You Are Not Broken

By Kelly Casperson, MD

Welcome to the podcast that rewrites everything you thought you knew about sex, hormones, and midlife. I help women—and the people who love them—reconnect with their bodies, their minds, and their

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The podcast currently has 388 episodes available.

Best of You Are Not Broken

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Number 1: 385. 500k on IG Celebration - Ask Me Anything
Half a million of you on Instagram. I still can't quite get over that number. To celebrate, this episode is all you — an open Ask Me Anything where I answer the questions you've actually been sending me. No guest, no agenda, just me working through your real questions about hormones, menopause, sexual health, and the stuff nobody explains to you in a normal doctor's appointment. We cover a lot of ground — how I ended up a urologist obsessed with female sexual health in the first place, the myths about hormone therapy I am still correcting in 2026, DHEA, the estrogen patch shortage, why your labs don't always tell the whole story, and yes, the Ferrari engine analogy makes another appearance. If you've been wondering something and never had the nerve to ask your own doctor — there's a good chance I answer it here. In This EpisodeHow I got here. My background as a urologist and how that path led me into female sexual health — a specialty most people don't expect a urologist to end up in.Hormones, menopause, and aging. Why hormones matter so much more than most of us were taught, and what's actually happening in your body during the menopause transition.Hormone therapy myths, corrected. I'm clearing up the misinformation that's still floating around about HRT — including specific questions on risk for women with a Factor V (Factor two) clotting diagnosis.DHEA and vaginal estrogen. What they do, why the estrogen patch shortage is happening, and what to switch to (gels, oral options) in the meantime.Testosterone, decoded. Comparing creams versus injections, how to interpret SHBG, and why I care more about how you feel than what the lab printout says.Progesterone tolerance. What to do when the standard dose doesn't agree with you, and where extended-release formulations fit in.Persistent UTIs on vaginal estrogen. Why they still happen even when you're doing everything "right," and what else might be going on.Weight gain and menopause. What the data actually says — and what gets blamed on hormones that isn't really about hormones at all.Talking about sex — with clients, with partners. A layered, step-by-step way to open the conversation about low libido without it feeling like a confrontation.Individualized care. Why hormone management should never be one-size-fits-all, and how I think about lab testing versus symptoms.What's next. vulvar DHEA, book clubs, and more ways to keep learning together. Subscribe, leave a review, and share this episode with someone who needs it. 🎙️ You Are Not Broken is available on Apple Podcasts, Spotify, and wherever you listen. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Take my ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Adult Sex Ed Master Class:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠My Website⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Interested in my sexual health and hormone clinic? ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Waitlist is open⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Thanks to our sponsor: Addyi, the little pink pill. To find out if Addyi is right for you, go to addyi.com/notbroken and use code NOTBROKEN for a $10 telemedicine appointment.And great news: with commercial insurance coverage Addyi is as little as $20 a month! Visit Addyi.com/notbroken. Eligible patients only. Restrictions apply. See Full Prescribing Information including Boxed Warning at addyi.com/pi Thanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com⁠ See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
August 23, 202651min
Number 2: 386. Nuances and Myths of Menopause with Dr. Shepherd
The longer we treat menopause as something to survive quietly instead of understanding fully, the more women get left without real answers. Dr. Shepherd is an OB-GYN, and we use menopause as the entry point into a much bigger conversation — the myths still circulating about menopause and sexual health, why clinician expertise and actual hands-on experience matter more than a lot of people realize, and how insurance and the broader healthcare system quietly shape what choices women even know they have. We also get into AI and new technology in medicine — where it genuinely helps, and where it's moving faster than anyone can vet it. And we land on something I keep coming back to on this show: aging well is not a solo project. Community and connection are part of the medicine. Dr. Jessica Shepherd is a board-certified OB-GYN focused on women's health, menopause, and sexual wellness in midlife. Generation M - Dr. Jessica Shepherd's book What We CoverMenopause as a gateway. Why menopause is so often the first time women start really engaging with their own health, and what that says about the gaps earlier in the system.The myths that won't die. Common misconceptions about menopause and sexual health that Dr. Shepherd still has to correct in the exam room, every week.Expertise actually matters. Why the clinician you choose, and how much hands-on experience they have, changes the quality of care you get, especially in a field this nuanced.The system shapes the choice. How insurance coverage and healthcare structures quietly limit what options get presented to women in the first place.AI in medicine — promise and risk. Where artificial intelligence and new technology are genuinely useful in healthcare, and where the pace of change is outrunning oversight.Community as medicine. Why connection and support are not a "nice to have" in aging well, they're part of the actual strategy. Thanks to our sponsor: Addyi, the little pink pill. To find out if Addyi is right for you, go to addyi.com/notbroken and use code NOTBROKEN for a $10 telemedicine appointment.And great news: with commercial insurance coverage Addyi is as little as $20 a month! Visit Addyi.com/notbroken. Eligible patients only. Restrictions apply. See Full Prescribing Information including Boxed Warning at addyi.com/pi Thanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com⁠ See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
August 30, 202649min
Number 3: 384. The Myth of Aging with Dr. Gilberg
Age is just a number. We say it all the time. Do we actually believe it? This week I sit down with Dr. Arnold Gilberg, MD, PhD — a psychiatrist with over 60 years of clinical experience and author of The Myth of Aging. Sixty years. Let that sink in for a second. He has watched mental health care go from something people hid to something people post about. And he has spent just as long studying what actually keeps people vital as they get older, and it is not what most of us assume. We get into what a psychiatrist actually is (and how that's different from a psychologist or a therapist), why the shame around therapy has mostly disappeared since the 1960s but hasn't fully left medicine itself, and why he'd argue we're over-medicating a problem that often needs connection more than a prescription. Then we go somewhere I did not expect, his own path to becoming a rabbi, and what spirituality has taught him about the mind that medicine alone couldn't. If you've ever felt "stuck," or assumed decline was just the deal you signed up for by getting older — this one's for you. Dr. Arnold Gilberg, MD, PhD, is a psychiatrist with more than six decades of clinical experience and the author of The Myth of Aging. Over the course of his career he has treated patients through massive shifts in how our culture understands mental health — from the stigma of the mid-20th century to today's very different, more open landscape. He is also a rabbi, a path that grew out of his clinical work and shapes how he thinks about meaning, purpose, and healing. The Myth of Aging book What We CoverPsychiatry vs. psychology vs. therapy. What a psychiatrist actually does, how that role differs from a psychologist or therapist, and why the lines have blurred (and shifted) as the field has evolved.From shame to normal. How therapy went from something you hid to something you casually mention at dinner — and why stigma still lingers inside the medical community itself, even as it's faded in the culture at large.The culture of medication. Dr. Gilbert doesn't hold back on this one — the over-reliance on medication, what gets missed when a prescription replaces psychotherapy, and why informed consent about side effects matters more than most patients realize.Body and mind are not separate systems. Why physical activity is one of the most underused tools in mental health care, and how movement changes the brain, not just the body.Becoming a rabbi. Dr. Gilbert's own journey into spirituality, and how faith and religion show up as legitimate tools for emotional and mental well-being — not as an alternative to psychiatry, but alongside it.Cultural shifts, real clinical impact. How broader acceptance of diverse sexualities and identities has changed what shows up in the therapy room and how mental health providers practice.Connection is the treatment. Why trust between patient and therapist predicts outcomes more than technique — and what that means for how we should be evaluating "good" therapy.The myth of aging, dismantled. Aging does not have to mean decline. Investment in physical, mental, and social health changes the trajectory — and it's never too late to start.Midlife crisis, reframed. What's actually happening during a midlife crisis, and why it can be the opening for real change instead of just a cliché to laugh off.Mindset changes your biology. The Harvard research on mindset and lifespan — and what it tells us about how much of "aging" is happening in our heads before it happens in our bodies.Getting unstuck. Practical ways to turn a feeling of stagnation into an actual growth opportunity.Community, movement, purpose. The three pillars Dr. Gilbert keeps coming back to for aging well — and why none of them are optional. Subscribe, leave a review, and share this episode with someone who needs it. 🎙️ You Are Not Broken is available on Apple Podcasts, Spotify, and wherever you listen. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Take my ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Adult Sex Ed Master Class:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠My Website⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Interested in my sexual health and hormone clinic? ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Waitlist is open⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Thanks to our sponsor: Addyi, the little pink pill. To find out if Addyi is right for you, go to addyi.com/notbroken and use code NOTBROKEN for a $10 telemedicine appointment.And great news: with commercial insurance coverage Addyi is as little as $20 a month! Visit Addyi.com/notbroken. Eligible patients only. Restrictions apply. See Full Prescribing Information including Boxed Warning at addyi.com/pi Thanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com⁠ See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
August 16, 202645min
Number 4: 382. Men, Menopause, and the Relationships in Between
Menopause doesn't just happen to a body, it happens to a relationship. In this episode, Traver Boehm joins Dr. Kelly Casperson to talk about what's actually going on hormonally during perimenopause and menopause, and what that means for the partners trying to understand it from the outside. Kelly breaks down the real difference between perimenopause and menopause (hint: most people are using these words wrong), what's happening biologically during the transition, and why the emotional and relational fallout is often just as real as the hot flashes. Then the conversation turns to men — what's shifting for them hormonally during this same midlife window, and how couples can actually talk to each other about all of it instead of quietly drifting apart. This one's for the women in it and the partners trying to show up for them. In this episode:Perimenopause vs. menopause, where one ends and the other beginsWhat hormonal changes are actually doing to mood, sleep, libido, and connectionThe emotional and relational ripple effects of menopause that no one prepares you forHormonal shifts in men during midlife, and why this isn't just a "her" conversationHow to actually talk to your partner about what's changingRebuilding pleasure and intimacy when everything else is in fluxReminder: none of this is individual medical advice, discuss your own plan with your own clinician. https://www.manuncivilized.com/ https://www.instagram.com/traverboehm Subscribe, leave a review, and share this episode with someone who needs it. 🎙️ You Are Not Broken is available on Apple Podcasts, Spotify, and wherever you listen. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Take my ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Adult Sex Ed Master Class:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠My Website⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Interested in my sexual health and hormone clinic? ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Waitlist is open⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Thanks to our sponsor: Addyi, the little pink pill. To find out if Addyi is right for you, go to addyi.com/notbroken and use code NOTBROKEN for a $10 telemedicine appointment.And great news: with commercial insurance coverage Addyi is as little as $20 a month! Visit Addyi.com/notbroken. Eligible patients only. Restrictions apply. See Full Prescribing Information including Boxed Warning at addyi.com/pi Thanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care. ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com⁠ See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
August 02, 20261h 17min
Number 5: 373. Sexual Health: Cervix, Vulva, and Vulvodynia Research
From the cervix to the vulva, so much of female anatomy has been understudied, misunderstood, and underserved — until now. In this episode, Dr. Kelly Casperson sits down with Dr. Andrew Goldstein, one of the world's foremost experts in vulvovaginal and cervical health, for a deep dive into the cutting edge of women's sexual medicine. We're talking new research, new treatments, and a whole lot of "why didn't anyone tell us this sooner?" energy. If you or someone you love has ever dealt with vulvar pain, lichen sclerosis, arousal difficulties, or just wants to understand their anatomy better — this one is unmissable. About Dr. Andrew Goldstein Dr. Andrew Goldstein is a board-certified OB/GYN and one of the world's leading specialists in vulvovaginal disorders, cervical health, and female sexual medicine. He is the founder of the Centers for Vulvovaginal Disorders, co-author of Reclaiming Desire, and a tireless advocate for research funding and clinical advancement in women's health. He has dedicated his career to conditions that medicine has long dismissed — and he is actively changing that. 🌐 vulvodynia.com When Sex Hurts Book In This Episode, We Cover: The significance of cervical innervation and its role in sexual pleasure — and why this is barely taught in medical school How common cervical excision procedures (like LEEP/LLETZ) can impact sexual function and urinary health Global efforts in cervical cancer prevention in resource-poor countries Surgical techniques designed to preserve nerves during cervical treatments The incredible impact of HPV vaccination on reducing cervical cancer rates worldwide A clear breakdown of vulvar anatomy and the misconceptions even providers carry Vulvodynia — causes, diagnosis, and the most exciting recent research breakthroughs Highlights from the Vulvodynia Research Summit: the top-ranked treatments from both expert and patient votes The surprising role of mast cells and allergic responses in vulvodynia Emerging therapies: topical ketotifen, localized nerve targeting, and novel chemical injections for pain relief How pelvic floor muscles contribute to vulvodynia — and what new research is showing Upcoming clinical trials on botulinum toxin for pelvic pain Lichen sclerosis — the autoimmune skin condition linked to cancer risk that far too many providers miss The game-changing potential of JAK-STAT pathway inhibitors for lichen sclerosis treatment Strata barrier cream and other topical therapies in the pipeline The road to FDA approvals and insurance coverage for these emerging treatments Topical sildenafil for female arousal disorders — the science, the promise, and how it works The drug delivery science behind why how a cream is formulated matters as much as what's in it Why advocacy and funding in women's health are inseparable from clinical progress — and what you can do Dare to Play Clinical Trials Registry Gynecologic Cancer Research Foundation National Vulvodynia Association Tightlipped Organization Dr. Andrew Goldstein: Website Listen to my Tedx Talk: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Why we need adult sex ed⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Take my ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Adult Sex Ed Master Class:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠My Website⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ Interested in my sexual health and hormone clinic? ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Waitlist is open⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ To learn more about Via vaginal moisturizer from Solv Wellness, visit ⁠⁠⁠⁠⁠⁠via4her.com⁠⁠⁠⁠⁠⁠ and get 20% off your first order. For an additional $5 off, use coupon code DRKELLY5. Clinicians can request patient materials or samples at ⁠⁠⁠⁠⁠⁠hcp.solvwellness.com⁠⁠⁠⁠⁠⁠. Thanks to our sponsor ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Midi Women's Health⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Designed by midlife experts, delivered by experienced clinicians, covered by insurance.Midi is the first virtual care clinic made exclusively for women 40+. Evidence-based treatments. Personalized midlife care.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://www.joinmidi.com⁠ Learn more about your ad choices. Visit podcastchoices.com/adchoices See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
May 31, 202653min