. But you're still gonna make some testosterone
even after the periods are done. Right, So testosterone is
kind of like slow but early, but can you can
keep getting making some estrogen is like in perimenopause, it's
like up down up down, super up, way down up
(51:22):
down here's the period. Now you're not going to have
one for a while. So estrogen is like spastic, right,
and then progesterone can kind of it's kind of doing
its own thing. Nobody's really paid it. It's like the
it's like the step brother that like doesn't doesn't come
out of its room. Much like, we haven't really looked
at progesterone very much. So, but progesteron is profoundly important
(51:42):
for mood and sleep. We just we just I think
we need more research, especially in perimenopause. But so to
say for a woman who's still she's perimenopause, she still
has her periods, maybe her energy is low, maybe her
sexual desire is low. To me, I'm like, I'm checking
that woman's testosterone way before I'm telling her to go
get PRP and her clitterists or lasers or you know
(52:05):
anything else. Is like, there's things happening in your body,
let's optimize them. And by the way, it's predamn cheap.
So but mean it all comes back to education. The
more we know, the less we're gonna fall victim to
people who just want to make money off of us.
Speaker 1 (52:21):
Yeah, okay, so with testosterone, when it's low for certain women.
I just had a conversation about this this week. That
can affect your ability to grow muscle. Yes, so I
have some clients. I mean I only work with people
forty plus and most of them are in their fifties
(52:42):
and their post metapuzzle and when they again, different conversation.
But when they come and they're like, well, I don't
want to get bulky, and I'm like, do you know
how you are? Like try? I'm like, do you know
how many women that like, we'll talk to them when
they're passed out on the floor just because they're trying
to main pin their muscle that they have.
Speaker 2 (53:03):
Dude, And the role of muscle and longevity, the role
of muscle and insulin resistance, the role of muscle in
bone health, the role of muscle in preventing falls. Like
I'm telling you, if you want to do anything to
help out your seventy two year old future self, lift
the weights. Please preaching to the choir, but it's like, dude,
(53:23):
muscles are so important.
Speaker 1 (53:25):
Yeah.
Speaker 2 (53:25):
I just saw a lady, she's sixty, she just came
back four months. So sometimes taking disasterone, especially when it's
appropriately dosed, and we can go into that, but she's
about four months in. She's like, I'm noticing now my
lean body mass, right, but in appropriately does hormones like
it's gonna get you there slowly, not like four months
(53:46):
is slow? Right, she spent she spent ten years without
the damn stuff. Yeah, but you know, to be like, yeah,
I think all tastostone's important and wound healing. Right, Orthopedic
is looking like the orthopedic world is looking. They did
a study where they gave dudes super high to stosterone,
like way more than standard replacement before hip replacements, and
(54:09):
they actually did better. No way, it's a little unorthodox,
but like people are, you know, I think we are
under because of the stigma and all the other things
that we're calling these things sex hormones. We're under researching
the role of hormones in healing and lean body mass.
Certainly we know how important it is for bone protection
(54:31):
and in women, your bone loss starts before your period's end.
I was like, oh, that happens after your periods end.
It's like no, no, no, this starts before because remember,
the hormones are already doing their thing before the period stop.
It's profoundly important.
Speaker 4 (54:49):
I am I am, I'm getting blood work done, oversation,
I'm giving you a standing ovation.
Speaker 1 (54:57):
I don't want it to end. I'm super sensitive in
your time, in our hours. But holy like my brain
is just running with all of these conversations that I mean,
I love what you're doing, Kelly. I love how I
love your personality number one. I mean that alone outside
of all of the education and knowledge that you're sharing,
(55:20):
but like it's just on the opposite side to wrap up, like,
I see women all the time that are just like
shamed about weight or the fact that they don't have
as much lean body mass and all of these things,
and I'm just like, why are we making our lives
miserable when it's just hard? I mean, and a lot
(55:42):
of that comes from biopsychosocial and it's just it makes
me so sad when women are just like kind of
told that after midlife, like well, why do you care
that much about your body or about your sex or
about you know anything. It's just it's very disheartening.
Speaker 2 (56:04):
And you know, I thought about this. These are things
I think about a lot, so you know, we're like, oh,
society tells women all these things. Ah, and it's like
we just lay down and fucking accept that. And it's like, no, no,
you get to decide. You control the narrative. You tell
people how to treat you, You tell people what women
are like at this age. Like there's I'm so sick
(56:26):
of this, like laying down and taking it attitude of
like do you not realize your power? We have immense power,
freaking use it.
Speaker 3 (56:38):
Yes, aimen to that. And I think the older we get,
the better we get. I don't think it's oh.
Speaker 2 (56:46):
My god, yeah, I mean just look, you know, I'm
so inspired by the thing of like, you know, Martha Stewart.
Stewart didn't make her first million, and I'm making this
up because I haven't looked recently, but like women kick
it in the gear in mid life.
Speaker 1 (57:01):
Yeah, for any woman to be like, oh.
Speaker 2 (57:03):
They told me that this is just blah blah blah,
it's like, no, no, no, this is when you can kick
it into gear. If that's what you want to do.
You don't have to do that, right. But it's like,
you write the narrative because we have the immense privilege
of living long and we've never lived this long before
on a global scale, we are literally making it up.
(57:24):
What aging looks like, all this is just a big
grand experiment for the next generation, right, We're trying to
help help out our kids.
Speaker 1 (57:33):
So what you are doing, I think it's like an amazing.
Speaker 2 (57:36):
Moment right now in mid life for women. And I'm
like so happy to be part of the conversation.
Speaker 1 (57:43):
Yes, that is the perfect way to end really quick.
Can people see you online? Do you do telehealth or
are you ful?
Speaker 2 (57:51):
It's a good question. So I practice in Washington State.
I currently only have a Washington state license. So what
that means is you must be the bullshit of the world, right, Like,
do you think healthcare is any different in North Carolina
than Washington State. No, But state regulations don't blame the
doctors for this, is what I'm saying. State regulations say
(58:13):
that the person has to be in the state where
the doctor is licensed, which makes again arcane state rules.
But I'm already booked out for months and months and
months taking care of Washingtonians. So I'm like, I have
no incentive to get other state licenses because I'm like,
I had I got nine million people in this state,
(58:33):
fifty percent of them are female. Right, But so the
point is I take care of Washington state people or
people who fly in right now. I have no problem
with you flying in, but.
Speaker 1 (58:44):
Oh I'm flying in. I'm gonna get on.
Speaker 2 (58:45):
Your note to me. I'm like, I like, you're in Boulder,
you have resources. I will get you the people.
Speaker 1 (58:50):
Yeah, okay, doctor Krollen phronsiac.
Speaker 2 (58:54):
You will say, you know me, I will help with her,
take taking care of you. We will get all the women,
all the balkamed in Boulder in Colorado, and it'll.
Speaker 1 (59:04):
Be will help other people done. I'm done, all right.
So your Instagram is that the best place for people
to get a hold of you or follow you? So
either in Instagram because I love it, but it gets
a little busy on there, you know, so you can
always send me an email info at Kellycasperson MD dot com.
That's through my website, which is Kellycasperson MD dot com.
(59:25):
My baby of babies is the podcast.
Speaker 2 (59:27):
You Are Not Broken. I love it. That's the long form,
right because like you have to hear these things a
couple of times to like understand hormones and like the
pelvis and how it works. So I love a lot,
Like podcasting is my favorite thing. So You're Not Broken?
And then the book is being re released September tenth,
(59:47):
so it's for pre sale on Amazon right now. If
you didn't get the book before, it's now taken down
and re releasing September tenth, which is you are not broken,
stop shooting all over your sex life.
Speaker 1 (01:00:00):
Okay, we're we're coming back on in September when you're
slammed exactly nine million. Everyone has like nine million Instagram lives. Oh,
I'm already pre booking, so we want to pre book
you now because this is amazing and we're making everyone
by the book. I'm going to pre buy the pre
sell right now on Amazon because I just think you're
(01:00:21):
fabulous and we are so grateful for your time and
for everything that you're doing to serve women. So thank
you so much for that, and we look forward to
your book launch.
Speaker 3 (01:00:34):
Yeah, thank you, thank you.
Speaker 2 (01:00:36):
Thank you guys so much for having me.
Speaker 1 (01:00:38):
Thanks for listening everyone.
Speaker 4 (01:00:40):
If you enjoyed this episode, please consider giving us a
five star rating and sharing the body Pod with your friends.
Speaker 1 (01:00:47):
Until next time, Beetles, Beetles, beetles,
Today on the Body Pod, we are rerunning doctor Kelly
Casperson's episode which is all about vaginal health and pleasure. Now,
Kelly is not only an incredible physician, but she is
also one of my favorite menopausal specialists in the space.
She is funny, she is vibrant, and this episode will
(00:23):
not only educate you, but keep you in stitches most
of the time. Enjoy this episode with doctor Kelly Casperson. Hi. Everyone,
my name is Haley and this is Laura and welcome
to the body Pod. Today on the Body Pod, we
(00:45):
have a super special treat interviewing urologist doctor Kelly Casperson.
If you are not familiar with her, you need to be.
She is the ted X speaker for why we need
adult sex education. It is fabulous, it is short, and
(01:05):
it packs a punch, so you will want to watch
that if you haven't. She's also the podcaster for You
Are Not Broken, as well as the author of a
book that's launching this fall that is the redo of
her original book, You Are Not Broken. You can now
pre sell that on Amazon. This podcast is spicy and
(01:31):
it will tap into every emotion that you have. Let's
get into the show, all right, Welcome back to the
Body Pod. Everyone. We are so excited we have doctor
Kelly Casperson here. We've already done her intro, so we
(01:51):
are so excited to just get into all of these
questions that we have and any questions that you have
sent in for us. So welcome doctor Casperson.
Speaker 2 (01:59):
Thanks for having having me.
Speaker 1 (02:01):
Okay, first of all, we were just saying this offline,
but you are so funny. And I when I was
watching your Ted Talk, I'm like, this person. I need
to live next door to Kelly because.
Speaker 3 (02:09):
The same we're like, why is she not our best friend?
Speaker 1 (02:12):
Yes?
Speaker 2 (02:13):
Thank you? Where do you guys live? Maybe we're close,
maybe we don't even know what older.
Speaker 3 (02:17):
I'm in Park City.
Speaker 2 (02:20):
I lived in Denver for six years. See missed opportunity.
Speaker 1 (02:23):
Well where are you now? You're in Washington.
Speaker 2 (02:26):
I'm in Washington State now. Oh yeah, yeah, Well that's
great to Denver for the first time last spring and
I was like, you, guys, hasn't always been this brown?
And they're like yeah, and I'm like, I forgot I
forgot right.
Speaker 1 (02:38):
And it's funny because every time I drive out of
state and you're just like you're leaving colorful Colorado. I'm like, no,
the fuck who came up with that tagline? They needed
they need to do.
Speaker 2 (02:53):
So my first date with my husband was in Boulder.
Speaker 1 (02:56):
Oh I love that.
Speaker 2 (03:00):
So it's special. There's two kids because of Boulder, Colorado.
I'll have you no, yeah, I love it.
Speaker 1 (03:09):
Well, okay, so Doctor Casperson, here we go. Let's talk
about Well, first of all, your Ted Talk, because I
just was blown away. I've watched it multiple times.
Speaker 2 (03:24):
And I'm always like, nobody ever talks about the Ted Talk.
Speaker 3 (03:27):
Oh my gosh. That was the first thing we wanted
to talk about.
Speaker 1 (03:30):
Yeah, talking about that Ted Talk. Why we need adult
sex ed I mean, we just had a sex therapist
on and she was like, adults need to be you know,
they need to be teaching their kids about sex ed better.
And then I'm like, we don't even know if we're.
Speaker 2 (03:45):
Talking about teach them what what Hollywood taught you? Like
it's a disaster.
Speaker 1 (03:49):
Yeah, so can we talk about that? For anyone who hasn't, well,
first of all, you need to go watch it right now.
But if you haven't, I.
Speaker 2 (03:57):
Watched the Ted Talk. If you type in Ted ex
Caspersus and it'll on Google or it'll pop up or
on YouTube, it'll anyways it pops up. Yeah.
Speaker 1 (04:06):
I love that.
Speaker 2 (04:07):
It's by like twelve minute. Baby. You know, you spend
like a half a year working on a TED Talk,
so I'm super glad I did it. The Ted Talk
started out so I like, I really started out diving
into female sexual health. And so the TED Talk started
out with female It was like going to be female education.
And because women have way less orgasms than men do,
(04:29):
and it's not because their body can't do it. Lesbians
have same amount of orgasms as men do. You literally
put a penis in the room and a woman's orgasms
go down. They did an amazing bisexuality study looking at that,
which is just like sweet research. But so it started
out female sex ed and then I was like, yeah, no,
well the other fifty percent aren't any better on this, right,
(04:52):
So the TED Talk really did open up to all
adults and being like, you won't think you're so broken
if you just get some basic information. Yeah.
Speaker 3 (05:02):
Yeah, OK.
Speaker 4 (05:03):
I love when you say in the podcast, when you
ask the question are you completely confident in the bedroom
and do you talk to your partner about it? I
just thought that was such a profound question. Because I
all of a sudden, I found myself asking myself like,
well am I I feel like I am, but then
it's like, well am I too? And I think it's
(05:25):
such a good question.
Speaker 2 (05:28):
Right, And then if you're not, be like, oh my god,
I've probably lived my whole life this way, yeah, or
what got me? What got me? Not what happened right,
like if I was, which I would say is the
more unique one. I think. I think we fumble around
in secrecy as teenagers learn something good, bad, neutral from
that first experience, and then we just take that forward.
Speaker 1 (05:48):
Yeah yeah, yeah, well I have to tell you I
this is these are the exact words that I've spoken forever.
Was like, I don't know, maybe I'm just broken exact words.
I'm just like I don't know what to say. And
so this was really enlightening.
Speaker 2 (06:05):
But that's what makes so easy to name my podcast,
because like when I started talking to women about sex,
like that's what they just kept saying. I'm broken, I'm broken,
I'm broken, I'm broken, and I'm like, well, actually, most
women don't have an orgasm from putting something in their vagina,
Like you're not broken, you just don't know that fact right,
and then like another woman if she had never had
an orgasm, and I'm like, well, ten percent of women
(06:26):
have never had an orgasm, so it's not, as I am,
isn't it wild? And like the sex researchers say, it's
not because it's it's rare, that it's actually because it's
a body problem. It's really And then you know, going
back to the ted talk of like sex is biopsychosocial.
It's not just our bodies, it's not just our hormones.
(06:47):
It is you know, the religion and beliefs your parents
gave you and your first experience and dude, the power
differentials and heterosexual relationships. I'm telling you, nobody talks about
this and it profoundly affects people sex lives.
Speaker 1 (07:01):
Oh my gosh. Okay, let's dig into that a little bit,
the biopsychosocial because I'd love that. And I'm sure a
lot of women are like, Okay, that sounds cool, but
let's let's dig into it.
Speaker 2 (07:13):
Probably like this sounds really complicated, because that's how I thought, like,
I'm like, that is a long word. So and I
actually like I hated that word because I'm like, I
think it sounds super clinical. It sounds like somebody knows
something that you don't know, Like do you have to
go to a to like grad school to figure out
what biopsychosocial means? And as I was writing the Ted talk,
Ted talks, you know, they're kind of formulaic, like three
(07:34):
important points blah blah blah, right for a Ted talk,
And I was like, oh crap, bio psycho social. It
makes sense, and it lends itself to a nice Ted
talk because then you can break down all the pieces.
But basically the word just means that, like everything's affected
by what's around you and how you were raised and
(07:55):
your body, right, which you could also say like are
eating styles and choices are biopsychosocial? You know, it's like
what does your body tolerate? What foods did you grow
up with? What does society tell you about the foods?
Speaker 1 (08:09):
Right?
Speaker 2 (08:09):
Like seeing is biopsychosocial. So once you kind of break
it down and be like, oh, right, yeah, that's just
like humans don't exist in a bubble. Your sexuality doesn't
exist in a bubble. It's influenced, whether it's probably not
consciously influenced, but you have been watching Hollywood movies. Your
whole life. You have been influenced about sex roles, gender roles,
(08:32):
who initiates how fast people orgasm? You know that the
glitterist is non existent? Right, Like you have been influenced
by that, because like what other good sex and do
we have in the United States? The data says our
sex and now is worse than it was in the nineties.
Speaker 1 (08:52):
Oh come on, I know.
Speaker 4 (08:53):
Why though, because of everything that's online that got political.
Speaker 2 (08:58):
It kind of got political. So like, but to me,
I'm like, you know, I'm a I'm a victim of
the ninety sex education. But I'm like, dude, you know
when I think of the female body parts that I
was taught, like, well, I think of like what was
on the screen, it was uterous and ovaries. That's the female.
That's like, although important body parts, not responsible for pleasure.
Speaker 1 (09:22):
Yeah, oh so what Okay, this is going off topic
of where I was gonna go, But how do you
think the kids growing up now with the porn industry,
let alone Hollywood but that are just like coming into
this and they're just like, oh, this is going to
be the sexual experience. This is amazing. Yeah, and then
(09:43):
they're like, uh no.
Speaker 2 (09:45):
So there's a profound disappointment between reality, their reality and
what they've been watching. So, I mean poor used to
be like so rare. You had to like go over
to your friend's house, sneak into their dad's claw find
the magazines that were in the brown paper bag, like legit,
because that was like my first experience with like male
(10:07):
gay porn in seventh grade at my friend's house. So
like it was like very hard to access. Now it's
I mean, it's in your it's in your pocket all
the time, right, So, like porn has profoundly influenced people's
perception of not only what women want, but how men
are supposed to perform. And so now that you know,
(10:29):
talking to my friends who do the sex set in
colleges and stuff and the health just the health centers,
guys coming in thinking their bodies are perfund profoundly broken
because they don't last two hours, or they think they
you know, ejaculated too soon, or and then they're coming
in super confused because they're like, I don't think the
women are liking what we're what we're doing because what
we're watching, right, So it's a profound disconnect. And part
(10:52):
of sex education is that a lot of audio visual
is performative. And this is a movie. I love the analogy.
This is not mine, but it's like learning to drive
by watching the Fast and the Furious franchise. Yes, that's
such a good end, like not reality, but we know
that right. We don't know that with sex egg because
we never got a good sex head to be like, oh,
(11:14):
these people are faking it.
Speaker 1 (11:16):
Yeah, oh so true. So do you see more male
or female clients or is it just pretty much a mix?
Speaker 2 (11:25):
I see you about seventy percent female, but I mean
I still see a lot of guys. Well, it's been
very interesting because I really deep dove into caring about
the female now in the like the last five years.
Is when a guy comes in for a rectile dysfunction
and you know, viaguer prescription whatever, you know, we talk
about their health because again, penises are biopsychosocial. Like if
(11:46):
the heart health that you have is not good, the
penis doesn't function, right, we'd never talk about a rectile dysfunction.
But so they're coming in for that, we're talking about
their heart, like you know all these things, and I'm like,
what's your plan with this? I thought these guys would
have a plan, like profoundly interesting that like nine out
of ten are like, I don't know. I was just gonna,
(12:09):
you know, go home and maybe have sex with my wife.
And I'm like, okay, so you haven't had sex in
five years? Does she know you're here? Does she consent
to you coming home with a super dick?
Speaker 4 (12:21):
Like?
Speaker 2 (12:22):
Have you had this conversation? And they're like, ten times
out of ten they're like, no, haven't had this conversation,
which is which is enlightening. I'm like, dude, people don't
talk about their sex lives. They've lived together for decades
and do not talk about their sex life. I gotta
tell you, things get so much better when you start
talking about it. And nobody's died so far. I've never
(12:44):
read a report of somebody dying from talking to their
partner about sex.
Speaker 4 (12:47):
That's so true. It's the lack of communication. But speaking
of the ED, that was a statistic that you shared
I think on Instagram that forty percent of me. Yeah,
those a lot of were Oh was that on the
TED talk forty percent of men? Oh yeah, forty percent
(13:08):
of men by the age of forty have a rectile dysfunction.
Speaker 3 (13:12):
Is that correct?
Speaker 2 (13:13):
Yeah? At least a little bit.
Speaker 4 (13:14):
Which that's what But to me, I'm like, if I
was a man, I would want to know that because
I love how you talk about the shaming and the shoulting,
because I think I would feel that as a man,
because obviously we have as women our own set of
shame and shooting.
Speaker 3 (13:34):
But that's a pretty powerful piece of information.
Speaker 2 (13:39):
Yeah, I mean, I think it really normalizes that our
bodies age. I think it normalizes that, like what you
choose to do with your health, whether it be drinking smoking,
by the way, drinkings horrific for erections, but yeah, exercise,
but like that is profound. Like, you know, I've got
guys in their eighties who have perfectly fine erections. It
(13:59):
does not I mean, everybody's going to have problems, but
I think it's you know, when women enter perimenopause menopause
and we start needing lubrication, by the way, we should
just start lubrication at like age eighteen. But lubrication, vaginal estrogen,
all the things is like normalizing it of like, dude,
guys have changes in their bodies too, right, Like none
(14:19):
of us are immune from the powers of aging, and
it's okay to do something about it and get it treated.
Speaker 1 (14:25):
Okay, I'm so happy because I always feel like we
get the shit the babies, menopause, men can go after
like younger girl, like we're aging up every I mean,
it's literally like I didn't even think that that many
men had to struggle with it, and of course they're
not as comfortable talking about it. No.
Speaker 2 (14:49):
Yeah, I just read this one study about like the
actual amount of a rectile dysfunction compared to like how
many people actually go to the doctor about it, right,
And Viger's over the counter in a lot of kundry,
so like in a lot of countries, guys don't have
to go And now we have all these online pharmacies,
so we're really opening access to people, kind of reducing
the challenge that it is to go see a doctor.
(15:12):
But it's super common for them. And you know, the
directions guys really tie erections to the definition of manlihood,
the definition of a man that you're fully capable, that
you can you know. But again, going back to the
sex ed, like good sex ed will tell you it's
(15:32):
okay to lose an erection in the middle of sexual activity.
It's normal and it happens, and it doesn't mean you're broken,
but guys don't know that. And then they watch the
movies and these guys are like obviously enhanced many times
and taking perform performance enhancing medications, right, so they don't
know that. And just like, erections are not reliable, but
(15:55):
good sex ed will will teach you that, and people
don't know that, so they just feel profoundly broke can
ashamed less like a man. Uh, you know. And the
more anxious and stressed you are about your erection, the
more you're gonna not sustain an erection because when the
body's stressed, erections are like now's not the time he's stressed, right,
so it actually can compound and make it worse.
Speaker 3 (16:17):
Oh, that performance anxiety, I'm sure totally.
Speaker 2 (16:21):
Yeah.
Speaker 1 (16:23):
I have to say the the vaginal dryness, which you
had the best podcast on that, the menopause symptom no
one talks about. I mean, come on, so let's move
on to the vaginal dryness and calling it the When
you said the volva vaginal atrophy, I'm like, nobody wants that.
Speaker 2 (16:45):
No, it gets worse, my friend, in the eighties it
was called the senile vagina. Stop it stop right, Well,
so it keeps at least it keeps kind of getting better.
I don't know, but yeah, because you're really nobody likes
vaginal atrophy, so we call it GSM or genital urinary
syndrome of menopause, right, which is a mouthful, but it's
(17:07):
a better term. And I'm like, well, nobody liked Bobbo
vaginal atrophy. That was an improvement just from senile vagina.
Speaker 1 (17:15):
So bad terrible.
Speaker 2 (17:17):
I was actually I was pulling The reason I know
this is I was pulling up that my guy at
the medical library was helping me. I was pulling up
an old study. Actually had to like take it off
of a shelf and xerox it for me, and it
was the study from which the user er lose it
myth comes from, because I'm like, where does this come from?
Let's go back and dig and find the thing that
(17:38):
like everybody kind of cites and in it they talk
about senile vaginas and I was like, whoa, that was
a gem I hadn't planned on discovering.
Speaker 1 (17:47):
God.
Speaker 2 (17:49):
Yeah, but getting back to like it, people don't know,
like you got it. It goes back to education again, like
people think menopause is a hot flesh menopause is not
a hot flesh and menopauseist is when you can no
longer get pregnant, But it's not that's not what it is.
Those are just like signs and consequences of what it is.
(18:10):
And what it is is a profound hormone change another
way of saying that is a profound enrochronology change, right,
Like you are outliving your ovaries, which is a whole
nother podcast of Like if you outlive your eyes, you
get glasses, If you outlive your hips, you get a
hip replacement. If you outlive your teeth, you get teeth.
Why are we so afraid of replacing what our ovaries are?
(18:32):
We're outliving, right, But so with that, your hormones go down,
including testosterone, and the pelvis is profoundly active and lovely
and healthy because of your hormones. So when your hormones
go down, your labia can disappear. Inner labia disappears. Nobody
knows that you can get more recurrent urinary tract infections,
(18:54):
pain with sex, more yeast infections, more burning when you
pee getting up at nightmare to pee frequency urgency. All
of those things are under the umbrella of genital urinary
syndrome of menopause or GSM, and explains that both the
genitals and the urinary system change because of menopause. Now
two more things and then I'll stop talking. This can
(19:15):
happen before your periods are done, because your hormones start
fluctuating before your peers. So people are like, my doctor
said I was too young because I was forty two. Like, no,
your estrogen can go low. Certainly, your testosterone is low
often by that age, and you can I saw a
woman shoes in her mid forties profound vaginal atrophy. And
what this means is you can't penetrate. Tampons are painful,
(19:38):
it burns when you pee. This is not just sex.
For the people who think sex is extra, I would
say it's an important quality of life piece. But can
happen certainly before menopause, and for a lot of people,
it happens eight years after menopause. So they come into
my office and they're like, but menopause was years ago,
and I'm like, well, yeah, but you still have low
hormones and now it's caught up to you and that departarment.
(20:00):
But because we don't have any education about what menopause
is people disconnect that what's going on in their pelvis
is because of a change in hormones.
Speaker 4 (20:10):
So is the best way to correct that or help
is through hormones.
Speaker 2 (20:19):
One hundred percent. Now, the medical the medical literature will
say try non hormonal treatments first. What that means is
lubricants and moisturizers. Lubricants and moisturizers are band aids. They
make skin feel better, but it doesn't actually like you
could you can put on glasses or you can just
print everything in twenty point font Right, you're like, well,
(20:42):
glasses actually like just make it all all better?
Speaker 3 (20:45):
Right.
Speaker 2 (20:48):
I think this is my opinion after being being into
this for a while, is I think vaginal estrogen what
other people call it local estrogen or pelvic estrogen. If
you're on Instagram, you don't want to save a jack
too much because they'll kick you off, and it's true,
So I call it pelvic or local estrogen. Okay, that's
just like skincare. It's skincare for down there. And I
(21:11):
think at a certain age women should just because what
do you want to do? Do you want to come
in to see me once your labia are gone? You
don't want to have sex anymore, and you're on your
fourth urinary traction fection. Perfectly reasonable if you want to
wait for that. Or you could be like, how can
I just like have good skincare so I don't have
that happen.
Speaker 3 (21:32):
Oh, it's like, gosh, do you.
Speaker 2 (21:33):
Want to come in once your face is skin down sinscreen?
I am it.
Speaker 1 (21:39):
I'm up skincare for the badge. I'm usided, dude.
Speaker 2 (21:42):
Skincare is like a twenty six billion dollar industry. Like
women care profoundly about their skincare, and this is just
vulvar vaginal bladder. It's generally urinary skincare very safe, incredibly safe,
so safe, it's over the counter in multiple cut, so
safe that breast cancer survivors can take it, so safe
(22:06):
that breast cancer patients who are currently treating their breast
cancer can take it. Vaginal estrogen just is in the pelvis.
It won't prevent your bones, right, it won't prevent usteoporosis,
It won't protect your brain, it won't protect your heart,
like all the amazing things that systemic estrogen will do. Right,
all it does is help GSM. And my argument is
(22:28):
it should be a preventative medicine, like H fifty five,
pick a number, like, here's your mammogram, here's your colonoscopy,
here's your vaginal estrogen.
Speaker 1 (22:37):
Okay, you need to be everyone's dog.
Speaker 3 (22:39):
Found.
Speaker 2 (22:44):
Don't ask me about anybody's ear problems.
Speaker 1 (22:46):
I cannot help. Yeah, well, okay, so I'm gonna I
always like throw myself under the bus on every podcast.
I'm like, well, here's my problem.
Speaker 3 (22:54):
I know both of us are like dragging our.
Speaker 2 (22:57):
Our podcast just created for the for the host, like
help themselves. I mean, come on, that's what we're all doing.
Speaker 1 (23:04):
So okay, the overactive bladder, I did not know that
was a symptom of perimenopause. And let me tell you,
I've gone to the urologist and I he had me
on the anti what are the called the anticol energics.
Speaker 2 (23:20):
Those are nasty drugs. Yes, by the way, I'm so annoyed.
Speaker 1 (23:24):
I was on it for like three years, and then
my new urrolis because this guy like bounced. He was like,
oh no, you can't be on that, like you don't
go on that long term. And I had no idea.
So now I'm like, well, why am I peeing all
the time?
Speaker 2 (23:37):
Freaking vaginal estrogen. What's wrong with your urologists. I'm allowed
to say that because I'm a urologist, Yes, exactly. And
I'm also allowed to say that because I was literally
in Denver, Colorado last spring, looking at how brown it was,
telling the Rocky Mountain Neurologic Society that vaginal estrogen is
equivalent to anti cool energics. Like, we literally have that
published data. The problem with that data is it's hiding
(23:59):
in the menopause drone and urologists besides me don't read that.
But I was literally in Denver last year telling the
Colorado urologists that vaginal estrogen is equivalent to the nasty
medications they put you on.
Speaker 1 (24:11):
My he's fired, he's he is.
Speaker 2 (24:14):
I have an amazing urologist, and you're boulder. Who's a
female that you can go see. Her name is doctor
Carolyn Phronsia. Go see her. She's amazing.
Speaker 1 (24:22):
Oh I'm seeing her as soon as I get off
this call. This is.
Speaker 2 (24:28):
Help me, help you.
Speaker 4 (24:29):
So overactive bladder and incontinent incontinence.
Speaker 2 (24:36):
Means bladder leakage.
Speaker 3 (24:37):
Okay, that's what I wanted to know the difference.
Speaker 4 (24:39):
So so many women always complain about if they sneeze,
if they jog, they're running, they're you know anything that
your he just comes out. What.
Speaker 2 (24:51):
Yeah, let's talk about that because that's super important and
very common. So leaking, when you cough, sneeze, laugh, trampoline,
double under exercise. Right, it's called stress in continence. People
think that means it's because you're stressed. It's not because
you're stressed. Stress means a force. So it's a force
on the bladder, force on the pelvis. Right, So running, jumping, coughing, sneezing,
(25:13):
all of that will push urine out of the pelvis.
Happens with aging, decrease, collagen decrease, hormones decrease, muscle strength. Also,
putting any sort of baby through a vagina once or
multiple times can increase. So there's many reasons that it happens.
Baginal estrogen may or may not help. Doesn't help everybody
(25:37):
with that. I've seen some women on systemic testosterone get
helped with that. I'm not saying that's why we should
use systemic tstosterone. It's another podcast episode, but sometimes systemic
hormones do help. Pelvic floor physical therapy can help greatly.
They're awesome and the traditional surgery was a sling. It's
called a midirethral sling. It's been around for twenty years,
(26:00):
done plenty of them. It's a great surgery, but I'm
giving you a three percent risk of mesh complications for
your life because I'm putting a permanent piece of mesh
in there. I will now offer you the best new
things in slice bread, which I went in very skeptical
and cynical because I'm not the youngest urologist anymore. It's
called bulkamid b U l K M I D. You
(26:22):
know how women get fillers for their face, yes, to
make their cheeks and their lips more full. It's filler
for your urethra.
Speaker 3 (26:31):
Oh my gosh.
Speaker 2 (26:32):
And it decreases strength and continents by like fifty to
eighty percent. It's a three minute procedure. There's no downtime.
I'm like a walking billboard. It's like you can exercise
the next day, you can have sex the next If
you have a sling, you can't have put anything in
your vagina for six weeks and you can't exercise Like
Downtime's a big deal for busy women. Bulkamid no downtime,
(26:54):
just the day you're having the procedure, I have you
pee before you leave my surgery center because I want
to make sure you're not haven't blocked, and it's not
permanent like a meshling is. But the benefit is you
don't have any risks of things being permanent in your body.
And so you just call me and you just tell
me when it wears off, and we give you more
insurance covers it. This is no brainer it's a no brainer.
(27:18):
Nobody knows about Bulkaman yet. It's been in Europe for
over seven years. It's been in America for about two
to three years. I went, I'm telling you, believe me.
I went in cynical and like, slings are pretty awesome.
Why am I gonna do something that's not maybe doesn't
let like I went in fit with a scientist mind.
I'm like, I don't know about this. If women tell
(27:39):
me they don't like it, I'm not gonna do it.
Like that's how I went in, And now I'm like,
these are the happiest freakin' women. They like bring me
house plants as thank you gifts. One woman came in
with no underwear on to just to show me she
can wear no underwear elk. She has like a love it,
like these are happy women because it's like it's hardly
(28:01):
a surgery. I give you a little ivy a aesesia
because if you're going to put a needle in myurethra,
I'd like a little ivan asesia, like no breathing tube,
no incisions, no stitches, like this is filler for your urethra,
for stress and contents and insurance covers it.
Speaker 3 (28:19):
I can't take it.
Speaker 4 (28:20):
And I feel like women don't care about going and
getting something done again because they're used to getting the
botox or getting you know, you go and get your
teeth cleaned.
Speaker 3 (28:30):
How often? I don't know. I just feel like that's
I agree.
Speaker 2 (28:35):
When I was starting to do this procedure, I had
a woman come back at a year. She's like, yeah,
more off, And I'm like, let listen, let me ask you.
Would you rather come back and see me once a
year for this or would you rather me give you
a sling?
Speaker 1 (28:47):
Right yeah?
Speaker 2 (28:49):
And she's like this once a year, hands down, keep
the mesh out of my body. And I'm like, the
women are speaking, man, they know what they want. We've
got options, they know they want the bulkamen. It's like
very rare that I see a woman and do a sling. Now,
it's usually like do a balkamid if it's what if
(29:09):
it didn't meet your expectations, let's do it again. So
you get two bulkamids before you've bought yourself a sling.
And I've probably done two hundred to two hundred and
fifty bulcamed in the last like two and a half years,
and I've put slings in four of those people.
Speaker 3 (29:23):
It's a great, oh.
Speaker 1 (29:24):
Come, this is amazing. And so it doesn't always come
down to like not having a strong pelvic floor.
Speaker 2 (29:32):
Not always. No, the the control of urine is actually
quite complicated, right, So it's like the integrity of your urethra,
how you integrity of the urethra, collagen and hormones. Right,
Estrogen really helps the mucosa, the collagen, the blood blood
just keeps things plump. So it does an atrophy. So
(29:55):
estrogen hormones also the descent of the urethra where it
rides underneath your pubic bone. It can get pushed down
a little bit by having a baby age all that stuff,
and then the muscles of the pelvic floor. So it's
not just you know, I agree with the pelvic floor.
Physical therapists try it. It's not invasive, they can help.
It makes a world a difference.
Speaker 1 (30:14):
But if it.
Speaker 2 (30:15):
Helped everybody, I would be out of a job in
that department. And I'm telling you, I'm not Yeah.
Speaker 4 (30:21):
Do you do vaginal reconstruction surgery Yeah, for prolabse yeah, yeah,
or just anything woman I don't do.
Speaker 2 (30:31):
I cringe. I get very I'm very I'm a protective person.
I get very protective of my women, and I get
very cringy anytime people are like tightening rejuvenation, Like those
words mean nothing, and you're playing on the insecurities of
women because they don't know if their vulva and vagina's normal.
And like, I think there's a huge market for preying
(30:52):
on women's insecurities about their genitals. So I do nothing
like that.
Speaker 4 (30:56):
Yeah.
Speaker 2 (30:57):
For me, it's like, dude, I had a baby, I
haven't bet on my hormones, the tennis balls falling out,
and I can't exercise. I'm like, fix it if you
want to fix it. Absolutely, So I do a lot
of pelvic surgeries, a lot of vaginal surgeries. But anybody
who's got a website about rejuvenation and tightening. What the
fuck is tightening? Okay, well we so we To me,
(31:18):
I'm like you people come to see me because sex
is painful, because it's too tight because they don't have estrogen.
So to me, I'm like anybody who's branding vaginal tightening
is I don't know a predator.
Speaker 4 (31:31):
Okay, well we read how you said there are three
things that you should never do, and I have done
two of them.
Speaker 1 (31:43):
R the vaginal kitness and the overactive bladder, which I've
done that. So I guess that.
Speaker 2 (31:51):
Anticke a energics for overactive bad.
Speaker 1 (31:52):
Yeah.
Speaker 4 (31:53):
So between Haley and I we have covered them all,
but her and I both have done pr P in
the dress.
Speaker 3 (32:00):
You please tell us why we shouldn't do either of them.
Speaker 2 (32:04):
Listen, if women want to spend their women can spend
their money however they want to spend their money, Like,
I'm not here to tell people not to. They can
dazzle their armpits for as much as I care. But
where I have a problem is when women are sold something,
yes for something for something that doesn't either solve their problem,
(32:28):
right yep. That's my big issue of like, you know,
take sexual desire. For example, sexual desire is quite complicated.
It's biopsychosocial. There's a great TED talk on it. But
it's like desires complex, right, Like it's your relationship, it's
how you view your body image, it's your hormones, it's
(32:49):
how good the sex is to begin with, Like, desires
really complex. And when a woman is sold like come
get these proprietary injections to improve disease desire. I know
that's bullshit because it will not affect everybody's desire because
desires complex. Yeah right, and by the way, it's thousands
(33:10):
of dollars. Insurance doesn't cover it, and you have to
keep doing it if it does work.
Speaker 3 (33:15):
Yeah, so believe it.
Speaker 2 (33:16):
For a woman who's like it were great, it's like, okay,
well just wait for it, Like it's just have you
budgeted for this plan?
Speaker 1 (33:23):
Right?
Speaker 2 (33:23):
Like totally. I always joke like women shouldn't have to
re mortgage their house to take care of their health.
Speaker 1 (33:29):
No.
Speaker 4 (33:29):
Yeah, that's such a good point though about the desire.
It is like we're missing that point. And in your
TED talk, I feel like one of the most important
things you said too is your biggest sex organ is
your brain and it's isn't that what you said?
Speaker 3 (33:46):
Did? I? I want to repeat it correctly, and I
just think, how you're exactly right.
Speaker 2 (33:54):
Totally. I mean if I think if I think my
body's a disaster, it's failed me. I'm worried about leaking.
I'm checking in on my thighs all the time. Like,
my experience of my sexual life is going to be
very different than if I came in being like this
is what I'm showing up with today and let's try
to have a good time, which is even different than fuck, yeah,
(34:15):
look at me. Yeah, this is awesome. I am hot, okay, right,
because I think we're always trying to get to neutral. Yeah,
And it's like, what if we were profoundly radical and
tried to get to freakin' awesome. There's a book on
that there, book called.
Speaker 1 (34:32):
This is our best podcast already.
Speaker 2 (34:36):
There's for people who are interested in at work to
get like, there's this book called The Body is Not
an Apology. I think Sonya Renee Taylor, if I'm getting
it right, it's like over on my bookshelf. But she's like,
why the hell are we striving for neutral?
Speaker 3 (34:51):
So good?
Speaker 2 (34:51):
And it's like as soon as she says, You're like,
oh right, we've put the bar real low.
Speaker 1 (34:56):
Yeah yeah, well, okay, this is like since I'm sharing everything,
Like when I see these things advertised, You're right, Like
I go down and book and I'm like, I don't
know if if I'm normal, Like how do you know?
Speaker 2 (35:13):
Because your body parts have been banned on the internet,
Like the only body parts we see are photoshopped or
video shopped or surgically augmented. It's very hard for people
to go and to see if they if like how
does my chin compare? Like you can go see a
(35:34):
whole bunch of different chints, right, yeah, but like it's
profoundly important to know that people sit within the Bell
curve and if they don't that, you know, we can
do something about it. And even if you don't sit
within the Bell curve, you can have an amazing sex
life anyways, if it's not, you know, a broken thing.
I saw this woman, older woman. She came in with
her I think he was her husband. We're doing a
(35:57):
pelvic exam for like I don't even remember what it
was for. And she was like, I'm so sorry, I'm
so sorry, I'm so ashamed, and I'm like, oh, you know,
tell me about that. And she's like my earlier husband,
like before, the before husband had told her that she
had a profoundly abnormal labia in volva, and I think
(36:18):
it was a little more derogatory of a term. I
made it medical, but like derogatory term about how horrific
her external genitalia were. And I was like, listen, I'm
gonna do you a favor. I look at like fifteen
volvas a day. I have a lot of volva knowledge
in my brain. I'm just gonna tell you where you
are on the bell curve.
Speaker 1 (36:36):
Yeah.
Speaker 2 (36:37):
She's like okay, Like I wanted to keep it like
super neutral. I'm like, I'm just going to tell you
how average you are. It did her exam and I'm like,
you're like so average, you're unforgettable. Like I can't actually
remember her vulva now right, I'm like, you're just like average,
normal bell curve, nothing remarkable. And her husband looked at
her and he's like, see, honey, I told you. And
(36:59):
I'm like, you get to release this asshole from your
brain now. But again, going back to sex ed, like
she took that one guy's advice. He wasn't he how
many involvements. Had that guy looked at right and taken
him as what her body was.
Speaker 3 (37:18):
That is so sad.
Speaker 2 (37:19):
Anyways, I don't remember the point of that story, but
like women are hiding in shame because they don't know
if they're normal or not. That's yes, that's the point.
Speaker 4 (37:31):
Well, all of you know, we're at this age where
when we are with our friends we're talking, we end
up talking about all of these different things. And a
lot of my friends have said that they feel like
their vagina has aged, like it's not looking the same
and they and sometimes functioning the same, and they do
(37:53):
want it to function like it did, but also look young.
And I never even thought about that until I started
having conversations about it, and I'm at an older age.
But what do you think is the best advice for
people that feel that way?
Speaker 2 (38:13):
Yeah? So, I mean again, this whole thing is biopsychosocial, right, Yeah,
it's like, why do you want to change your body part? Oh?
Because society told you youngers better? Okay, interesting, so there
might not actually be anything wrong with the body part
you're just coming to And by the way, we wear clothes,
like ninety nine percent of the time, like Society's literally
(38:36):
not like I understand the face so much more because
it's your billboard, right, But it's like, dude, literally, maybe
a couple of people are looking at your volva and
ideally they're having a hell of a good time with
it and not trying to judge your like your anatomical
age by it.
Speaker 1 (38:52):
Yeah.
Speaker 2 (38:53):
Right, But that's why I love these conversations, because like
you just take somebody's concern and you just freaking blow
it out of the water by being like, is anybody
asking how old you are? And you're like, hold on,
let me check my volva.
Speaker 4 (39:05):
Yeah, And what's funny is all, yeah, we'll save Well
did your husband seeming like are there any complaints? It's
like no, he'd be all over it every day. Yeah.
Speaker 2 (39:16):
So I'm like, okay, this is my advice. Number One,
nothing prevents us from aging except for death. Yeah, so true,
you like nothing is stopping the clock. And do you
spend spend your whole life wishing you were a different
age or your body look different at the on your deathbed,
you kind of wish you didn't do that, Like, enjoy
(39:36):
the time you had, right. Number two, save your money,
go get yourself some phenomenal good hormone healthcare because our
I would agree, our volvas do change with age. We
lose volume, we lose elasticity, and a twenty dollars bottle
of vaginal estrogen does a world of difference, and we
(39:59):
should be putting it on our clitterists. We should put
putting it on our labia minora. And that six o'clock
entrance to the vagina is nasty. It gets tight, and
that's the first part that starts hurting when people start
complaining of dryness or pain with sex. So when I
see people being like get tighter, I'm like, dude, just
give it. Give yourself five years with no hormones and
you'll be tight to the point that you hate sex.
(40:21):
So like, I don't think that tightness should be a
branding thing at all. It makes no sense to me.
If you want to work on tightness, like get a
good pelvic floor physical therapist, get your muscles toned right. Yeah,
so pelvic floor physical therapy and then vaginal estrogen. But
don't remortgage the house or brain, like go out to
dinner or go on vacation. With the amount of money
(40:42):
that people are taking from women praying on their insecurity
that their vulva doesn't look twenty like your partner doesn't care.
They probably just want more sex. Yeah, what are we try?
But when all you see online is like the plastic
surgery images of this is how I can change a volva,
you start thinking that's necessary. It is completely not necessary
(41:05):
to a great sex life. So true, Well spend your
money on.
Speaker 1 (41:08):
Good vibrators, for sure. That's what I thought you were
going to say. When you said hormut it on hormone.
Speaker 2 (41:15):
I was like, we're having the vibrate vibrary conversation. Wow,
we invest in some good vibrators, Like a twenty dollars
vibrator is kind of a piece of crap.
Speaker 1 (41:25):
Yeah, in my opinion, this is this is the best. Okay,
the pelvic floor physical therapist. I went because I had
a lot of issues with my my last my third
child birth. I didn't know that entelled and when I
went in there, I was like, well.
Speaker 2 (41:43):
That was spir is personal and for people, I want
to address that right because I see a lot of
women say I don't want to go because I'm worried
about an internal exam stuff like that, and I'm like,
you need to communicate that to them. You need to
tell them you're boues, whether you've had a history of trauma.
You don't have to tell the details. But I fully
(42:04):
respect if a woman is not ready to get naked
and have some fingers in her for, you know, checking
out her hip joint on the first date, I get it.
Speaker 1 (42:12):
Yeah.
Speaker 2 (42:13):
And physical therapists can do a lot without going inside
of you. They're very talented people. They're better than doctors
are at assessing pelvic floor muscles and inside the vagina
is the way to do that. But they can do
a lot without doing that, and you can also get
to know them. Is this a good fit? Are we
(42:34):
aligned in what the plan is? Do I feel good
showing up here right? Like you don't have to rush
into the internal exam, but you got to communicate it.
You can't be like, well here I go and then
be like I wish I didn't I wish we didn't
do that. Like address that, bring that up on the
front end, is would be my advice.
Speaker 3 (42:51):
That's good advice.
Speaker 1 (42:52):
Oh, I just didn't know what I was getting into.
I mean, like, the lady was amazing, but I was
just like she's like, okay, so this is what's happening.
I was like, ah, well, I thought I was coming
in here for a hamstring something. Where are we going
with this?
Speaker 2 (43:09):
You learned a lot. But with I mean, they're incredibly talented.
There is like not a pelvic floor physical therapist that
I haven't liked yet. They're invaluable people. I mean, it's
so silly our healthcare system, right, Like I'm a surgeon.
People come to me first of all not wanting surgery,
and then I'm like, you know, I'm a surgeon and
They're like no, I didn't know that. And I'm like, okay,
(43:30):
well Google. But but I'm like, you can go to
physical therapy first. The surgeon doesn't have to be your
first stop, right, And so many good pelvic floor physical
therapists will tell you though. They'll be like, go see
a doctor, get on vaginal estrogen, like they know the
importance of hormones in pelvic health. So we're all it's
all just kind of like a mutual love fest that
(43:50):
like we love them, they love us because we all
do a different part to help help a woman.
Speaker 4 (43:58):
So besides the estrogen, what is another essential hormone that
you feel like is really helpful for women?
Speaker 3 (44:10):
Testosterone and progosta.
Speaker 2 (44:12):
Yeah, so there's three. I mean, there's three hormones that
we can buy, right, like that, we have pharmacies that
we've created our bodies. Well, I mean besides the other
hormones of like insulin, thyroid, you know all tho sick.
But we're talking like perimenopause menopause hormones. And to call
these sex hormones is a complete misnomer, Like, yes, our
(44:34):
gonads make most of them, but like they work in
your brain, they work in your heart, they help with
insulin resistance. Like the fact that we've labeled them sex
hormones is actually like a dismissal of their importance. They're
vitally important for our entire body. But again we didn't
get taught that. But so there we have many hormones
(44:54):
within the like there's many types of estrogen. There's several
types of androgens, like all of these different things. But
we have three that like money can buy, money can
buy testosterone, progesterone, estrogen. Our ovaries make testosterone which then
gets converted into estrogen. So it's actually wrong to say
(45:18):
ovaries make estrogen because you're missing out. You're missing out
the fact that like we actually have more testosterone in
our bodies than estrogen because we make testosterone to make
some estrogen, which is I didn't even get taught that
in medical school. Like it's insulting how little we know
about our bodies. But so to me, in perimenopause and menopause,
(45:39):
those are the three options on the table, and I
think they're all important and they all do different things.
And if you see somebody for hormones and they don't
talk about all three of those things, then I wouldn't
say they're comprehensive if they're only would. I like put
this on Instagram the other day and like, if your
only option for a woman is a pellet of one type,
(46:01):
you're a one trick pony. You're not actually a hormone expert.
Speaker 3 (46:05):
I loved when you said that.
Speaker 1 (46:07):
Oh, I loved when you said the pharmacists or assholes quote.
I was like, yeah, so let's talk about that. The
testosterone and the lack of you know how hard it
is to get from it.
Speaker 2 (46:23):
It's embarrassing. And the reason why it's embarrassing is because
I know, I trust and I believe that in the
future it's going to be better. Like I know that
I know there is a world where we have good
access to this, and so I'm like, oh my god,
I'm part of the generation where it's embarrassing, but like
(46:44):
we have to help get it there. Right. So ovaries
make testosterone. All people have testosterone. Men just have more
of it, right, Like people need to know that because
otherwise I come in looking like this crazy person who's
like testosterone for women, and they're like what right, So
(47:04):
you got to like go back to the education first.
But the FDA has about twenty different products for testosterone
for men. We have zero for women. The FDA has
said we want five more years of safety data for
testosterone for women, more safety data than we have for men.
The additional problem, because of the Olympic doping scandals of
(47:28):
the seventies and eighties, our legislature got a little pissed
that people were doping, so they put in the FED
a federal act that all of these synthetic androgens are
now banned substances, and on that list was one naturally
occurring hormone called testosterone. People do not overdose testosterone like
(47:49):
they do not do it. They might become they might
have gros some more hair and get angry, like there's
side effects, but like too much disosterone doesn't kill a person.
But it's on this list of banned subst stances, including
fentanyl and oxycodone. What that does is it prevents access
because now we've labeled it as unsafe instead of something
your body naturally makes. Right, So we've got two problems.
(48:11):
We do not have a female dosed product approved by
the FDA. That means insurance won't cover it, and you
have to dose it appropriately and it's actually difficult to do.
The other problem is now it's on the DEA list.
Your name goes on a register of being somebody who
has a controlled substance it legit. Yeah, California has its
(48:33):
own list because they wanted today want to know everybody
who's taken oxycodone and fentanyl and ope tiestosterones on that list,
and you have to see a doctor every six months
for your prescription instead of every year because it's on
that list. And it also carries the stigma of doctors
being like that's unsafe. That's a steroid. Of like, course
it's a steroid, so but so it's cholesterol, like something
(48:55):
being a steroid means nothing. So yeah, we've got a lot,
a lot of barriers to testosterone. But let me tell you,
there is nothing like testosterone appropriately dosed in a woman
made midlife where she comes back to see me and
she says, I'm back.
Speaker 3 (49:15):
Oh, I just got the chills.
Speaker 2 (49:18):
I feel more like myself. And I'm like, at the
end of the day, if my job as a doctor
isn't to make you feel more like yourself, what are
we doing? You know? Like, there is something profoundly better
about women when they are on testosterone. They come back
and they're like, I can think faster, I'm quicker, I
(49:39):
have more energy, I can recover better from the gym more.
I just had a woman She's like, I'm more interested
in the world. Again, You're never going to get an
FDA approval for something that makes you more interested in
the world, right, Like, it's these these stories that come back.
The other bullshit about testosterone for women is that the
main global consensus it is for low desire. Why is
(50:04):
the only legitimate reason for you to be on a
hormone for you to sleep with somebody else?
Speaker 1 (50:09):
Good point, Well, messed up.
Speaker 2 (50:12):
It's so messed up. I didn't even think about that.
Like my male brother pointed that out to me. He's like, Kelly,
isn't it kind of weird that, like the only reason
for women to take testosterone is to like sleep with dudes?
And I'm like, yes, bro, Yes, yes, bro, thanks for
putting that out to me.
Speaker 1 (50:28):
Gosh, and I don't want to be on any anyone's list,
any government.
Speaker 2 (50:34):
Get as you are if you take testosterone.
Speaker 1 (50:37):
Or like America's most wanted.
Speaker 2 (50:39):
It makes it sound like you're doing something dangerous. And
so in a woman's body, the testosterone she has in
her twenties is about forty to fifty percent higher than
the testosterone she has in her forties. Wow, testosterone starts
going down much early. We kind of think of menopause
as like and on Tuesday, the ovaries stopped and then
(50:59):
everything fell off a cliff. Right, That's not how it
works for testosterone. It's a very much slower decline, but
it starts earlier. But you're still gonna make some testosterone
even after the periods are done. Right, So testosterone is
kind of like slow but early, but can you can
keep getting making some estrogen is like in perimenopause, it's
like up down up down, super up, way down up
(51:22):
down here's the period. Now you're not going to have
one for a while. So estrogen is like spastic, right,
and then progesterone can kind of it's kind of doing
its own thing. Nobody's really paid it. It's like the
it's like the step brother that like doesn't doesn't come
out of its room. Much like, we haven't really looked
at progesterone very much. So, but progesteron is profoundly important
(51:42):
for mood and sleep. We just we just I think
we need more research, especially in perimenopause. But so to
say for a woman who's still she's perimenopause, she still
has her periods, maybe her energy is low, maybe her
sexual desire is low. To me, I'm like, I'm checking
that woman's testosterone way before I'm telling her to go
get PRP and her clitterists or lasers or you know
(52:05):
anything else. Is like, there's things happening in your body,
let's optimize them. And by the way, it's predamn cheap.
So but mean it all comes back to education. The
more we know, the less we're gonna fall victim to
people who just want to make money off of us.
Speaker 1 (52:21):
Yeah, okay, so with testosterone, when it's low for certain women.
I just had a conversation about this this week. That
can affect your ability to grow muscle. Yes, so I
have some clients. I mean I only work with people
forty plus and most of them are in their fifties
(52:42):
and their post metapuzzle and when they again, different conversation.
But when they come and they're like, well, I don't
want to get bulky, and I'm like, do you know
how you are? Like try? I'm like, do you know
how many women that like, we'll talk to them when
they're passed out on the floor just because they're trying
to main pin their muscle that they have.
Speaker 2 (53:03):
Dude, And the role of muscle and longevity, the role
of muscle and insulin resistance, the role of muscle in
bone health, the role of muscle in preventing falls. Like
I'm telling you, if you want to do anything to
help out your seventy two year old future self, lift
the weights. Please preaching to the choir, but it's like, dude,
(53:23):
muscles are so important.
Speaker 1 (53:25):
Yeah.
Speaker 2 (53:25):
I just saw a lady, she's sixty, she just came
back four months. So sometimes taking disasterone, especially when it's
appropriately dosed, and we can go into that, but she's
about four months in. She's like, I'm noticing now my
lean body mass, right, but in appropriately does hormones like
it's gonna get you there slowly, not like four months
(53:46):
is slow? Right, she spent she spent ten years without
the damn stuff. Yeah, but you know, to be like, yeah,
I think all tastostone's important and wound healing. Right, Orthopedic
is looking like the orthopedic world is looking. They did
a study where they gave dudes super high to stosterone,
like way more than standard replacement before hip replacements, and
(54:09):
they actually did better. No way, it's a little unorthodox,
but like people are, you know, I think we are
under because of the stigma and all the other things
that we're calling these things sex hormones. We're under researching
the role of hormones in healing and lean body mass.
Certainly we know how important it is for bone protection
(54:31):
and in women, your bone loss starts before your period's end.
I was like, oh, that happens after your periods end.
It's like no, no, no, this starts before because remember,
the hormones are already doing their thing before the period stop.
It's profoundly important.
Speaker 4 (54:49):
I am I am, I'm getting blood work done, oversation,
I'm giving you a standing ovation.
Speaker 1 (54:57):
I don't want it to end. I'm super sensitive in
your time, in our hours. But holy like my brain
is just running with all of these conversations that I mean,
I love what you're doing, Kelly. I love how I
love your personality number one. I mean that alone outside
of all of the education and knowledge that you're sharing,
(55:20):
but like it's just on the opposite side to wrap up, like,
I see women all the time that are just like
shamed about weight or the fact that they don't have
as much lean body mass and all of these things,
and I'm just like, why are we making our lives
miserable when it's just hard? I mean, and a lot
(55:42):
of that comes from biopsychosocial and it's just it makes
me so sad when women are just like kind of
told that after midlife, like well, why do you care
that much about your body or about your sex or
about you know anything. It's just it's very disheartening.
Speaker 2 (56:04):
And you know, I thought about this. These are things
I think about a lot, so you know, we're like, oh,
society tells women all these things. Ah, and it's like
we just lay down and fucking accept that. And it's like, no, no,
you get to decide. You control the narrative. You tell
people how to treat you, You tell people what women
are like at this age. Like there's I'm so sick
(56:26):
of this, like laying down and taking it attitude of
like do you not realize your power? We have immense power,
freaking use it.
Speaker 3 (56:38):
Yes, aimen to that. And I think the older we get,
the better we get. I don't think it's oh.
Speaker 2 (56:46):
My god, yeah, I mean just look, you know, I'm
so inspired by the thing of like, you know, Martha Stewart.
Stewart didn't make her first million, and I'm making this
up because I haven't looked recently, but like women kick
it in the gear in mid life.
Speaker 1 (57:01):
Yeah, for any woman to be like, oh.
Speaker 2 (57:03):
They told me that this is just blah blah blah,
it's like, no, no, no, this is when you can kick
it into gear. If that's what you want to do.
You don't have to do that, right. But it's like,
you write the narrative because we have the immense privilege
of living long and we've never lived this long before
on a global scale, we are literally making it up.
(57:24):
What aging looks like, all this is just a big
grand experiment for the next generation, right, We're trying to
help help out our kids.
Speaker 1 (57:33):
So what you are doing, I think it's like an amazing.
Speaker 2 (57:36):
Moment right now in mid life for women. And I'm
like so happy to be part of the conversation.
Speaker 1 (57:43):
Yes, that is the perfect way to end really quick.
Can people see you online? Do you do telehealth or
are you ful?
Speaker 2 (57:51):
It's a good question. So I practice in Washington State.
I currently only have a Washington state license. So what
that means is you must be the bullshit of the world, right, Like,
do you think healthcare is any different in North Carolina
than Washington State. No, But state regulations don't blame the
doctors for this, is what I'm saying. State regulations say
(58:13):
that the person has to be in the state where
the doctor is licensed, which makes again arcane state rules.
But I'm already booked out for months and months and
months taking care of Washingtonians. So I'm like, I have
no incentive to get other state licenses because I'm like,
I had I got nine million people in this state,
(58:33):
fifty percent of them are female. Right, But so the
point is I take care of Washington state people or
people who fly in right now. I have no problem
with you flying in, but.
Speaker 1 (58:44):
Oh I'm flying in. I'm gonna get on.
Speaker 2 (58:45):
Your note to me. I'm like, I like, you're in Boulder,
you have resources. I will get you the people.
Speaker 1 (58:50):
Yeah, okay, doctor Krollen phronsiac.
Speaker 2 (58:54):
You will say, you know me, I will help with her,
take taking care of you. We will get all the women,
all the balkamed in Boulder in Colorado, and it'll.
Speaker 1 (59:04):
Be will help other people done. I'm done, all right.
So your Instagram is that the best place for people
to get a hold of you or follow you? So
either in Instagram because I love it, but it gets
a little busy on there, you know, so you can
always send me an email info at Kellycasperson MD dot com.
That's through my website, which is Kellycasperson MD dot com.
(59:25):
My baby of babies is the podcast.
Speaker 2 (59:27):
You Are Not Broken. I love it. That's the long form,
right because like you have to hear these things a
couple of times to like understand hormones and like the
pelvis and how it works. So I love a lot,
Like podcasting is my favorite thing. So You're Not Broken?
And then the book is being re released September tenth,
(59:47):
so it's for pre sale on Amazon right now. If
you didn't get the book before, it's now taken down
and re releasing September tenth, which is you are not broken,
stop shooting all over your sex life.
Speaker 1 (01:00:00):
Okay, we're we're coming back on in September when you're
slammed exactly nine million. Everyone has like nine million Instagram lives. Oh,
I'm already pre booking, so we want to pre book
you now because this is amazing and we're making everyone
by the book. I'm going to pre buy the pre
sell right now on Amazon because I just think you're
(01:00:21):
fabulous and we are so grateful for your time and
for everything that you're doing to serve women. So thank
you so much for that, and we look forward to
your book launch.
Speaker 3 (01:00:34):
Yeah, thank you, thank you.
Speaker 2 (01:00:36):
Thank you guys so much for having me.
Speaker 1 (01:00:38):
Thanks for listening everyone.
Speaker 4 (01:00:40):
If you enjoyed this episode, please consider giving us a
five star rating and sharing the body Pod with your friends.
Speaker 1 (01:00:47):
Until next time, Beetles, Beetles, beetles,
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