August 16, 2024 • 57 mins
Unlock the truth about hormones and women's health with our enlightening episode featuring Dr. Kelly Casperson, a distinguished urologist turned women's sexual health advocate. Have you ever wondered why testosterone is crucial for women too? Dr. Casperson unpacks common misconceptions about hormones, revealing their significant roles in brain, bone, and muscle health for both genders. Her journey from treating kidney stones and bladder cancer to becoming a key player in women's midlife well-being is inspiring and informative.
This episode dives deep into the systemic sexism in healthcare that limits women's access to essential hormone treatments like testosterone. Discover why it's vital for women to be their own advocates, demanding proper hormone checks and pushing for systemic changes in the medical community. Dr. Casperson also shares her insights on the controversial rise of pellet clinics and the risks associated with high-dose testosterone treatments. You'll learn practical tips on how to manage hormone therapy effectively, ensuring optimal health outcomes.
We also explore the complexities of interpreting female testosterone levels and why standard lab ranges might not be sufficient. Dr. Casperson explains the importance of finding knowledgeable healthcare providers and giving treatments adequate time to show results. Whether you're postmenopausal, in late perimenopause, or simply interested in hormone health, this episode provides comprehensive guidance and expert advice to help you navigate your journey. Don't miss this opportunity to empower yourself with knowledge and take control of your health.
Dr. Kelly Casperson is a urologist, public speaker, sex educator, and top international podcaster whose mission is empowering women to live their best lives. Dr. Kelly identified the need for better resources and developed a sex education class for women that covers topics like sexual health, intimacy, mind work, and the science of desire. She combines education, humor, and candor in her podcast "You Are Not Broken" where she dismantles the myths women have learned and normalizes healthy, enjoyable sex worth desiring, in addition to essential education on midlife health and hormones. Follow Dr. Kelly on Instagram (@kellycaspersonmd), or visit kellycaspersonmd.com.
Order Dr. Casperson’s book, “You Are Not Broken: Stop “Should-ing” All Over Your Sex Life” here.
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Welcome to The MiDOViA Menopause Podcast! Your trusted source for evidence-based, science-backed information related to menopause.
MiDOViA is dedicated to changing the narrative about menopause by educating, raising awareness and supporting women in this stage of life, both at home and in the workplace. Visit midovia.com to learn more.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to the Medovia Menopause Podcast, your
trusted source forevidence-based, science-backed
information related to menopause.
Medovia is dedicated tochanging the narrative about
menopause by educating, raisingawareness and supporting women
in this stage of life, both athome and in the workplace.
(00:21):
Visit medoviacom to learn morehome and in the workplace.
Visit Medoviacom to learn more.
I'm one of your hosts, aprilHaberman, and I'm joined by Kim
Hart.
We're co-founders of Medovia,certified health coaches,
registered yoga teachers andmidlife mamas specializing in
menopause.
You're listening to anotherepisode of our podcast, where we
(00:43):
offer expert guidance for themost transformative stage of
life, bringing you realconversations, education and
resources to help you overcomechallenges and reach your full
potential through midlife.
Join us and our special guestseach episode as we bring vibrant
, fun and truthful conversationand let us help you have a
(01:07):
deeper understanding ofmenopause.
Hi friends, we have a specialtreat today.
We have Dr Kelly Kasperson onthe show and for those of you
that are familiar with DrKasperson, you know that this is
going to be a fun episode.
Dr Kasperson is a urologist,public speaker, sex educator and
(01:28):
top international podcasterwhose mission is empowering
women to live their best lives.
Dr Kasperson identified theneed for better resources and
developed a sex education classfor women that covers topics
like sexual health, intimacy,mind work and the science of
desire.
She combines her education,lots of humor and candor in her
(01:51):
podcast you Are Not Broken,where she dismantles the myths
that women have learned andnormalizes healthy, enjoyable
sex worth desiring, in additionto the essential education on
midlife health and hormones.
There's a lot packed in there.
You can follow Dr Kelly onInstagram at kellycaspersonmd,
or follow kellycaspersonmdcom.
(02:14):
Let's go right to the show,kelly.
We are so incredibly excited tohave you with us, dr Casperson.
We met in June, I think, at theWomen in Work Summit and, for
(02:35):
those of you that weren't there,dr Kasperson comes up next to
me, sits in a chair and I lookdown and you've got a cast on
your leg, which I didn't expect,and I think that little snafu
had partly.
It was partly due to your lovelyblack lab, I think, and I'm
glad to see that you are allhealed.
I can't see your leg, but Iassume that you are out of the
cast.
Speaker 2 (02:54):
Yes, thank you.
Yeah, I had just been sidelinedby a black lab on a hike it was
like the most Pacific Northwestinjury that exists and I
hobbled my way down to Seattle,had an amazing night and I was
such a good patient.
I did the physical therapy, Idid the massage, I got checked
out to make sure it wasn'tanything severe, so I was like I
think I healed properly and I'mback.
(03:14):
I'm back Good.
Speaker 1 (03:16):
Yay, and you're hiking again.
I hope in the Pacific Northwest.
All right, good, we're going togo on a hike someday.
We were just talking about thatbefore we hopped on here and
hit record.
We you know, kim and I probablyhave gathered 100 questions for
you today and, no kidding, thelist just gets longer and longer
and there's just so much tounpack.
(03:36):
We're not going to be able tounpack it all on this podcast,
but we're thrilled to have you,because I want to start here
with your story, because yourstory is really incredible.
We were also talking, before wehit record, on the privilege
that we have of leaning into ourpassion and changing our mind
(03:58):
and changing our career, andyou've just got such an
incredible story in how youstarted and where you are right
now.
You just got such an incrediblestory in how you started and
where you are right now.
So, if we can, let's dive inand go back to the very
beginning.
You're a urologist, and how theheck did you start in that
trade, first of all, thatprofession, rather and tell me
(04:20):
that story.
And then, how did you lead tosexual health, because that's
different, right?
Yeah, what happened?
Speaker 2 (04:31):
So for people who don't know, a urologist is a
surgeon, a specialty surgeon,who operates on kidneys, bladder
, technically male genitalia,although there is the niche of
female urology, but not allurologists can move around a
female pelvis with ease Kidneystones, bladder cancer, prostate
, enlarged men who can't pee,right, so really genital urinary
structures is what theurologist does.
So when I was looking I thoughtit was going to be internal
(04:53):
medicine because I wanted toknow everything.
I bought all the books inmedical school.
I just loved reading it and Idid a two-week urology rotation
only men.
I was in Minnesota.
There was one female urologistin the entire state.
I have yet to remember her andnow I don't remember her name,
but there was one in the stateand so I'd never met her.
But the male urologist, theywere happy, they were funny,
(05:16):
they fixed thingsinstantaneously, which is kind
of hard in medicine, right, andso like, kidney stone gone,
bladder cancer gone.
And I was like, because youshowed up, big things happened
in that day and that was veryattractive, the short term,
instant gratification.
So like, okay, I'll just dowhatever beats urology, because
(05:37):
you spend another year doing abunch of stuff and nothing beat
urology.
So that's what I ended up doingand trained in Denver for six
years, was in Bellingham forseven years when I got my seven
year itch.
So for anybody who hasn't heardof the seven year itch, it's
legitimate, whether it's yourrelationship or your career.
Something happens at seven years.
You kind of get like, you getbored, you get a little.
(05:57):
What am I doing?
And I'm like oh, recurrenturinary tract infections, day in
, day out.
Train for you know a decade totell people to drink more water
and pee more yeah, yeah and um,so it was kind of having that
like career midlife crisis, andthen that was when the universe
was like she's ready, you knowyou have to be like ready to
receive the message.
(06:17):
So I had a woman come in.
I was very bonded with herbecause I had cured her from
cancer years in the past.
We just see each other everyonce, once a year.
How are you doing, how's things?
And she was crying because ofher sexless marriage great
marriage, just not not full ofphysical sexual health and was.
She was very, very disturbedabout it and I'm handing her a
(06:38):
box of Kleenex and the lightningstrikes my brain and I don't
know how to help her.
I was like, does anybody knowhow to help her?
Because when I was in trainingfor urology, we were told women
were difficult.
I was told to do a fellowshipso that I didn't have to deal
with women.
Women are difficult.
They took too long in theclinic and we'll never figure
them out.
And the gynecologists are.
(06:59):
They're dealing with them likelegit things.
I was told that I didn'tquestion then because you're the
trainee, right?
And so I was like well, is ittrue?
Is it true?
We haven't figured any.
How come we give by?
We've been giving viagra as aprescription since 1998.
Who's taking care of the peoplewho are supposed to be sleeping
with the people we're givingthe viagra to yeah, right, and
so, like, all these questionsjust started coming up for me
(07:21):
when I started learning and Iwas was like oh, we actually
know a lot about female sexualhealth.
It just doesn't trickle down tothe people because Hollywood
feeds us a load of baloney andthe doctors don't know.
So there's this voice in myhead and the voice was like you
need to talk.
And I was like this voice issuper annoying.
(07:42):
No, I'm fine, but like everymorning, the voice was like you
need to talk, you need to talk,you need to talk and one day I
was like I don't know enough yet, Like I didn't.
There was there's one fellowshipin female sexual health.
Now there's two.
Wow, so that means two people ayear in this country get
actually fellowship trained infemale sexual health, and so I
(08:02):
hadn't done one of those.
Like all of this, like I wasn'tsmart enough.
Who?
Speaker 1 (08:06):
am I All those messages?
Speaker 2 (08:08):
right All those messages.
So I was waiting for permissionfor somebody to like tell me I
knew enough.
And like I was waiting forsomebody to like pick up the
phone and be like Kelly, youshould start a podcast.
And like I, even it was so bad,like I even knew who that
person was.
I was waiting for permissionand so I got out of the shower
one day and we're all good ideasof the shower come from.
Speaker 1 (08:27):
Exactly.
Speaker 2 (08:28):
Lightning strikes again and they're like.
The only permission you need isyour own Do it, I was like God
darn it.
Like that's true, right.
So I started a podcast four anda half years ago and it's doing
very well.
It's like usually in the top 10of medicine on Apple.
It's called you Are Not Brokenand it really started out with
(08:49):
sexual health because that wasmy like women need to be
educated on this, blah, blahblah.
And so the book came out youAre Not Broken Stop Shoulding
All Over your Sex Life Becausepeople, you know, it's like we
have all these shoulds.
Like you should have sex acertain amount of times a week.
You should take this long toorgasm.
You should, you should orgasm.
Like this, right, like we haveall these shoulds about what we
(09:10):
think sex is.
And so wrote the book and, uh,really, women started being like
yeah, but you know what happenswith menopause?
And I'm like what happens withmenopause, right?
And they're like your sex lifegoes away.
And I'm like is that true?
And so that was like the nextdeep dive of like what it?
(09:30):
What happened?
I'm staring down the barrel atthis, what the heck is coming,
right, what's coming?
And so it's then started to getinto like is that true?
Are hormones related?
Why are we so scared ofhormones?
What's the truth about hormonesand breast cancer and just
started like digging deep on allof that stuff that kept coming
up.
And then I was like, oh we,because of the women's health
(09:53):
initiative, we are incrediblynumber one in the dark about
what's actually happening.
People just think this is a hotflash right they have no idea
that like it's a profoundhormonal change.
I say change because people getall moody when I'm like it's,
the hormones go very, very lowand people are like we don't
like the word.
Oh, I don't like the word andI'm like you guys need to
(10:16):
freaking deal with what'shappening.
Speaker 1 (10:18):
So yeah, yeah, Interesting, interesting yeah.
Speaker 2 (10:22):
It's super interesting that women get picky
about the word.
But because I had posted, it'sovarian decline, I think, or I'd
posted something about ovariandemise, ovarian decline,
something that it was kind ofmedical, it wasn't demise and
people get all like you guysdon't know what this is.
Yeah, like that's what it is.
And so really started educatingabout hormones and educating
(10:45):
about fear and then startedprescribing it in my clinic and
I'm a urologist, so we give 10times the dose of testosterone
to men, like every Tuesday.
Like I am not afraid oftestosterone and I know what
testosterone, how good it is forpeople.
Speaker 1 (10:59):
Yeah.
Speaker 2 (10:59):
So really started kind of becoming the like sex
med hormone testosterone guru ofthe United States of America.
Speaker 1 (11:07):
Yeah, you really are, and roll credits.
Note first, you do have a.
What do we call it?
It's a new release of your book.
Speaker 2 (11:18):
Yeah, a re-release.
Speaker 1 (11:19):
Okay, there you go.
Speaker 2 (11:21):
So it's yeah, a publisher bought the rights to
the book and is now it's goingworldwide.
So it's in UK, canada,australia right now.
Speaker 1 (11:28):
We're so excited it's coming in September so you can
pre-order that, I know you can.
We're going to put that in ourshow notes.
Just super excited I did too.
And you're going to have allkinds of fun things with some,
you know, private conversationswith anyone that's pre-ordered,
and so we can right.
Yeah, yeah, I'm pretty excited,all of that in the show notes,
(11:50):
but I I just first of all, Iwant to say I love the story.
You went from urologist tosexual health expert.
Now you're hormonal healthexpert and I want to dive into
testosterone, estrogen hormones,because there are so many
questions about that, as youjust said.
(12:11):
And you just said somethingthat I don't think that our
general audience might realizethat males take 10 times the
amount of hormone testosteronethat we do right, but there's
not an FDA approved testosteronefor women that's dosed at that
(12:32):
one 10th of the male hormone,correct?
So let's unpack that a littlebit.
Let's talk about that.
We also know that testosteroneis good for our bodies, not just
to increase our libido.
So that's where we go.
You know, when we talk to women, it immediately equates to sex
(12:54):
libido, and that's the onlyreason why I need to take
testosterone.
And, by the way, if I taketestosterone, I might grow hair
on my face and places that Idon't want it, and so can we.
Can we talk about that a littlebit?
And what the heck?
Why are there so many confusingmessages out there on
testosterone?
Speaker 2 (13:14):
Yeah, it's a one of my favorite topics because you
and you have to start well andwe'll back up for the people.
Because if I just come out ofthe gate and be like all women
need testosterone, like I sound,sound crazy yeah right, because
their lack of education hasn'tcaught up to like where I am or
I'm like how do you want it?
Do you want to inject it?
You want a cream?
You want a gel right right,like, like.
(13:35):
You have to catch up to to whereI am.
So all bodies make testosterone.
It was labeled the male sexhormone just by a bunch of male
researchers, because researcherswere men back in the day and
just got labeled androgen, whichmeans if you look it up, it
(13:55):
means the male sexualcharacteristics.
But it's completely made up.
Men make estrogen, women maketestosterone.
It's like calling insulin maleor calling thyroid female of
like.
No, these are just things allbodies have.
We just have them in differentratios.
So the first part of the wholediscussion is really cutting
(14:17):
down these gendered terms thatwe used, which kind of puts
these hormones in a box, and itputs these hormones in a box of
like.
That's for him.
This is for her side note.
Men have more estrogen in theirbodies than women do after
menopause.
Speaker 1 (14:32):
Interesting.
Speaker 2 (14:33):
Yes, men have a level of 30 to 40 on average and
women have a level of like lessthan 10.
That's estrogen after menopause.
So just to open people's mindsof like everybody has hormones,
everybody needs hormones.
The hormones go crazy low inmenopause to the point of you
know, I have this woman andshe's like I want estrogen and
(14:54):
blah, blah, blah.
And I look at, I point to herhusband and I'm like you know,
he has more estrogen in his bodythan you do right now.
And that really helps themrealize like, oh, I have a
profoundly low level of estrogennow because I don't think of
him as having estrogen.
But estrogen in men is verygood for their bone health, is
also really good for theirlibido and sexual health.
(15:16):
They've got amazing studieswhere they knocked out men's
estrogen and they're like eh, ah, that's interesting.
But you don't go around withthe stereotype of like estrogen
is great for men's sex livesright, right.
Speaker 3 (15:28):
So you have to back up that either yeah.
Speaker 2 (15:32):
So you have to back up and be like okay.
So now we know everybody makestestosterone.
And the other thing we need toknow is before menopause.
So when we're having normalcycles, our testosterone women's
testosterone level is fourtimes our estrogen level.
Speaker 3 (15:47):
We don't know that either.
Speaker 2 (15:49):
So we're always told.
The other interesting thing isyou can't make estrogen in your
body if it doesn't go throughthe testosterone pathway.
So you take cholesterol andthen cholesterol goes into all
of these hormones.
It first has to becometestosterone before it becomes
estrogen.
People think these are likeseparate floating things.
We get our estrogen from ourtestosterone, which is four
(16:12):
times what our estrogen level is.
It's important.
It's important.
But our body doesn't just usetestosterone to make estrogen.
We also use we havetestosterone receptors in our
brains and our bones and ourmuscles everywhere else.
So that's the spiel of likeokay, now we can talk about
testosterone in women andactually using it as a
pharmacologic drug.
(16:34):
Once we understand I'm nottrying to take something that a
man has and put it in your bodythat you've never seen before
seen before.
The other interesting thing toknow about testosterone is it
doesn't fall off a cliff whenyour periods stop.
Testosterone starts decliningfrom our 20s and really kind of
has a low, a gentle slope downinto our 40s, where it stays low
(16:55):
.
Now the interesting thing andwe need more data on but we're
finding that women in their 70stheir testosterone is starting
to rise again, naturally.
We don't know why that'simportant or why that's
happening, but we think thosewomen tend to have more heart
protection from it.
Interesting data on naturaltestosterone levels when you're
(17:15):
older and risk of heart attacks,heart disease.
So that's infancy research,because nobody was really
looking.
Speaker 1 (17:22):
testosterone in 70-year-olds yeah, that's
fascinating to me.
Speaker 2 (17:25):
Yeah, so testosterone tends to.
It goes down slowly from 20 to40, stays very low and then in
some women will start to riseagain much later in life.
But we do not have an FDAapproved product for it, the FDA
.
There's a I don't know how elseto say it.
There's a strong gender biasright, we've had.
We have multiple forms of ViagraFDA approved since 1998.
(17:48):
We just got two FDA approvedmedications for women's low
libido a couple of years ago, sowe're horribly behind on equity
and equality when it comes toequal issues.
So men have an FDA approved.
They have about 20 FDA approvedtestosterone products.
Speaker 1 (18:07):
And we have two, did you just say?
Speaker 2 (18:08):
No for testosterone.
Well, we don't have any FDAapproved testosterone right
Testosterone we have zero.
And look at the numbers About 15to 20% of men that might be
generous will use a testosteroneproduct, because not all men
get low testosterone.
What percentage of women getlow testosterone?
A hundred percent.
So if my math was mathing, wewould have more products
(18:31):
available than the men do Now.
The other gender issue with theFDA is male testosterone.
Is FDA approved forhypogonadism low hormones why do
you take hormones?
Cause your hormones are low?
The FDA has said, and it willhappen, that when we get it FDA
approved testosterone dose forwomen, it will be approved for
(18:53):
low libido.
Speaker 1 (18:55):
And that's it.
That's okay.
Speaker 2 (18:57):
Yeah, so, so, yeah, it should make you mad.
And so in Australia,australia's FDA, they have their
own FDA, but they're FDAapproved for low libido in
Australia.
And so women come to me andthey're like, do I need should I
lie to my doctor, should I sayI have an issue with my sexual
health to get this testosterone?
And it's the, it's the, thetail wagging, the dog right, dog
(19:18):
right.
Because, like, well, the mostdata we have is for low libido.
Why is that?
Because the fda said they'llapprove one for low libido,
right, so the research followswhat you're actually going to
get it approved for?
Um, there is, we have otherdata for testosterone and you
only, you only have to talk to awoman who takes testosterone,
who understands how great shefeels, and this is not not just
(19:39):
for sex and the other.
The other thing to step back of, like, what's libido?
Libido is a mood.
Where do moods come from?
Moods come from our brain.
Okay, so testosterone works inyour brain.
Yeah, yeah, and there's a bigrole in cognitive health,
clarity, thinking.
I mean.
So many women are like I'mfaster, I'm quicker, the world's
(20:02):
more in color, I'm asking morequestions, I'm more curious.
My German I learned as a kid,is coming back.
My math is faster.
It's a brain hormone, and tosay it's libido really is like
you guys.
Libido is in the brain.
Where do you think libido is?
Speaker 1 (20:17):
Yeah, and it's so limiting, limiting, it's just so
limiting and so frustrating how?
Speaker 2 (20:23):
sexist is it to say like I'm going to give you
something for your interest insleeping with somebody else?
Right, that's crazy right it'sso nuts, like people should be.
You know, I only have to openmy mouth and actually like
explain all this and then peopleare like who do?
I sign me up yeah, yeah, writeyour legisl, write your
legislatures right here.
Write the FDA.
It matters, right?
Insurance companies won't,won't pay for your testosterone,
(20:46):
but they'll pay for maletestosterone and they'll pay for
people who are transitioning tomale testosterone which, by the
way, it's not FDA approved for.
And so the women have to beloud to say I want this.
Women pay more out of pocketfor their health care than men
do, and this is one reason whyis because they're like we're
(21:07):
not going to cover it.
Speaker 1 (21:11):
It's't cover it, right?
So here we are in 2024 andwe're still having the same
conversations, and that'sincredibly frustrating.
So what do you know?
What do women do?
If there isn't an FDA approvedtestosterone and and we don't
(21:31):
understand how testosteroneaffects our body, what do what
do we do, right?
So here are and we go to thedoctor and they might say, well,
you need hormones.
But I have never had a doctortalk to me about testosterone.
It's always estrogen andprogestin.
I mean, it's just yeah, always.
Speaker 3 (21:53):
And I just had a whole blood workup done on
everything, on every everythingand on the on the hormone piece.
Testosterone was not on there.
I was looking again thismorning as we were preparing for
this, because I was like where?
And I love my doctor, she'ssuper smart and would like do
the right thing, but it seemslike I need to specifically ask
for my testosterone to bechecked.
(22:15):
You do you do at this point?
Speaker 2 (22:18):
I I listen, I went to medical school and didn't learn
that women had testosterone intheir bodies, and it was
probably only like three yearsago where I learned that we have
more testosterone than estrogenin our bodies, like you know,
shut the door.
So, unless you're like, I'minnately curious about these
topics, right, and so my levelof education now is not where I
(22:41):
was when I got done with medicalschool, and so doctors have to
be innately curious or they haveto learn from other doctors,
because once you're 10, 20 yearsin practice, you're not
learning new things unlessyou're like, very interested.
But here's, this is how thechange happens.
Women go in and they requestand they ask and they demand and
they repeat themselves, becauseI've had many doctors come to
(23:04):
me and they're like listen, Ineed to learn this now, because
women keep coming in, right, andso thinking about, how do we
change systems?
Do we change systems from topdown or do we change systems
from bottom up?
And I really think with thehormone menopause world, we're
changing the system from thebottom up, because if we are
expecting what there's 1 milliondoctors in America if we're
(23:24):
expecting 1 million doctors toget an education that they
didn't get or they got theopposite education because they
trained during the Women'sHealth Initiative.
When hormones remember, hormonescause cancer for a while.
Now they don't again, becausethat was bad research, right.
But we can't wait, for thedoctors are too busy, right,
(23:44):
exactly Busy.
So to me I'm like I educate thewoman, she goes in and that's
how we get it to change.
But going back to this specifictestosterone issue, it is a big
issue and this is kind of wherethe pellet, the pellet wellness
.
Yeah, let's talk about thisBecause our healthcare system
number one doesn't pay for theseproducts.
(24:06):
Number two, isn't educatedabout these products.
Women will go to these clinicswhere all they offer is pellets,
and to me I'm like, if you onlyoffer one type of hormone,
you're not a hormone expert.
You're a one-trick pony andyou're making money off those
and you're not a hormone expert.
You're a one trick pony andyou're making money off those
and you're making a lot of money, Right, Right.
But I get it.
I understand why women go andsome women do very well.
(24:30):
If everybody did poorly, they'dshut down.
Speaker 1 (24:33):
Yeah, sure.
Speaker 2 (24:34):
Some women do very well, but pellets are super
physiologic, so they're going totake you if you're already in a
low state and now I shoot youpast normal and I put you up
really high.
With these levels, whether it'sestrogen or testosterone, side
effects happen.
Speaker 1 (24:50):
And then a high dose, fast and quick right.
So my analogy is like you knowwe live at sea level.
Speaker 2 (24:55):
If you fly me to Everest Base Camp, I'm going to
fall over.
Yeah right, like I'm not usedto.
It is like you know we live atsea level.
If you fly me to Everest basecamp, I'm going to fall over.
Speaker 3 (25:01):
Yeah, right Like.
Speaker 2 (25:02):
I'm not used to it, but like, if you fly me to
Denver, I'll probably be prettyhappy in Denver, like Denver.
Speaker 1 (25:06):
Oh.
Speaker 2 (25:06):
I'm so going to use that yeah Right.
And so to me I'm like get toDenver.
Then there are some people wholike going.
They might want to go to Nepal,but like a lot of people are
happy at Denver.
Speaker 3 (25:17):
Yeah.
Speaker 2 (25:18):
So hang out there.
But yeah, so the side effectscan be irreversible.
Really high doses oftestosterone enlargement, so
really high doses, think youknow 10 times the male dose, but
high doses.
You can get enlargement of yourAdam's apple.
You can get irreversibleclitoral enlargement.
You can get, you know,androgenic alopecia, which is
(25:38):
male pattern balding, and soagain, not everybody.
That's why these places exist.
They exist because Westernmedicine is failing people,
Insurance companies aren'tcovering it and women want to
feel better.
I get why they go there.
I just don't think it's themost comprehensive, best way to
get your hormones.
Speaker 1 (25:56):
Yeah.
Speaker 3 (25:57):
Go ahead, kamie.
How can women advocate forthemselves?
You were saying, like you know,show up and ask for it.
But you're doing a lot ofeducation and we want to talk
about your book too Veryimportant work that you're doing
there.
But how should women thinkabout when they?
How do they get informed?
How do they ask for what theywant?
How do they help change it?
(26:17):
Like you said, ask the doctor,the doctor, but what?
Speaker 2 (26:19):
what would you tell our audience about really how to
move the not dial I mean to me.
I'm like there's, there's goodpeople, whether I always ask
women how do you like to consumeyour content?
Right?
Do you like to listen that'spodcast?
Do you like to read?
That's a book um, estrogenmatters is an incredible book
about hormones.
My book for you are Are NotBroken for Sexual Health.
(26:40):
To advocate in the office forsexual health is very
uncomfortable.
The doctors are uncomfortable,the patients everybody's
uncomfortable.
Speaker 1 (26:47):
Yeah.
Speaker 2 (26:48):
So you can say hey, I've read this book.
I brought this book in and forwhen people, when women come and
see me, like I've made my jobreally easy by working really
hard.
Because now when women come seeme, they're educated, they've
listened to my podcast, they'veread the book, they're on my
Instagram, they're like let's goand have this conversation
Exactly.
Speaker 1 (27:07):
They're not scared about it.
Speaker 2 (27:08):
You have to get over so many barriers.
You have to get over the fearof hormones.
You have to get over you know,so many issues and navigate.
I didn't even know hormones gotlow and right, like all this
education, before you can sayyou can go advocate right and so
to like, when women come see me, they're, they're just ready to
go, because they've done thatalready, you know, and it's it's
(27:31):
more fun for me because now wecan just talk about really high
level stuff or like other coolstuff.
So it's education first, thenyou can't be empowered about
this stuff if you don't knowright.
So education, then empowerment.
Speaker 1 (27:45):
Yeah, and I think there are a lot of hurdles still
.
I mean, you mentioned the study20 years ago that is still
scaring the dickens out of womenright now about hormones and
we're still having thatconversation with women that
hormones are safe.
So barrier, and then right, andthen and then and then.
(28:06):
So advocating, I think comesback to education.
I agree.
Speaker 2 (28:11):
Yeah, and knowing who you're seeing right, which is
not always easy, especially ifyour insurance is limiting to
you to be like these are yourfive doctors you get to choose
from, but so seeing somebodywho's experienced in sex med,
that's probably the best.
Tip is sex med docs, and if yougo to ISHWISH International
Society for the Study of Women'sSexual Health, ishwishorg, you
can type in your zip code Okay,so what a sex med doc?
(28:33):
Why they're so special isnumber one, they're comfortable
talking about sex.
But number two, they understandthe role of hormones in sex
life, so they're usually prettyproficient at hormones as well.
So, that's kind of your like twofor one for being like.
They've already had thisconversation 10 times today.
It's going to be awkward, nomatter what.
(28:55):
Like I get it.
It's hard to talk aboutpersonal stuff, but like seeing
somebody who's like, yeah, I dosex, med and hormones, it's a
heck of a lot easier.
Yeah, I mean the other thing.
If you know, for primary care,there are 74 million midlife
women in this country.
We need all doctors on boardwith this, right, we need
everybody.
But if you don't have arelationship with a doctor which
(29:17):
I think the doctor relationshipin this country is at its worst
, all time low, because people,you know, people move and jobs
move now and like you're not ina community like you used to be,
and so you know I'm fortunate.
I've had my primary care doctorfor years.
She knows who I am, she knowswhat I do, so she's very willing
(29:37):
to like.
She's like Kelly, just tell mewhat you want, right.
But but not everybody has thatand not especially if you have a
doctor who doesn't see a lot ofmenopausal people, right, it's,
doesn't think that anythinghappens with the vulva, with
menopause, right, like somebodywho knows what happens to your
sexual health and your hormone.
Health, as your hormones changeis, is incredibly important and
(30:00):
the relationship is important.
They trust you, they knowyou're going to come back, they
know you're not asking forsomething crazy.
And that's a relationship.
And I think for hormones belike can I try X, y and Z?
I will come back in threemonths, we'll adjust as needed.
Those are the magic words whenyou ask a doctor for a
prescription.
Speaker 1 (30:19):
Okay, can you say that again?
Then we're going to try.
Speaker 2 (30:22):
Can we try X, y and Z ?
I will come back in threemonths and I will tell you how
I'm doing and we'll adjust asneeded.
That is the magic word forgetting a prescription.
Speaker 1 (30:33):
Okay, we're going to add that to our resources as
well.
When you are training, really,because we talk to women about
how to approach your doctor andhow to best prepare for those
doctor visits, and this isreally great information for
them to advocate for themselves.
Um, I want to.
I want to talk about can we goback to testosterone for just a
minute before we move on and Iwant to talk about your book.
(30:55):
Um, when we are looking attestosterone and dosing and the
fact that there isn't an FDAapproved level for women, how do
you do that?
What does it look like?
So there's still that confusion, right?
So if I go to my doctor and I'masking for this, not just for
(31:15):
libido, what am I looking forand what am I asking for?
Speaker 2 (31:19):
Yep.
So we always get a baselinetestosterone just to see where
it is.
There's the rare woman who'sgoing to have a high
testosterone.
You don't want to give her moretestosterone.
I've never seen that woman,because most of my people are
postmenopause and lateperimenopause.
But so get a baseline.
That's how you know that it'slow to begin with, and then you
recheck it in about two monthsand you can say oh yeah, you're
(31:41):
absorbing or you're notabsorbing, or you need more, and
blah, blah.
So I like to to follow thiswith levels in the beginning.
Okay, there's two main optionsPellets aside.
Pellets are an option, butagain, I think you have to work
your way up to a pellet.
You've been on testosterone fora while.
You just want like an easyevery three month dose instead
of a daily dose.
You know that you're where yourlevels and you like your levels
(32:02):
to be a little.
So to me I'm like earn a pelletif you're going to do a pellet
is how I think about it.
So I don't.
I never advocate for off thebat pellets because there's just
too many women that go fromzero to 300 and don't like it.
So with what I call physiologicdose testosterone so giving I'm
giving a woman a little bitmaybe higher where she was when
(32:24):
she was like 32.
Right, I mean, the best thingto do would have been to check
all of our labs when we were 28,that would have been nice.
Speaker 1 (32:32):
Maybe that will change too.
Speaker 2 (32:34):
Yeah Right, nobody has that.
So we're kind of we're a littlebit guessing of like where you
were happy with your, with yoursex drive and your energy and
your, you know, lean body massand stuff like that but get a
baseline.
The two main ways to do it isyou can take the male dose or a
male product which is test them,or a testosterone gel, and you
(32:55):
make a tube or a packet bonus.
If you can get the tubes, I gothrough Amazon.
Amazon's nice.
You get the tubes on Amazon andyou'd make a tube last seven to
10 days.
Now that's not accurate, but Iwould argue like it's pretty
darn good.
It's going to get you like youknow, for the women who are,
like, obsessing over one tenthof like, maybe that's not the
(33:16):
right way to do it for you, youknow.
So that's not the right way todo it for you, you know, okay,
um, so that's great.
You can get a prescription ofuh 30, so it comes in packs of
30 for men.
It's a one month supply, okay,and then you take that and you
do one tenth the dose.
So that's going to last you 300days.
So it's going to last you 10months and that's, I think 211
(33:37):
$211 on Amazon Pharmacy.
Yeah.
Speaker 3 (33:40):
Yeah, not bad.
Costco also is very cheap.
Speaker 2 (33:43):
Now a lot of.
And why is Amazon nice?
Amazon's nice?
Because I don't have apharmacist in the middle of a
grocery store chiding my womanover.
Do you know what you're doing?
Because some of the pharmacistsget a little bully on this.
Okay, no-transcript.
Speaker 1 (34:00):
You don't have to talk to them.
Speaker 2 (34:02):
Yeah, I got mine.
Mine got approved on Amazon andcame to mind.
It comes to your house too,which is nice.
Ok, so that's the, that's thedosing, the male FDA approved
product.
Then we check your levels inabout two months, two to three
months and on that, some people,it takes four to six months for
for you to notice.
Right so give it some time.
Check your levels, make sureyou're kind of up.
(34:23):
The other problem withtestosterone is the female range
on labs.
I think, and a lot of expertsthink, is low Okay.
So if a female lab dose is,they're going to say anything
over like 30, 35 is a hightestosterone.
I disagree.
A lot of studies show thatwomen do really well in the high
(34:44):
double digits to 150 withoutgetting a lot of side effects.
So you have to kind of go tosomebody who knows how to
interpret these labs, because Idon't even think the labs are
that accurate.
The Quest labs, for example,their female testosterone range
is based off of one paper.
Oh wow.
So you have to understand yourlabs, right.
(35:06):
You have to understand why yourlab says what's normal and
what's not normal.
So recheck your labs, but dogive it four to six months and
they say if you don't notice anyimprovement in symptoms after
four to six months, you couldstop.
Yeah, okay.
Now I might argue, because I'mthe hormone expert testosterone
is helping your bone.
Testosterone is helping yourheart.
Speaker 3 (35:22):
testosterone is helping your bone testosterone
is helping your heart.
Speaker 2 (35:24):
Testosterone is helping your brain.
You can't always feel thosethings that's right now right,
that's another podcast for thepreventative use of hormones,
right, which is kind of.
You know, that's where thethought leaders are now.
Right now it really mainstreamis like what symptoms do you
have?
Do we help your symptoms?
Speaker 1 (35:40):
and then the thought leaders are like there there's a
, you can't think about yourwhole health span Right.
Speaker 2 (35:46):
You can't feel your insulin working, but you'd like
to know that it's working on theright.
Same thing with the sexhormones.
Speaker 3 (35:53):
Right so those are.
Speaker 2 (35:54):
So the second.
So that's male testosterone,fda approved.
The other way to do it, whichis easier, is get it compounded
at a compounding pharmacy.
Five milligrams a day, one pump, 90 pumps, there's your three
months supply.
It's about 70 bucks.
One pump to your leg every day,easy.
Speaker 1 (36:12):
I kind of like the pump.
Speaker 2 (36:13):
It's a lot more idiot proof.
I have the estrogen spray.
Speaker 1 (36:15):
I'm like let's just take it you like the once a day
estrogen, I like the once a daybecause I don't have to think
about it.
I don't have to do math, Idon't have to figure out what
day it is and did I take it?
You know all of that, so thatsounds better to me.
Speaker 2 (36:27):
My opinion about this is 100% of women will have low
hormones.
We should have 20 differentproduct options.
We should have 30 differentproduct options.
Speaker 1 (36:37):
Like the fact that for estrogen.
Speaker 2 (36:39):
we only have four options for something that
affects 100% of people, to meonly have four options for
something that affects a hundredpercent of people To me.
I'm like, where's the?
Speaker 1 (36:47):
innovation.
Yeah, it's there, it's there.
Speaker 3 (36:51):
And there's an opportunity?
Speaker 1 (36:52):
I don't know, but they jack up the prices.
Speaker 3 (36:53):
I want a ring.
Speaker 2 (36:55):
Why I want a.
I want a vaginal ring that hastestosterone, estrogen,
progesterone in it.
Speaker 1 (37:00):
I was going to ask you the question If I got to
design something Right.
Speaker 2 (37:02):
I was going to ask you the question If I got to
design something, that's what Iwould design, because then it
would cover my vulvar, bladder,vagina, all of that, those
structures too.
Speaker 1 (37:18):
That would be the best.
Because we haven't even talkedabout that.
We haven't even talked aboutthe vagina vaginal atrophy.
I know you're a huge fan ofthat being preventative medicine
as well.
Right, we need that vaginalestrogen.
Why even wait until we'rehaving painful sex?
Speaker 3 (37:32):
That's the big question why are we waiting?
Speaker 2 (37:34):
until after.
I think we wait for two reasons.
I think we wait for threereasons about the time.
The first reason is Westernmedicine is very good at
treating disease, not preventingit.
And if I'm a doctor who's intopreventing it and you come into
my office and I'm like, oh,you're 45, here's your vaginal
estrogen, I've got eight moreminutes to talk to you about it.
You don't know what estrogen is.
(37:55):
You still think estrogen isgoing to kill you.
Your insurance might not coverit.
You are uncomfortable talkingLike it's a big ask to be
preventative for the averageperson, right, but to me I'm
like.
I'm like mammogram, colonoscopy, vaginal estrogen here you go,
um, because the average.
So that's number one.
(38:16):
Number two is sex is difficultto talk about, right?
How many women come see me?
They've stopped having sexeight years ago, right.
Eight years ago, six years ago,five years ago.
This isn't like a sex hurt onceI'm going to get it checked out
, yeah, which is what men do.
Men are like.
Erections were iffy one time.
Speaker 3 (38:34):
Check this out.
Speaker 2 (38:38):
Yeah, whereas women are like it.
Just it just started hurting sowe just stopped having sex.
That was eight years ago, right.
And then the third reason iswomen don't, because we don't
know what menopause is and wethink it's the end of periods
and a hot flash.
We don't understand that thepain with sex is because of low
hormones, right, right, right.
(38:58):
And so those are the threereasons that vaginal estrogen
isn't happening at age 45.
But I had this insight theother day because you know I'm a
big preventative and for peoplewho don't know, vaginal
estrogen is incredibly low dose.
There's literally hardly aperson who can't be on it.
There's always an asterisk ofoh yeah, you can't.
(39:23):
But, like breast cancersurvivors, everybody, for for
the most part, can be on vaginalestrogen because it's not
systemic, it's not going, it'snot going to help.
I always say it's not going tohelp your bones, it's not going
to help your heart and it's notgoing to help your brain.
It's such low dose.
It's only for bladder health,vagina health.
Vagina and bladder share a wall, so they're condo, they're
condo mates.
Um so vaginal, yeah, it's justso incredibly important.
(39:46):
But they don't know thathormone changes is why you get
overactive bladder and you startgetting up more at night and
you start getting more recurrentUTIs and all those things.
People don't know that that's ahormone thing.
Speaker 1 (40:00):
There is so much that is related to hormones it is
mind boggling.
Speaker 2 (40:06):
It's everything Hormone receptors are everywhere
Vertigo, ringing in the ear,joint aches and pains.
There was, finally, a paperjust got published, like two
weeks ago, which it was, to myknowledge, the first time this
has been written in the medicalliterature the musculoskeletal
syndrome of menopause oh so good.
This has been written in themedical literature the
(40:27):
musculoskeletal syndrome ofmenopause, oh so good.
And it's 50 to 80% of womenjoin aches and pains because in
our collagen, our tendons, allhave testosterone receptors,
estrogen receptors.
Speaker 1 (40:36):
Yeah, here, here I'm raising my hand on that one
right.
I'm really like hello, yeah,but if you look at it, you would
have told me that five yearsago, right, yeah, yeah, your
shoulder's.
Speaker 2 (40:44):
Look at it, you would have told me that five years
ago, right, yeah, yeah, yourshoulder starting to get stiff.
Throw on an estrogen patch, um,the, the um.
What was I going to say?
Oh, the top two reasons thatwomen stop having sex in midlife
are availability of partner andsystemic hormone.
Menopause changes, hot flashes,night sweats, poor sleep, joint
aches and pains.
(41:04):
You don't feel good, you don'tfeel like yourself, right, right
, and so that libido followsthat, right, and certainly, if
you're having pain, dryness,issues of penetration you do not
want, women will come in andthey'll be like I have two
problems.
I have pain with sex and lowlibido, and I always like to
take problems away from peoplebecause you don't need more
(41:24):
problems, right, and I'm like no, you have one problem.
You have pain with sex.
You can't expect a libido tohappen.
That's right when there's painwith sex.
So I'm like fix the pain withsex, you make sex fun again.
Yeah, libido can follow.
Speaker 1 (41:38):
And there's good news .
There is good news right.
We have hormones, we havethings that can help with all of
these challenges.
Speaker 2 (41:46):
So that's the good.
Yeah, and I think myperspective, this is all good
news.
Yeah, people are like we'regetting older.
I'm like, damn right, you are.
Speaker 1 (41:54):
It's a freaking blessing yeah, we get to right,
we get to live longer.
Speaker 2 (41:59):
This myth that we have to deal like that.
It's like some burden and I'm,like you know, 200, 300 years
ago, the privilege of livingpast 47, like it was not
universally.
Is it universally accepted thatyou're, by and large, going to
go through menopause now?
yeah that was a privilegeoffered to very few until very
(42:21):
recently, and I like to remindpeople of of like we're figuring
out aging on a global scale forthe first time ever.
Yeah, yeah, we did.
To me, all of this is aprivilege, like oh my God, I
have to floss.
It's like, yeah, because youstill have teeth.
Speaker 3 (42:39):
Like it's a privilege right.
Speaker 2 (42:41):
Like, oh my God, I have to wear a seatbelt.
Seat belt like you don't thinkabout, it's like a privilege to
drive the car and you know whatmakes it safer.
And so I think, and it's justthat little healthy dose of like
reframing, yeah, like, oh mygod, to have the opportunity to
be on this earth for 80 years,yeah, that's brand new it is and
(43:01):
you're right, it's a privilegeand I I do think that reminder
and shift in perspective isincredibly important.
Yeah, I mean I just like to tobreak down everybody's limiting
beliefs.
Right, because they're likehormones aren't natural and I'm
like you have shoes on, yeah,you have heat right.
Like you have glasses, like whyand people will say that, about
(43:23):
sex too, they'll be like I havevibrators.
They just seem so unnatural.
And I'm like I have twovibrators for my mouth.
I have like an electrictoothbrush and a water pick.
Why are you picking yournatural for this one thing in
your life?
You have a.
You have a mysterious, magicalinternet that comes into your
house and you can buy pantsright like like we're living in
(43:46):
magic at this point, and forpeople who get all like
naturally with hormones and sex,I'm like get rid of the
internet then, because that'snot natural nobody's gonna get
rid of that right like so.
It's like you just changepeople's their moody perspective
a little bit to be like it'skind of a good.
It's a good reminder yeah it is,but I think I mean to me.
(44:08):
I'm like we have a newresponsibility to age well,
because never have we put a bodythrough 40 years of low
hormones and expected the bonesnot to break.
Right, right, right, right Likethe risk, the risk of hip
fracture for us now islegitimate.
Speaker 1 (44:24):
Yeah.
Speaker 2 (44:25):
Because we're going to go 40 years without hormones.
Speaker 1 (44:27):
We're learning how to do that.
Speaker 2 (44:29):
We're learning how to do it.
We're learning how to age on aglobal scale for the first time
ever.
Speaker 1 (44:33):
Yeah, and I think that's what our age group is
doing right.
I think we really are.
We all have daughters here.
We want that to be differentfor them and we're changing that
and we're learning so that theycan grow older better.
Speaker 2 (44:50):
I think a lot of us are watching our parents and
we're starting to say I don'twant that.
Speaker 1 (44:56):
Yeah, I agree.
Speaker 2 (44:57):
Right, how does that not happen?
And the truth is you have tostart now.
You can't start when you're 73.
You can Some people do I dostart older people on hormones.
That's another podcast episode.
But, by and large, protect yourbones before they are weak,
protect your mind before it'shaving issues.
(45:18):
And again, it's a mindsetchange, because in Western
medicine, come see me when yourhip breaks, come see me when you
have dementia.
Women are saying I don't wantto do that, though what can I?
Do to prevent things.
Speaker 3 (45:32):
Like, if there was a.
Speaker 2 (45:32):
if there was a drug that men could take that made
them live longer, decrease therisk of colon cancer by 30
percent, increase their lifespanby three years, decrease the
risk of heart attack by 50percent, decrease the risk of
heart attack by 50%.
Decrease the risk of all bonefractures by 30 to 50%, do you
think they would be on this drugand everybody's like, yeah, a
dude would take that.
Those are good.
(45:52):
Oh yeah, if you haveprediabetes, it decreases your
risk of diabetes developing thatby 30%.
Everybody would be on that drug.
It's called estrogen.
What are we questioning?
Speaker 1 (46:04):
What are we questioning, seriously?
What are we questioning?
I'm going to ask you thisquestion because I really want
you to say it, because you're adoctor.
If I say it doesn't have thesame level of respect, but I
want to ask you a question here.
So you know, for the record,you just talked about
preventative care, right?
Why not take these drugsestrogen, um as a preventative
(46:29):
medicine for all of these thingsthat you just mentioned?
What age?
And I know that that is reallyhard to say.
You know this particular age,age range, let's just say age
range, would that be?
what age, would that be?
Speaker 2 (46:44):
Well, menopause.
Average age of menopause inamerica is 51.
We know your hormones don'tfall off.
This is the other myth of likethat periods are irrelevant.
I got some.
I got some heat for saying thaton the internet the other day,
but, like people use periods asa marker of it.
Speaker 3 (46:59):
But now it's okay to start it.
Speaker 2 (47:01):
It's.
They're irrelevant.
They're like you've got some, alittle bit of some, hormones,
sometimes when you're stillhaving a little bit of periods,
but there's no cliff that youdrop off of.
The new push now is we areseverely undertreating our
perimenopausal women.
Massive suffering and, manypeople would argue, more
suffering because the body'svery sensitive to changes in
(47:25):
hormone levels.
Once your hormone levels arejust flatlined, like it,
actually things mellow out alittle bit, not entirely your
bones really start taking a dive, like the heart disease, the
things you can't see, but likemood, sleep, hot flashes, joints
, aches and pains.
Like the perimenopausal woman,because of the fluctuation, is
suffering without help themajority of the time.
(47:46):
So, but by preventative, ifwe're having the preventative
question, some people wouldargue perimenopause, because the
biggest rate of bone loss is inthe final years of
perimenopause.
So you could argue that.
You know to me I'm like listenby by mid fifties, start having
(48:06):
the conversation.
Speaker 1 (48:07):
Yeah, I asked that question, um, because there's
often well, I asked it forseveral reasons, but, um, we
often hear from women.
I don't need to worry aboutthat right now.
I don't need.
I don't need that informationbecause I think I've already
been through it.
Speaker 3 (48:24):
Yeah, or either you're post-menopause, and I
don't need that informationbecause I think that yeah or
either you're post-menopause andI don't need to worry about.
Speaker 1 (48:29):
oh, I've been through that, I don't need that.
Speaker 2 (48:31):
Yeah, they think it's ended because they don't know
what it is.
Speaker 1 (48:34):
Right.
Or yeah, the perimenopausestage right.
Like I had no idea that all ofthis was happening to my body at
this young age was happening tomy body at this young age.
I never thought that I wouldhave to think about menopause
and hormones when I was late 30s, early 40s and I went through
early menopause.
So smack me in the face rightLike, oh yeah, yes, you actually
(48:56):
do need to have thoseconversations April.
So I do think it's importantand that's why I asked it.
Speaker 2 (49:03):
So thanks for- we all have that bias.
We all have that bias in ourhead, right Like when I close my
eyes and think of a menopausalwoman.
I'm thinking of Betty White onthe Golden Girls.
100% Right.
Speaker 1 (49:13):
Well, if you Google it, if you go to Adobe Stock,
right, okay, so we use AdobeStock everybody for all of our
stock images, for whatever,right?
If you type in that search barmenopausal women, that's what
you get.
That's what you get, anyway,with a fan, right Like waving
(49:36):
yourself.
Speaker 2 (49:36):
Yeah, and untreated and untreated.
Yeah, I mean the myth thatwomen, our bodies, were made for
suffering.
Speaker 1 (49:45):
So we should suffer Like it's it's, it's a very
oppressive language.
Yeah, we don't have to sufferand it comes back.
No, and there is help andadvocate for yourself.
Speaker 2 (49:58):
It's.
You know, it's kind of likeadvocate for yourself.
Yeah, it's kind of like thebody positivity world of like,
just get to neutral, just get towhere you accept your body.
It's like no, no, no, no, no,you can actually feel really
good.
Yeah, right, like it's like thislike good enough to be neutral
of.
Like no, no, no, you canactually love your body and you
can actually feel good.
When you're this age, you mightneed to do some things, you
(50:26):
know.
You might need to prioritizeyour health, and I think that's
the important takeaway.
Also, like for both for sex andfor hormones, is like these
things don't exist in a bubble.
Like hormones are nice, butthat's that's not your, just
your sex life.
That's not just men.
Like you need to exercise.
And for sex is like you need toknow how you get turned on.
You need to set aside time forthat.
You need to work on yourmindset about what you think sex
is Like.
It's not just like here's somevaginal estrogen.
(50:48):
Enjoy sex.
If you think hormones are theonly thing, you are going to be
disappointed.
But hormones are tools, they'remessengers and they can be
profoundly helpful.
But you still have to do allthe other things.
Speaker 1 (51:03):
Yeah yeah.
You have to do some work, youhave to do some self-reflection,
you have to take the time andpause.
Sometimes we're scared of thatand sometimes we don't give
ourselves permission to do that.
Speaker 3 (51:15):
Well, and Kelly, you said when I heard you speak at
the Women in Work, you said youask women when they come to your
office what do you want?
And it made such an impact onme to just like I even asked
that question about what it isthat you want and that so many
people are like I don't know.
Speaker 1 (51:34):
We haven't asked her, we haven't asked ourselves, we
haven't asked ourselves.
So yeah, and I do want to justkind of like like chime in and
say, yes, you've made a hugeimpact on Kim with that question
, because it keeps surfacingsince June, since June Right.
I mean, like she keeps comingback to that and I'm like really
(51:55):
important question.
Speaker 2 (51:57):
I mean, you know it's .
It's, I think, ancientphilosophy, or you know lots of
self-help of like tune inbecause your body, because you
do know, you do, you do.
You got to get quiet and youmight have to try something, but
you'd like that's the magic ofit, is like you do know, and I
think for some people they'relike they've just been telling
themselves they don't know.
Speaker 3 (52:18):
It's like, yeah, you do or don't know how to listen,
like you, when, when you heard Ineed to speak, you were like no
, no, no, no, no, no, no, no, no.
And then you kept hearing it.
You kept hearing it, right?
Speaker 2 (52:28):
Yeah, quiet enough to listen, oh yeah, that's a good
way to end this podcast.
So I was at a conference.
I was at a physician conferenceabout a year later I had
started the podcast, blah blah,blah and the voice got quiet for
(52:52):
those who are listening to thatend of that story.
So the voice, she got quiet andthere was somebody speaking at
the conference and they saidthat what that voice is, is your
future self pulling you forward?
And I was like, oh so now?
So she I mean she talks to meevery once in a while and she
was like two years ago she'slike you got to quit your job,
you got to open up your ownclinic.
You know, need you don't, don'tdo this urology thing full bore
anymore.
And I knew her and the voice.
I knew the voice enough now,like I trusted her on the whole
podcast journey thing and andthen I knew she got quiet when I
(53:15):
was doing what I was supposedto be doing.
And now she's like you need tostop this urology.
And you are no.
Speaker 1 (53:21):
And then I'm like god damn it she's back, yeah, but
now I like I trust her and I'mlike God damn it, she's back,
yeah.
Speaker 2 (53:26):
But now I like I trust her and I'm like, hi, yeah
, like hey, it's good to see youReally Right.
I have to quit my my good.
Yeah, that's what I got, okay.
Speaker 1 (53:36):
You know that's exciting too.
It's really exciting thatyou're opening up your own
clinic.
Speaker 2 (53:46):
That's in Bellingham Washington.
So yeah, I mean to me.
I'm like I want the doctorpatient relationship.
Yeah it's gone.
It's completely gone with thecurrent health insurance model
of everybody's moving around andyour insurance drops so you
can't see that person anymore.
And when you do see that person, you see them for 10 minutes
Like the doctor.
Patient relationship is gone.
And me, having doctored thislong now, what people want?
(54:08):
They want the relationship,they want to feel heard, they
want to feel like somebody cares.
That's the doctoring that Iwant to do.
Speaker 3 (54:20):
That's so great.
Speaker 2 (54:21):
And so I have to get out of the broken system in
order to do it.
That's so great and so I haveto get out of the the broken
system in order to do it.
Yeah, because, because oursystem doesn't, the doctor
patient relationship is not.
It's not on the top 10 thingsthat matter it's not western
medicine is really good atbreaking a femur, fixing a femur
fracture.
we're very good at a lot ofthings, sure, but that doctor
patient relationship and beinglike I don't know what your
(54:43):
exact hormone combo is going tobe, but I'm here to figure it
out with you, yeah.
Speaker 1 (54:46):
Let's try something, let's figure it out, let me know
.
Speaker 2 (54:49):
Let me know.
I texted one of my patientslast night and I'm like are you
sleeping?
Oh, her big thing was she wasnot sleeping Right, hadn't slept
in years, wow.
And so I texted her at her.
I was like you sleeping, andshe's like I slept till 10 in
the morning I haven't done andlike she was, ecstatic.
It was a good she didn't havean overslept a job or something
yeah but she was like ecstatic,wow, wow, and I'm like that's
(55:13):
what I want.
Speaker 1 (55:14):
That feels so good I want that relationship so good,
not not just for her, but youtoo, right?
oh yeah, totally to be like ah,look what I did yeah, yeah, well
, your information on your newclinic will be on your website
to Kelly Patterson mdcom.
So, um, all of your informationis on your website.
I love your website, by the way, um, but we, we and all of our
(55:35):
podcasts, um, with a rapid fire.
So we're going to rapid fireand get to know you a little bit
better, and then we have onequestion that we ask every guest
, and we'll get to that in justa moment.
But you're a Washingtonian,you're local.
We were talking about thebeautiful Pacific Northwest that
we live in, but, curious, wehave lakes, oceans, rivers.
(55:56):
What would you rather?
Sit by with a cup of coffee,water, yeah, what body of water?
Speaker 2 (56:05):
by with a cup of coffee Water.
Yeah, what body of water?
Oh, I look at a lake right now.
So lake is good, ocean's good,any water.
Speaker 1 (56:13):
I grew up in Duluth Minnesota, so I had Lake
Superior in my backyard.
So water to me.
So water, water, water.
Just doesn't matter.
Speaker 3 (56:17):
What's the best piece of advice you've ever received?
Speaker 2 (56:19):
You're in charge of your own education.
Speaker 3 (56:21):
Love it.
Speaker 1 (56:22):
Thank you, dr Casperson.
Thank you for listening to theMedovia Menopause Podcast.
If you enjoyed today's show,please give it a thumbs up,
subscribe for future episodes,leave a review and share this
episode with a friend.
There are more than 50 millionwomen in the US who are
navigating the menopausetransition.
(56:43):
Us who are navigating themenopause transition.
The situation is compounded bythe presence of stigma, shame
and secrecy surroundingmenopause, posing significant
challenges and disruptions inwomen's personal and
professional spheres.
Medovia is out to change thenarrative.
Learn more at medoviacom.
That's M-I-D-O-V-I-A dot com.
Welcome to the Medovia Menopause Podcast, your
trusted source forevidence-based, science-backed
information related to menopause.
Medovia is dedicated tochanging the narrative about
menopause by educating, raisingawareness and supporting women
in this stage of life, both athome and in the workplace.
(00:21):
Visit medoviacom to learn morehome and in the workplace.
Visit Medoviacom to learn more.
I'm one of your hosts, aprilHaberman, and I'm joined by Kim
Hart.
We're co-founders of Medovia,certified health coaches,
registered yoga teachers andmidlife mamas specializing in
menopause.
You're listening to anotherepisode of our podcast, where we
(00:43):
offer expert guidance for themost transformative stage of
life, bringing you realconversations, education and
resources to help you overcomechallenges and reach your full
potential through midlife.
Join us and our special guestseach episode as we bring vibrant
, fun and truthful conversationand let us help you have a
(01:07):
deeper understanding ofmenopause.
Hi friends, we have a specialtreat today.
We have Dr Kelly Kasperson onthe show and for those of you
that are familiar with DrKasperson, you know that this is
going to be a fun episode.
Dr Kasperson is a urologist,public speaker, sex educator and
(01:28):
top international podcasterwhose mission is empowering
women to live their best lives.
Dr Kasperson identified theneed for better resources and
developed a sex education classfor women that covers topics
like sexual health, intimacy,mind work and the science of
desire.
She combines her education,lots of humor and candor in her
(01:51):
podcast you Are Not Broken,where she dismantles the myths
that women have learned andnormalizes healthy, enjoyable
sex worth desiring, in additionto the essential education on
midlife health and hormones.
There's a lot packed in there.
You can follow Dr Kelly onInstagram at kellycaspersonmd,
or follow kellycaspersonmdcom.
(02:14):
Let's go right to the show,kelly.
We are so incredibly excited tohave you with us, dr Casperson.
We met in June, I think, at theWomen in Work Summit and, for
(02:35):
those of you that weren't there,dr Kasperson comes up next to
me, sits in a chair and I lookdown and you've got a cast on
your leg, which I didn't expect,and I think that little snafu
had partly.
It was partly due to your lovelyblack lab, I think, and I'm
glad to see that you are allhealed.
I can't see your leg, but Iassume that you are out of the
cast.
Speaker 2 (02:54):
Yes, thank you.
Yeah, I had just been sidelinedby a black lab on a hike it was
like the most Pacific Northwestinjury that exists and I
hobbled my way down to Seattle,had an amazing night and I was
such a good patient.
I did the physical therapy, Idid the massage, I got checked
out to make sure it wasn'tanything severe, so I was like I
think I healed properly and I'mback.
(03:14):
I'm back Good.
Speaker 1 (03:16):
Yay, and you're hiking again.
I hope in the Pacific Northwest.
All right, good, we're going togo on a hike someday.
We were just talking about thatbefore we hopped on here and
hit record.
We you know, kim and I probablyhave gathered 100 questions for
you today and, no kidding, thelist just gets longer and longer
and there's just so much tounpack.
(03:36):
We're not going to be able tounpack it all on this podcast,
but we're thrilled to have you,because I want to start here
with your story, because yourstory is really incredible.
We were also talking, before wehit record, on the privilege
that we have of leaning into ourpassion and changing our mind
(03:58):
and changing our career, andyou've just got such an
incredible story in how youstarted and where you are right
now.
You just got such an incrediblestory in how you started and
where you are right now.
So, if we can, let's dive inand go back to the very
beginning.
You're a urologist, and how theheck did you start in that
trade, first of all, thatprofession, rather and tell me
(04:20):
that story.
And then, how did you lead tosexual health, because that's
different, right?
Yeah, what happened?
Speaker 2 (04:31):
So for people who don't know, a urologist is a
surgeon, a specialty surgeon,who operates on kidneys, bladder
, technically male genitalia,although there is the niche of
female urology, but not allurologists can move around a
female pelvis with ease Kidneystones, bladder cancer, prostate
, enlarged men who can't pee,right, so really genital urinary
structures is what theurologist does.
So when I was looking I thoughtit was going to be internal
(04:53):
medicine because I wanted toknow everything.
I bought all the books inmedical school.
I just loved reading it and Idid a two-week urology rotation
only men.
I was in Minnesota.
There was one female urologistin the entire state.
I have yet to remember her andnow I don't remember her name,
but there was one in the stateand so I'd never met her.
But the male urologist, theywere happy, they were funny,
(05:16):
they fixed thingsinstantaneously, which is kind
of hard in medicine, right, andso like, kidney stone gone,
bladder cancer gone.
And I was like, because youshowed up, big things happened
in that day and that was veryattractive, the short term,
instant gratification.
So like, okay, I'll just dowhatever beats urology, because
(05:37):
you spend another year doing abunch of stuff and nothing beat
urology.
So that's what I ended up doingand trained in Denver for six
years, was in Bellingham forseven years when I got my seven
year itch.
So for anybody who hasn't heardof the seven year itch, it's
legitimate, whether it's yourrelationship or your career.
Something happens at seven years.
You kind of get like, you getbored, you get a little.
(05:57):
What am I doing?
And I'm like oh, recurrenturinary tract infections, day in
, day out.
Train for you know a decade totell people to drink more water
and pee more yeah, yeah and um,so it was kind of having that
like career midlife crisis, andthen that was when the universe
was like she's ready, you knowyou have to be like ready to
receive the message.
(06:17):
So I had a woman come in.
I was very bonded with herbecause I had cured her from
cancer years in the past.
We just see each other everyonce, once a year.
How are you doing, how's things?
And she was crying because ofher sexless marriage great
marriage, just not not full ofphysical sexual health and was.
She was very, very disturbedabout it and I'm handing her a
(06:38):
box of Kleenex and the lightningstrikes my brain and I don't
know how to help her.
I was like, does anybody knowhow to help her?
Because when I was in trainingfor urology, we were told women
were difficult.
I was told to do a fellowshipso that I didn't have to deal
with women.
Women are difficult.
They took too long in theclinic and we'll never figure
them out.
And the gynecologists are.
(06:59):
They're dealing with them likelegit things.
I was told that I didn'tquestion then because you're the
trainee, right?
And so I was like well, is ittrue?
Is it true?
We haven't figured any.
How come we give by?
We've been giving viagra as aprescription since 1998.
Who's taking care of the peoplewho are supposed to be sleeping
with the people we're givingthe viagra to yeah, right, and
so, like, all these questionsjust started coming up for me
(07:21):
when I started learning and Iwas was like oh, we actually
know a lot about female sexualhealth.
It just doesn't trickle down tothe people because Hollywood
feeds us a load of baloney andthe doctors don't know.
So there's this voice in myhead and the voice was like you
need to talk.
And I was like this voice issuper annoying.
(07:42):
No, I'm fine, but like everymorning, the voice was like you
need to talk, you need to talk,you need to talk and one day I
was like I don't know enough yet, Like I didn't.
There was there's one fellowshipin female sexual health.
Now there's two.
Wow, so that means two people ayear in this country get
actually fellowship trained infemale sexual health, and so I
(08:02):
hadn't done one of those.
Like all of this, like I wasn'tsmart enough.
Who?
Speaker 1 (08:06):
am I All those messages?
Speaker 2 (08:08):
right All those messages.
So I was waiting for permissionfor somebody to like tell me I
knew enough.
And like I was waiting forsomebody to like pick up the
phone and be like Kelly, youshould start a podcast.
And like I, even it was so bad,like I even knew who that
person was.
I was waiting for permissionand so I got out of the shower
one day and we're all good ideasof the shower come from.
Speaker 1 (08:27):
Exactly.
Speaker 2 (08:28):
Lightning strikes again and they're like.
The only permission you need isyour own Do it, I was like God
darn it.
Like that's true, right.
So I started a podcast four anda half years ago and it's doing
very well.
It's like usually in the top 10of medicine on Apple.
It's called you Are Not Brokenand it really started out with
(08:49):
sexual health because that wasmy like women need to be
educated on this, blah, blahblah.
And so the book came out youAre Not Broken Stop Shoulding
All Over your Sex Life Becausepeople, you know, it's like we
have all these shoulds.
Like you should have sex acertain amount of times a week.
You should take this long toorgasm.
You should, you should orgasm.
Like this, right, like we haveall these shoulds about what we
(09:10):
think sex is.
And so wrote the book and, uh,really, women started being like
yeah, but you know what happenswith menopause?
And I'm like what happens withmenopause, right?
And they're like your sex lifegoes away.
And I'm like is that true?
And so that was like the nextdeep dive of like what it?
(09:30):
What happened?
I'm staring down the barrel atthis, what the heck is coming,
right, what's coming?
And so it's then started to getinto like is that true?
Are hormones related?
Why are we so scared ofhormones?
What's the truth about hormonesand breast cancer and just
started like digging deep on allof that stuff that kept coming
up.
And then I was like, oh we,because of the women's health
(09:53):
initiative, we are incrediblynumber one in the dark about
what's actually happening.
People just think this is a hotflash right they have no idea
that like it's a profoundhormonal change.
I say change because people getall moody when I'm like it's,
the hormones go very, very lowand people are like we don't
like the word.
Oh, I don't like the word andI'm like you guys need to
(10:16):
freaking deal with what'shappening.
Speaker 1 (10:18):
So yeah, yeah, Interesting, interesting yeah.
Speaker 2 (10:22):
It's super interesting that women get picky
about the word.
But because I had posted, it'sovarian decline, I think, or I'd
posted something about ovariandemise, ovarian decline,
something that it was kind ofmedical, it wasn't demise and
people get all like you guysdon't know what this is.
Yeah, like that's what it is.
And so really started educatingabout hormones and educating
(10:45):
about fear and then startedprescribing it in my clinic and
I'm a urologist, so we give 10times the dose of testosterone
to men, like every Tuesday.
Like I am not afraid oftestosterone and I know what
testosterone, how good it is forpeople.
Speaker 1 (10:59):
Yeah.
Speaker 2 (10:59):
So really started kind of becoming the like sex
med hormone testosterone guru ofthe United States of America.
Speaker 1 (11:07):
Yeah, you really are, and roll credits.
Note first, you do have a.
What do we call it?
It's a new release of your book.
Speaker 2 (11:18):
Yeah, a re-release.
Speaker 1 (11:19):
Okay, there you go.
Speaker 2 (11:21):
So it's yeah, a publisher bought the rights to
the book and is now it's goingworldwide.
So it's in UK, canada,australia right now.
Speaker 1 (11:28):
We're so excited it's coming in September so you can
pre-order that, I know you can.
We're going to put that in ourshow notes.
Just super excited I did too.
And you're going to have allkinds of fun things with some,
you know, private conversationswith anyone that's pre-ordered,
and so we can right.
Yeah, yeah, I'm pretty excited,all of that in the show notes,
(11:50):
but I I just first of all, Iwant to say I love the story.
You went from urologist tosexual health expert.
Now you're hormonal healthexpert and I want to dive into
testosterone, estrogen hormones,because there are so many
questions about that, as youjust said.
(12:11):
And you just said somethingthat I don't think that our
general audience might realizethat males take 10 times the
amount of hormone testosteronethat we do right, but there's
not an FDA approved testosteronefor women that's dosed at that
(12:32):
one 10th of the male hormone,correct?
So let's unpack that a littlebit.
Let's talk about that.
We also know that testosteroneis good for our bodies, not just
to increase our libido.
So that's where we go.
You know, when we talk to women, it immediately equates to sex
(12:54):
libido, and that's the onlyreason why I need to take
testosterone.
And, by the way, if I taketestosterone, I might grow hair
on my face and places that Idon't want it, and so can we.
Can we talk about that a littlebit?
And what the heck?
Why are there so many confusingmessages out there on
testosterone?
Speaker 2 (13:14):
Yeah, it's a one of my favorite topics because you
and you have to start well andwe'll back up for the people.
Because if I just come out ofthe gate and be like all women
need testosterone, like I sound,sound crazy yeah right, because
their lack of education hasn'tcaught up to like where I am or
I'm like how do you want it?
Do you want to inject it?
You want a cream?
You want a gel right right,like, like.
(13:35):
You have to catch up to to whereI am.
So all bodies make testosterone.
It was labeled the male sexhormone just by a bunch of male
researchers, because researcherswere men back in the day and
just got labeled androgen, whichmeans if you look it up, it
(13:55):
means the male sexualcharacteristics.
But it's completely made up.
Men make estrogen, women maketestosterone.
It's like calling insulin maleor calling thyroid female of
like.
No, these are just things allbodies have.
We just have them in differentratios.
So the first part of the wholediscussion is really cutting
(14:17):
down these gendered terms thatwe used, which kind of puts
these hormones in a box, and itputs these hormones in a box of
like.
That's for him.
This is for her side note.
Men have more estrogen in theirbodies than women do after
menopause.
Speaker 1 (14:32):
Interesting.
Speaker 2 (14:33):
Yes, men have a level of 30 to 40 on average and
women have a level of like lessthan 10.
That's estrogen after menopause.
So just to open people's mindsof like everybody has hormones,
everybody needs hormones.
The hormones go crazy low inmenopause to the point of you
know, I have this woman andshe's like I want estrogen and
(14:54):
blah, blah, blah.
And I look at, I point to herhusband and I'm like you know,
he has more estrogen in his bodythan you do right now.
And that really helps themrealize like, oh, I have a
profoundly low level of estrogennow because I don't think of
him as having estrogen.
But estrogen in men is verygood for their bone health, is
also really good for theirlibido and sexual health.
(15:16):
They've got amazing studieswhere they knocked out men's
estrogen and they're like eh, ah, that's interesting.
But you don't go around withthe stereotype of like estrogen
is great for men's sex livesright, right.
Speaker 3 (15:28):
So you have to back up that either yeah.
Speaker 2 (15:32):
So you have to back up and be like okay.
So now we know everybody makestestosterone.
And the other thing we need toknow is before menopause.
So when we're having normalcycles, our testosterone women's
testosterone level is fourtimes our estrogen level.
Speaker 3 (15:47):
We don't know that either.
Speaker 2 (15:49):
So we're always told.
The other interesting thing isyou can't make estrogen in your
body if it doesn't go throughthe testosterone pathway.
So you take cholesterol andthen cholesterol goes into all
of these hormones.
It first has to becometestosterone before it becomes
estrogen.
People think these are likeseparate floating things.
We get our estrogen from ourtestosterone, which is four
(16:12):
times what our estrogen level is.
It's important.
It's important.
But our body doesn't just usetestosterone to make estrogen.
We also use we havetestosterone receptors in our
brains and our bones and ourmuscles everywhere else.
So that's the spiel of likeokay, now we can talk about
testosterone in women andactually using it as a
pharmacologic drug.
(16:34):
Once we understand I'm nottrying to take something that a
man has and put it in your bodythat you've never seen before
seen before.
The other interesting thing toknow about testosterone is it
doesn't fall off a cliff whenyour periods stop.
Testosterone starts decliningfrom our 20s and really kind of
has a low, a gentle slope downinto our 40s, where it stays low
(16:55):
.
Now the interesting thing andwe need more data on but we're
finding that women in their 70stheir testosterone is starting
to rise again, naturally.
We don't know why that'simportant or why that's
happening, but we think thosewomen tend to have more heart
protection from it.
Interesting data on naturaltestosterone levels when you're
(17:15):
older and risk of heart attacks,heart disease.
So that's infancy research,because nobody was really
looking.
Speaker 1 (17:22):
testosterone in 70-year-olds yeah, that's
fascinating to me.
Speaker 2 (17:25):
Yeah, so testosterone tends to.
It goes down slowly from 20 to40, stays very low and then in
some women will start to riseagain much later in life.
But we do not have an FDAapproved product for it, the FDA
.
There's a I don't know how elseto say it.
There's a strong gender biasright, we've had.
We have multiple forms of ViagraFDA approved since 1998.
(17:48):
We just got two FDA approvedmedications for women's low
libido a couple of years ago, sowe're horribly behind on equity
and equality when it comes toequal issues.
So men have an FDA approved.
They have about 20 FDA approvedtestosterone products.
Speaker 1 (18:07):
And we have two, did you just say?
Speaker 2 (18:08):
No for testosterone.
Well, we don't have any FDAapproved testosterone right
Testosterone we have zero.
And look at the numbers About 15to 20% of men that might be
generous will use a testosteroneproduct, because not all men
get low testosterone.
What percentage of women getlow testosterone?
A hundred percent.
So if my math was mathing, wewould have more products
(18:31):
available than the men do Now.
The other gender issue with theFDA is male testosterone.
Is FDA approved forhypogonadism low hormones why do
you take hormones?
Cause your hormones are low?
The FDA has said, and it willhappen, that when we get it FDA
approved testosterone dose forwomen, it will be approved for
(18:53):
low libido.
Speaker 1 (18:55):
And that's it.
That's okay.
Speaker 2 (18:57):
Yeah, so, so, yeah, it should make you mad.
And so in Australia,australia's FDA, they have their
own FDA, but they're FDAapproved for low libido in
Australia.
And so women come to me andthey're like, do I need should I
lie to my doctor, should I sayI have an issue with my sexual
health to get this testosterone?
And it's the, it's the, thetail wagging, the dog right, dog
(19:18):
right.
Because, like, well, the mostdata we have is for low libido.
Why is that?
Because the fda said they'llapprove one for low libido,
right, so the research followswhat you're actually going to
get it approved for?
Um, there is, we have otherdata for testosterone and you
only, you only have to talk to awoman who takes testosterone,
who understands how great shefeels, and this is not not just
(19:39):
for sex and the other.
The other thing to step back of, like, what's libido?
Libido is a mood.
Where do moods come from?
Moods come from our brain.
Okay, so testosterone works inyour brain.
Yeah, yeah, and there's a bigrole in cognitive health,
clarity, thinking.
I mean.
So many women are like I'mfaster, I'm quicker, the world's
(20:02):
more in color, I'm asking morequestions, I'm more curious.
My German I learned as a kid,is coming back.
My math is faster.
It's a brain hormone, and tosay it's libido really is like
you guys.
Libido is in the brain.
Where do you think libido is?
Speaker 1 (20:17):
Yeah, and it's so limiting, limiting, it's just so
limiting and so frustrating how?
Speaker 2 (20:23):
sexist is it to say like I'm going to give you
something for your interest insleeping with somebody else?
Right, that's crazy right it'sso nuts, like people should be.
You know, I only have to openmy mouth and actually like
explain all this and then peopleare like who do?
I sign me up yeah, yeah, writeyour legisl, write your
legislatures right here.
Write the FDA.
It matters, right?
Insurance companies won't,won't pay for your testosterone,
(20:46):
but they'll pay for maletestosterone and they'll pay for
people who are transitioning tomale testosterone which, by the
way, it's not FDA approved for.
And so the women have to beloud to say I want this.
Women pay more out of pocketfor their health care than men
do, and this is one reason whyis because they're like we're
(21:07):
not going to cover it.
Speaker 1 (21:11):
It's't cover it, right?
So here we are in 2024 andwe're still having the same
conversations, and that'sincredibly frustrating.
So what do you know?
What do women do?
If there isn't an FDA approvedtestosterone and and we don't
(21:31):
understand how testosteroneaffects our body, what do what
do we do, right?
So here are and we go to thedoctor and they might say, well,
you need hormones.
But I have never had a doctortalk to me about testosterone.
It's always estrogen andprogestin.
I mean, it's just yeah, always.
Speaker 3 (21:53):
And I just had a whole blood workup done on
everything, on every everythingand on the on the hormone piece.
Testosterone was not on there.
I was looking again thismorning as we were preparing for
this, because I was like where?
And I love my doctor, she'ssuper smart and would like do
the right thing, but it seemslike I need to specifically ask
for my testosterone to bechecked.
(22:15):
You do you do at this point?
Speaker 2 (22:18):
I I listen, I went to medical school and didn't learn
that women had testosterone intheir bodies, and it was
probably only like three yearsago where I learned that we have
more testosterone than estrogenin our bodies, like you know,
shut the door.
So, unless you're like, I'minnately curious about these
topics, right, and so my levelof education now is not where I
(22:41):
was when I got done with medicalschool, and so doctors have to
be innately curious or they haveto learn from other doctors,
because once you're 10, 20 yearsin practice, you're not
learning new things unlessyou're like, very interested.
But here's, this is how thechange happens.
Women go in and they requestand they ask and they demand and
they repeat themselves, becauseI've had many doctors come to
(23:04):
me and they're like listen, Ineed to learn this now, because
women keep coming in, right, andso thinking about, how do we
change systems?
Do we change systems from topdown or do we change systems
from bottom up?
And I really think with thehormone menopause world, we're
changing the system from thebottom up, because if we are
expecting what there's 1 milliondoctors in America if we're
(23:24):
expecting 1 million doctors toget an education that they
didn't get or they got theopposite education because they
trained during the Women'sHealth Initiative.
When hormones remember, hormonescause cancer for a while.
Now they don't again, becausethat was bad research, right.
But we can't wait, for thedoctors are too busy, right,
(23:44):
exactly Busy.
So to me I'm like I educate thewoman, she goes in and that's
how we get it to change.
But going back to this specifictestosterone issue, it is a big
issue and this is kind of wherethe pellet, the pellet wellness
.
Yeah, let's talk about thisBecause our healthcare system
number one doesn't pay for theseproducts.
(24:06):
Number two, isn't educatedabout these products.
Women will go to these clinicswhere all they offer is pellets,
and to me I'm like, if you onlyoffer one type of hormone,
you're not a hormone expert.
You're a one-trick pony andyou're making money off those
and you're not a hormone expert.
You're a one trick pony andyou're making money off those
and you're making a lot of money, Right, Right.
But I get it.
I understand why women go andsome women do very well.
(24:30):
If everybody did poorly, they'dshut down.
Speaker 1 (24:33):
Yeah, sure.
Speaker 2 (24:34):
Some women do very well, but pellets are super
physiologic, so they're going totake you if you're already in a
low state and now I shoot youpast normal and I put you up
really high.
With these levels, whether it'sestrogen or testosterone, side
effects happen.
Speaker 1 (24:50):
And then a high dose, fast and quick right.
So my analogy is like you knowwe live at sea level.
Speaker 2 (24:55):
If you fly me to Everest Base Camp, I'm going to
fall over.
Yeah right, like I'm not usedto.
It is like you know we live atsea level.
If you fly me to Everest basecamp, I'm going to fall over.
Speaker 3 (25:01):
Yeah, right Like.
Speaker 2 (25:02):
I'm not used to it, but like, if you fly me to
Denver, I'll probably be prettyhappy in Denver, like Denver.
Speaker 1 (25:06):
Oh.
Speaker 2 (25:06):
I'm so going to use that yeah Right.
And so to me I'm like get toDenver.
Then there are some people wholike going.
They might want to go to Nepal,but like a lot of people are
happy at Denver.
Speaker 3 (25:17):
Yeah.
Speaker 2 (25:18):
So hang out there.
But yeah, so the side effectscan be irreversible.
Really high doses oftestosterone enlargement, so
really high doses, think youknow 10 times the male dose, but
high doses.
You can get enlargement of yourAdam's apple.
You can get irreversibleclitoral enlargement.
You can get, you know,androgenic alopecia, which is
(25:38):
male pattern balding, and soagain, not everybody.
That's why these places exist.
They exist because Westernmedicine is failing people,
Insurance companies aren'tcovering it and women want to
feel better.
I get why they go there.
I just don't think it's themost comprehensive, best way to
get your hormones.
Speaker 1 (25:56):
Yeah.
Speaker 3 (25:57):
Go ahead, kamie.
How can women advocate forthemselves?
You were saying, like you know,show up and ask for it.
But you're doing a lot ofeducation and we want to talk
about your book too Veryimportant work that you're doing
there.
But how should women thinkabout when they?
How do they get informed?
How do they ask for what theywant?
How do they help change it?
(26:17):
Like you said, ask the doctor,the doctor, but what?
Speaker 2 (26:19):
what would you tell our audience about really how to
move the not dial I mean to me.
I'm like there's, there's goodpeople, whether I always ask
women how do you like to consumeyour content?
Right?
Do you like to listen that'spodcast?
Do you like to read?
That's a book um, estrogenmatters is an incredible book
about hormones.
My book for you are Are NotBroken for Sexual Health.
(26:40):
To advocate in the office forsexual health is very
uncomfortable.
The doctors are uncomfortable,the patients everybody's
uncomfortable.
Speaker 1 (26:47):
Yeah.
Speaker 2 (26:48):
So you can say hey, I've read this book.
I brought this book in and forwhen people, when women come and
see me, like I've made my jobreally easy by working really
hard.
Because now when women come seeme, they're educated, they've
listened to my podcast, they'veread the book, they're on my
Instagram, they're like let's goand have this conversation
Exactly.
Speaker 1 (27:07):
They're not scared about it.
Speaker 2 (27:08):
You have to get over so many barriers.
You have to get over the fearof hormones.
You have to get over you know,so many issues and navigate.
I didn't even know hormones gotlow and right, like all this
education, before you can sayyou can go advocate right and so
to like, when women come see me, they're, they're just ready to
go, because they've done thatalready, you know, and it's it's
(27:31):
more fun for me because now wecan just talk about really high
level stuff or like other coolstuff.
So it's education first, thenyou can't be empowered about
this stuff if you don't knowright.
So education, then empowerment.
Speaker 1 (27:45):
Yeah, and I think there are a lot of hurdles still
.
I mean, you mentioned the study20 years ago that is still
scaring the dickens out of womenright now about hormones and
we're still having thatconversation with women that
hormones are safe.
So barrier, and then right, andthen and then and then.
(28:06):
So advocating, I think comesback to education.
I agree.
Speaker 2 (28:11):
Yeah, and knowing who you're seeing right, which is
not always easy, especially ifyour insurance is limiting to
you to be like these are yourfive doctors you get to choose
from, but so seeing somebodywho's experienced in sex med,
that's probably the best.
Tip is sex med docs, and if yougo to ISHWISH International
Society for the Study of Women'sSexual Health, ishwishorg, you
can type in your zip code Okay,so what a sex med doc?
(28:33):
Why they're so special isnumber one, they're comfortable
talking about sex.
But number two, they understandthe role of hormones in sex
life, so they're usually prettyproficient at hormones as well.
So, that's kind of your like twofor one for being like.
They've already had thisconversation 10 times today.
It's going to be awkward, nomatter what.
(28:55):
Like I get it.
It's hard to talk aboutpersonal stuff, but like seeing
somebody who's like, yeah, I dosex, med and hormones, it's a
heck of a lot easier.
Yeah, I mean the other thing.
If you know, for primary care,there are 74 million midlife
women in this country.
We need all doctors on boardwith this, right, we need
everybody.
But if you don't have arelationship with a doctor which
(29:17):
I think the doctor relationshipin this country is at its worst
, all time low, because people,you know, people move and jobs
move now and like you're not ina community like you used to be,
and so you know I'm fortunate.
I've had my primary care doctorfor years.
She knows who I am, she knowswhat I do, so she's very willing
(29:37):
to like.
She's like Kelly, just tell mewhat you want, right.
But but not everybody has thatand not especially if you have a
doctor who doesn't see a lot ofmenopausal people, right, it's,
doesn't think that anythinghappens with the vulva, with
menopause, right, like somebodywho knows what happens to your
sexual health and your hormone.
Health, as your hormones changeis, is incredibly important and
(30:00):
the relationship is important.
They trust you, they knowyou're going to come back, they
know you're not asking forsomething crazy.
And that's a relationship.
And I think for hormones belike can I try X, y and Z?
I will come back in threemonths, we'll adjust as needed.
Those are the magic words whenyou ask a doctor for a
prescription.
Speaker 1 (30:19):
Okay, can you say that again?
Then we're going to try.
Speaker 2 (30:22):
Can we try X, y and Z ?
I will come back in threemonths and I will tell you how
I'm doing and we'll adjust asneeded.
That is the magic word forgetting a prescription.
Speaker 1 (30:33):
Okay, we're going to add that to our resources as
well.
When you are training, really,because we talk to women about
how to approach your doctor andhow to best prepare for those
doctor visits, and this isreally great information for
them to advocate for themselves.
Um, I want to.
I want to talk about can we goback to testosterone for just a
minute before we move on and Iwant to talk about your book.
(30:55):
Um, when we are looking attestosterone and dosing and the
fact that there isn't an FDAapproved level for women, how do
you do that?
What does it look like?
So there's still that confusion, right?
So if I go to my doctor and I'masking for this, not just for
(31:15):
libido, what am I looking forand what am I asking for?
Speaker 2 (31:19):
Yep.
So we always get a baselinetestosterone just to see where
it is.
There's the rare woman who'sgoing to have a high
testosterone.
You don't want to give her moretestosterone.
I've never seen that woman,because most of my people are
postmenopause and lateperimenopause.
But so get a baseline.
That's how you know that it'slow to begin with, and then you
recheck it in about two monthsand you can say oh yeah, you're
(31:41):
absorbing or you're notabsorbing, or you need more, and
blah, blah.
So I like to to follow thiswith levels in the beginning.
Okay, there's two main optionsPellets aside.
Pellets are an option, butagain, I think you have to work
your way up to a pellet.
You've been on testosterone fora while.
You just want like an easyevery three month dose instead
of a daily dose.
You know that you're where yourlevels and you like your levels
(32:02):
to be a little.
So to me I'm like earn a pelletif you're going to do a pellet
is how I think about it.
So I don't.
I never advocate for off thebat pellets because there's just
too many women that go fromzero to 300 and don't like it.
So with what I call physiologicdose testosterone so giving I'm
giving a woman a little bitmaybe higher where she was when
(32:24):
she was like 32.
Right, I mean, the best thingto do would have been to check
all of our labs when we were 28,that would have been nice.
Speaker 1 (32:32):
Maybe that will change too.
Speaker 2 (32:34):
Yeah Right, nobody has that.
So we're kind of we're a littlebit guessing of like where you
were happy with your, with yoursex drive and your energy and
your, you know, lean body massand stuff like that but get a
baseline.
The two main ways to do it isyou can take the male dose or a
male product which is test them,or a testosterone gel, and you
(32:55):
make a tube or a packet bonus.
If you can get the tubes, I gothrough Amazon.
Amazon's nice.
You get the tubes on Amazon andyou'd make a tube last seven to
10 days.
Now that's not accurate, but Iwould argue like it's pretty
darn good.
It's going to get you like youknow, for the women who are,
like, obsessing over one tenthof like, maybe that's not the
(33:16):
right way to do it for you, youknow.
So that's not the right way todo it for you, you know, okay,
um, so that's great.
You can get a prescription ofuh 30, so it comes in packs of
30 for men.
It's a one month supply, okay,and then you take that and you
do one tenth the dose.
So that's going to last you 300days.
So it's going to last you 10months and that's, I think 211
(33:37):
$211 on Amazon Pharmacy.
Yeah.
Speaker 3 (33:40):
Yeah, not bad.
Costco also is very cheap.
Speaker 2 (33:43):
Now a lot of.
And why is Amazon nice?
Amazon's nice?
Because I don't have apharmacist in the middle of a
grocery store chiding my womanover.
Do you know what you're doing?
Because some of the pharmacistsget a little bully on this.
Okay, no-transcript.
Speaker 1 (34:00):
You don't have to talk to them.
Speaker 2 (34:02):
Yeah, I got mine.
Mine got approved on Amazon andcame to mind.
It comes to your house too,which is nice.
Ok, so that's the, that's thedosing, the male FDA approved
product.
Then we check your levels inabout two months, two to three
months and on that, some people,it takes four to six months for
for you to notice.
Right so give it some time.
Check your levels, make sureyou're kind of up.
(34:23):
The other problem withtestosterone is the female range
on labs.
I think, and a lot of expertsthink, is low Okay.
So if a female lab dose is,they're going to say anything
over like 30, 35 is a hightestosterone.
I disagree.
A lot of studies show thatwomen do really well in the high
(34:44):
double digits to 150 withoutgetting a lot of side effects.
So you have to kind of go tosomebody who knows how to
interpret these labs, because Idon't even think the labs are
that accurate.
The Quest labs, for example,their female testosterone range
is based off of one paper.
Oh wow.
So you have to understand yourlabs, right.
(35:06):
You have to understand why yourlab says what's normal and
what's not normal.
So recheck your labs, but dogive it four to six months and
they say if you don't notice anyimprovement in symptoms after
four to six months, you couldstop.
Yeah, okay.
Now I might argue, because I'mthe hormone expert testosterone
is helping your bone.
Testosterone is helping yourheart.
Speaker 3 (35:22):
testosterone is helping your bone testosterone
is helping your heart.
Speaker 2 (35:24):
Testosterone is helping your brain.
You can't always feel thosethings that's right now right,
that's another podcast for thepreventative use of hormones,
right, which is kind of.
You know, that's where thethought leaders are now.
Right now it really mainstreamis like what symptoms do you
have?
Do we help your symptoms?
Speaker 1 (35:40):
and then the thought leaders are like there there's a
, you can't think about yourwhole health span Right.
Speaker 2 (35:46):
You can't feel your insulin working, but you'd like
to know that it's working on theright.
Same thing with the sexhormones.
Speaker 3 (35:53):
Right so those are.
Speaker 2 (35:54):
So the second.
So that's male testosterone,fda approved.
The other way to do it, whichis easier, is get it compounded
at a compounding pharmacy.
Five milligrams a day, one pump, 90 pumps, there's your three
months supply.
It's about 70 bucks.
One pump to your leg every day,easy.
Speaker 1 (36:12):
I kind of like the pump.
Speaker 2 (36:13):
It's a lot more idiot proof.
I have the estrogen spray.
Speaker 1 (36:15):
I'm like let's just take it you like the once a day
estrogen, I like the once a daybecause I don't have to think
about it.
I don't have to do math, Idon't have to figure out what
day it is and did I take it?
You know all of that, so thatsounds better to me.
Speaker 2 (36:27):
My opinion about this is 100% of women will have low
hormones.
We should have 20 differentproduct options.
We should have 30 differentproduct options.
Speaker 1 (36:37):
Like the fact that for estrogen.
Speaker 2 (36:39):
we only have four options for something that
affects 100% of people, to meonly have four options for
something that affects a hundredpercent of people To me.
I'm like, where's the?
Speaker 1 (36:47):
innovation.
Yeah, it's there, it's there.
Speaker 3 (36:51):
And there's an opportunity?
Speaker 1 (36:52):
I don't know, but they jack up the prices.
Speaker 3 (36:53):
I want a ring.
Speaker 2 (36:55):
Why I want a.
I want a vaginal ring that hastestosterone, estrogen,
progesterone in it.
Speaker 1 (37:00):
I was going to ask you the question If I got to
design something Right.
Speaker 2 (37:02):
I was going to ask you the question If I got to
design something, that's what Iwould design, because then it
would cover my vulvar, bladder,vagina, all of that, those
structures too.
Speaker 1 (37:18):
That would be the best.
Because we haven't even talkedabout that.
We haven't even talked aboutthe vagina vaginal atrophy.
I know you're a huge fan ofthat being preventative medicine
as well.
Right, we need that vaginalestrogen.
Why even wait until we'rehaving painful sex?
Speaker 3 (37:32):
That's the big question why are we waiting?
Speaker 2 (37:34):
until after.
I think we wait for two reasons.
I think we wait for threereasons about the time.
The first reason is Westernmedicine is very good at
treating disease, not preventingit.
And if I'm a doctor who's intopreventing it and you come into
my office and I'm like, oh,you're 45, here's your vaginal
estrogen, I've got eight moreminutes to talk to you about it.
You don't know what estrogen is.
(37:55):
You still think estrogen isgoing to kill you.
Your insurance might not coverit.
You are uncomfortable talkingLike it's a big ask to be
preventative for the averageperson, right, but to me I'm
like.
I'm like mammogram, colonoscopy, vaginal estrogen here you go,
um, because the average.
So that's number one.
(38:16):
Number two is sex is difficultto talk about, right?
How many women come see me?
They've stopped having sexeight years ago, right.
Eight years ago, six years ago,five years ago.
This isn't like a sex hurt onceI'm going to get it checked out
, yeah, which is what men do.
Men are like.
Erections were iffy one time.
Speaker 3 (38:34):
Check this out.
Speaker 2 (38:38):
Yeah, whereas women are like it.
Just it just started hurting sowe just stopped having sex.
That was eight years ago, right.
And then the third reason iswomen don't, because we don't
know what menopause is and wethink it's the end of periods
and a hot flash.
We don't understand that thepain with sex is because of low
hormones, right, right, right.
(38:58):
And so those are the threereasons that vaginal estrogen
isn't happening at age 45.
But I had this insight theother day because you know I'm a
big preventative and for peoplewho don't know, vaginal
estrogen is incredibly low dose.
There's literally hardly aperson who can't be on it.
There's always an asterisk ofoh yeah, you can't.
(39:23):
But, like breast cancersurvivors, everybody, for for
the most part, can be on vaginalestrogen because it's not
systemic, it's not going, it'snot going to help.
I always say it's not going tohelp your bones, it's not going
to help your heart and it's notgoing to help your brain.
It's such low dose.
It's only for bladder health,vagina health.
Vagina and bladder share a wall, so they're condo, they're
condo mates.
Um so vaginal, yeah, it's justso incredibly important.
(39:46):
But they don't know thathormone changes is why you get
overactive bladder and you startgetting up more at night and
you start getting more recurrentUTIs and all those things.
People don't know that that's ahormone thing.
Speaker 1 (40:00):
There is so much that is related to hormones it is
mind boggling.
Speaker 2 (40:06):
It's everything Hormone receptors are everywhere
Vertigo, ringing in the ear,joint aches and pains.
There was, finally, a paperjust got published, like two
weeks ago, which it was, to myknowledge, the first time this
has been written in the medicalliterature the musculoskeletal
syndrome of menopause oh so good.
This has been written in themedical literature the
(40:27):
musculoskeletal syndrome ofmenopause, oh so good.
And it's 50 to 80% of womenjoin aches and pains because in
our collagen, our tendons, allhave testosterone receptors,
estrogen receptors.
Speaker 1 (40:36):
Yeah, here, here I'm raising my hand on that one
right.
I'm really like hello, yeah,but if you look at it, you would
have told me that five yearsago, right, yeah, yeah, your
shoulder's.
Speaker 2 (40:44):
Look at it, you would have told me that five years
ago, right, yeah, yeah, yourshoulder starting to get stiff.
Throw on an estrogen patch, um,the, the um.
What was I going to say?
Oh, the top two reasons thatwomen stop having sex in midlife
are availability of partner andsystemic hormone.
Menopause changes, hot flashes,night sweats, poor sleep, joint
aches and pains.
(41:04):
You don't feel good, you don'tfeel like yourself, right, right
, and so that libido followsthat, right, and certainly, if
you're having pain, dryness,issues of penetration you do not
want, women will come in andthey'll be like I have two
problems.
I have pain with sex and lowlibido, and I always like to
take problems away from peoplebecause you don't need more
(41:24):
problems, right, and I'm like no, you have one problem.
You have pain with sex.
You can't expect a libido tohappen.
That's right when there's painwith sex.
So I'm like fix the pain withsex, you make sex fun again.
Yeah, libido can follow.
Speaker 1 (41:38):
And there's good news .
There is good news right.
We have hormones, we havethings that can help with all of
these challenges.
Speaker 2 (41:46):
So that's the good.
Yeah, and I think myperspective, this is all good
news.
Yeah, people are like we'regetting older.
I'm like, damn right, you are.
Speaker 1 (41:54):
It's a freaking blessing yeah, we get to right,
we get to live longer.
Speaker 2 (41:59):
This myth that we have to deal like that.
It's like some burden and I'm,like you know, 200, 300 years
ago, the privilege of livingpast 47, like it was not
universally.
Is it universally accepted thatyou're, by and large, going to
go through menopause now?
yeah that was a privilegeoffered to very few until very
(42:21):
recently, and I like to remindpeople of of like we're figuring
out aging on a global scale forthe first time ever.
Yeah, yeah, we did.
To me, all of this is aprivilege, like oh my God, I
have to floss.
It's like, yeah, because youstill have teeth.
Speaker 3 (42:39):
Like it's a privilege right.
Speaker 2 (42:41):
Like, oh my God, I have to wear a seatbelt.
Seat belt like you don't thinkabout, it's like a privilege to
drive the car and you know whatmakes it safer.
And so I think, and it's justthat little healthy dose of like
reframing, yeah, like, oh mygod, to have the opportunity to
be on this earth for 80 years,yeah, that's brand new it is and
(43:01):
you're right, it's a privilegeand I I do think that reminder
and shift in perspective isincredibly important.
Yeah, I mean I just like to tobreak down everybody's limiting
beliefs.
Right, because they're likehormones aren't natural and I'm
like you have shoes on, yeah,you have heat right.
Like you have glasses, like whyand people will say that, about
(43:23):
sex too, they'll be like I havevibrators.
They just seem so unnatural.
And I'm like I have twovibrators for my mouth.
I have like an electrictoothbrush and a water pick.
Why are you picking yournatural for this one thing in
your life?
You have a.
You have a mysterious, magicalinternet that comes into your
house and you can buy pantsright like like we're living in
(43:46):
magic at this point, and forpeople who get all like
naturally with hormones and sex,I'm like get rid of the
internet then, because that'snot natural nobody's gonna get
rid of that right like so.
It's like you just changepeople's their moody perspective
a little bit to be like it'skind of a good.
It's a good reminder yeah it is,but I think I mean to me.
(44:08):
I'm like we have a newresponsibility to age well,
because never have we put a bodythrough 40 years of low
hormones and expected the bonesnot to break.
Right, right, right, right Likethe risk, the risk of hip
fracture for us now islegitimate.
Speaker 1 (44:24):
Yeah.
Speaker 2 (44:25):
Because we're going to go 40 years without hormones.
Speaker 1 (44:27):
We're learning how to do that.
Speaker 2 (44:29):
We're learning how to do it.
We're learning how to age on aglobal scale for the first time
ever.
Speaker 1 (44:33):
Yeah, and I think that's what our age group is
doing right.
I think we really are.
We all have daughters here.
We want that to be differentfor them and we're changing that
and we're learning so that theycan grow older better.
Speaker 2 (44:50):
I think a lot of us are watching our parents and
we're starting to say I don'twant that.
Speaker 1 (44:56):
Yeah, I agree.
Speaker 2 (44:57):
Right, how does that not happen?
And the truth is you have tostart now.
You can't start when you're 73.
You can Some people do I dostart older people on hormones.
That's another podcast episode.
But, by and large, protect yourbones before they are weak,
protect your mind before it'shaving issues.
(45:18):
And again, it's a mindsetchange, because in Western
medicine, come see me when yourhip breaks, come see me when you
have dementia.
Women are saying I don't wantto do that, though what can I?
Do to prevent things.
Speaker 3 (45:32):
Like, if there was a.
Speaker 2 (45:32):
if there was a drug that men could take that made
them live longer, decrease therisk of colon cancer by 30
percent, increase their lifespanby three years, decrease the
risk of heart attack by 50percent, decrease the risk of
heart attack by 50%.
Decrease the risk of all bonefractures by 30 to 50%, do you
think they would be on this drugand everybody's like, yeah, a
dude would take that.
Those are good.
(45:52):
Oh yeah, if you haveprediabetes, it decreases your
risk of diabetes developing thatby 30%.
Everybody would be on that drug.
It's called estrogen.
What are we questioning?
Speaker 1 (46:04):
What are we questioning, seriously?
What are we questioning?
I'm going to ask you thisquestion because I really want
you to say it, because you're adoctor.
If I say it doesn't have thesame level of respect, but I
want to ask you a question here.
So you know, for the record,you just talked about
preventative care, right?
Why not take these drugsestrogen, um as a preventative
(46:29):
medicine for all of these thingsthat you just mentioned?
What age?
And I know that that is reallyhard to say.
You know this particular age,age range, let's just say age
range, would that be?
what age, would that be?
Speaker 2 (46:44):
Well, menopause.
Average age of menopause inamerica is 51.
We know your hormones don'tfall off.
This is the other myth of likethat periods are irrelevant.
I got some.
I got some heat for saying thaton the internet the other day,
but, like people use periods asa marker of it.
Speaker 3 (46:59):
But now it's okay to start it.
Speaker 2 (47:01):
It's.
They're irrelevant.
They're like you've got some, alittle bit of some, hormones,
sometimes when you're stillhaving a little bit of periods,
but there's no cliff that youdrop off of.
The new push now is we areseverely undertreating our
perimenopausal women.
Massive suffering and, manypeople would argue, more
suffering because the body'svery sensitive to changes in
(47:25):
hormone levels.
Once your hormone levels arejust flatlined, like it,
actually things mellow out alittle bit, not entirely your
bones really start taking a dive, like the heart disease, the
things you can't see, but likemood, sleep, hot flashes, joints
, aches and pains.
Like the perimenopausal woman,because of the fluctuation, is
suffering without help themajority of the time.
(47:46):
So, but by preventative, ifwe're having the preventative
question, some people wouldargue perimenopause, because the
biggest rate of bone loss is inthe final years of
perimenopause.
So you could argue that.
You know to me I'm like listenby by mid fifties, start having
(48:06):
the conversation.
Speaker 1 (48:07):
Yeah, I asked that question, um, because there's
often well, I asked it forseveral reasons, but, um, we
often hear from women.
I don't need to worry aboutthat right now.
I don't need.
I don't need that informationbecause I think I've already
been through it.
Speaker 3 (48:24):
Yeah, or either you're post-menopause, and I
don't need that informationbecause I think that yeah or
either you're post-menopause andI don't need to worry about.
Speaker 1 (48:29):
oh, I've been through that, I don't need that.
Speaker 2 (48:31):
Yeah, they think it's ended because they don't know
what it is.
Speaker 1 (48:34):
Right.
Or yeah, the perimenopausestage right.
Like I had no idea that all ofthis was happening to my body at
this young age was happening tomy body at this young age.
I never thought that I wouldhave to think about menopause
and hormones when I was late 30s, early 40s and I went through
early menopause.
So smack me in the face rightLike, oh yeah, yes, you actually
(48:56):
do need to have thoseconversations April.
So I do think it's importantand that's why I asked it.
Speaker 2 (49:03):
So thanks for- we all have that bias.
We all have that bias in ourhead, right Like when I close my
eyes and think of a menopausalwoman.
I'm thinking of Betty White onthe Golden Girls.
100% Right.
Speaker 1 (49:13):
Well, if you Google it, if you go to Adobe Stock,
right, okay, so we use AdobeStock everybody for all of our
stock images, for whatever,right?
If you type in that search barmenopausal women, that's what
you get.
That's what you get, anyway,with a fan, right Like waving
(49:36):
yourself.
Speaker 2 (49:36):
Yeah, and untreated and untreated.
Yeah, I mean the myth thatwomen, our bodies, were made for
suffering.
Speaker 1 (49:45):
So we should suffer Like it's it's, it's a very
oppressive language.
Yeah, we don't have to sufferand it comes back.
No, and there is help andadvocate for yourself.
Speaker 2 (49:58):
It's.
You know, it's kind of likeadvocate for yourself.
Yeah, it's kind of like thebody positivity world of like,
just get to neutral, just get towhere you accept your body.
It's like no, no, no, no, no,you can actually feel really
good.
Yeah, right, like it's like thislike good enough to be neutral
of.
Like no, no, no, you canactually love your body and you
can actually feel good.
When you're this age, you mightneed to do some things, you
(50:26):
know.
You might need to prioritizeyour health, and I think that's
the important takeaway.
Also, like for both for sex andfor hormones, is like these
things don't exist in a bubble.
Like hormones are nice, butthat's that's not your, just
your sex life.
That's not just men.
Like you need to exercise.
And for sex is like you need toknow how you get turned on.
You need to set aside time forthat.
You need to work on yourmindset about what you think sex
is Like.
It's not just like here's somevaginal estrogen.
(50:48):
Enjoy sex.
If you think hormones are theonly thing, you are going to be
disappointed.
But hormones are tools, they'remessengers and they can be
profoundly helpful.
But you still have to do allthe other things.
Speaker 1 (51:03):
Yeah yeah.
You have to do some work, youhave to do some self-reflection,
you have to take the time andpause.
Sometimes we're scared of thatand sometimes we don't give
ourselves permission to do that.
Speaker 3 (51:15):
Well, and Kelly, you said when I heard you speak at
the Women in Work, you said youask women when they come to your
office what do you want?
And it made such an impact onme to just like I even asked
that question about what it isthat you want and that so many
people are like I don't know.
Speaker 1 (51:34):
We haven't asked her, we haven't asked ourselves, we
haven't asked ourselves.
So yeah, and I do want to justkind of like like chime in and
say, yes, you've made a hugeimpact on Kim with that question
, because it keeps surfacingsince June, since June Right.
I mean, like she keeps comingback to that and I'm like really
(51:55):
important question.
Speaker 2 (51:57):
I mean, you know it's .
It's, I think, ancientphilosophy, or you know lots of
self-help of like tune inbecause your body, because you
do know, you do, you do.
You got to get quiet and youmight have to try something, but
you'd like that's the magic ofit, is like you do know, and I
think for some people they'relike they've just been telling
themselves they don't know.
Speaker 3 (52:18):
It's like, yeah, you do or don't know how to listen,
like you, when, when you heard Ineed to speak, you were like no
, no, no, no, no, no, no, no, no.
And then you kept hearing it.
You kept hearing it, right?
Speaker 2 (52:28):
Yeah, quiet enough to listen, oh yeah, that's a good
way to end this podcast.
So I was at a conference.
I was at a physician conferenceabout a year later I had
started the podcast, blah blah,blah and the voice got quiet for
(52:52):
those who are listening to thatend of that story.
So the voice, she got quiet andthere was somebody speaking at
the conference and they saidthat what that voice is, is your
future self pulling you forward?
And I was like, oh so now?
So she I mean she talks to meevery once in a while and she
was like two years ago she'slike you got to quit your job,
you got to open up your ownclinic.
You know, need you don't, don'tdo this urology thing full bore
anymore.
And I knew her and the voice.
I knew the voice enough now,like I trusted her on the whole
podcast journey thing and andthen I knew she got quiet when I
(53:15):
was doing what I was supposedto be doing.
And now she's like you need tostop this urology.
And you are no.
Speaker 1 (53:21):
And then I'm like god damn it she's back, yeah, but
now I like I trust her and I'mlike God damn it, she's back,
yeah.
Speaker 2 (53:26):
But now I like I trust her and I'm like, hi, yeah
, like hey, it's good to see youReally Right.
I have to quit my my good.
Yeah, that's what I got, okay.
Speaker 1 (53:36):
You know that's exciting too.
It's really exciting thatyou're opening up your own
clinic.
Speaker 2 (53:46):
That's in Bellingham Washington.
So yeah, I mean to me.
I'm like I want the doctorpatient relationship.
Yeah it's gone.
It's completely gone with thecurrent health insurance model
of everybody's moving around andyour insurance drops so you
can't see that person anymore.
And when you do see that person, you see them for 10 minutes
Like the doctor.
Patient relationship is gone.
And me, having doctored thislong now, what people want?
(54:08):
They want the relationship,they want to feel heard, they
want to feel like somebody cares.
That's the doctoring that Iwant to do.
Speaker 3 (54:20):
That's so great.
Speaker 2 (54:21):
And so I have to get out of the broken system in
order to do it.
That's so great and so I haveto get out of the the broken
system in order to do it.
Yeah, because, because oursystem doesn't, the doctor
patient relationship is not.
It's not on the top 10 thingsthat matter it's not western
medicine is really good atbreaking a femur, fixing a femur
fracture.
we're very good at a lot ofthings, sure, but that doctor
patient relationship and beinglike I don't know what your
(54:43):
exact hormone combo is going tobe, but I'm here to figure it
out with you, yeah.
Speaker 1 (54:46):
Let's try something, let's figure it out, let me know
.
Speaker 2 (54:49):
Let me know.
I texted one of my patientslast night and I'm like are you
sleeping?
Oh, her big thing was she wasnot sleeping Right, hadn't slept
in years, wow.
And so I texted her at her.
I was like you sleeping, andshe's like I slept till 10 in
the morning I haven't done andlike she was, ecstatic.
It was a good she didn't havean overslept a job or something
yeah but she was like ecstatic,wow, wow, and I'm like that's
(55:13):
what I want.
Speaker 1 (55:14):
That feels so good I want that relationship so good,
not not just for her, but youtoo, right?
oh yeah, totally to be like ah,look what I did yeah, yeah, well
, your information on your newclinic will be on your website
to Kelly Patterson mdcom.
So, um, all of your informationis on your website.
I love your website, by the way, um, but we, we and all of our
(55:35):
podcasts, um, with a rapid fire.
So we're going to rapid fireand get to know you a little bit
better, and then we have onequestion that we ask every guest
, and we'll get to that in justa moment.
But you're a Washingtonian,you're local.
We were talking about thebeautiful Pacific Northwest that
we live in, but, curious, wehave lakes, oceans, rivers.
(55:56):
What would you rather?
Sit by with a cup of coffee,water, yeah, what body of water?
Speaker 2 (56:05):
by with a cup of coffee Water.
Yeah, what body of water?
Oh, I look at a lake right now.
So lake is good, ocean's good,any water.
Speaker 1 (56:13):
I grew up in Duluth Minnesota, so I had Lake
Superior in my backyard.
So water to me.
So water, water, water.
Just doesn't matter.
Speaker 3 (56:17):
What's the best piece of advice you've ever received?
Speaker 2 (56:19):
You're in charge of your own education.
Speaker 3 (56:21):
Love it.
Speaker 1 (56:22):
Thank you, dr Casperson.
Thank you for listening to theMedovia Menopause Podcast.
If you enjoyed today's show,please give it a thumbs up,
subscribe for future episodes,leave a review and share this
episode with a friend.
There are more than 50 millionwomen in the US who are
navigating the menopausetransition.
(56:43):
Us who are navigating themenopause transition.
The situation is compounded bythe presence of stigma, shame
and secrecy surroundingmenopause, posing significant
challenges and disruptions inwomen's personal and
professional spheres.
Medovia is out to change thenarrative.
Learn more at medoviacom.
That's M-I-D-O-V-I-A dot com.
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