You Are Not Broken
By KJ Casperson, MD
Whether you are young or past menopause, single or in a long-term relationship, it is never too late or too early to realize YOU ARE NOT BROKEN. With humor, candor and ease, I break down the stories that we have been told about being sexual beings, to help us play, and normalize our intimacy. Nothing in this podcast is personal medical advice, of course.
You Are Not BrokenOct 17, 2021
214. "I Want To Want" – Desire, Bigger Penises, The Orgasm Gap, Testosterone Decreases Breast Cancer
Member question: Lichen Sclerosis, decreased sensation and libido – I discuss two types of desire – spontaneous and responsive and three options pharmacologically for low desire.
A couple options for if you "want to want": testosterone, Addyi and Vyleesi.
Pneuma for penile girthiness - if you want to be a shower.
The Orgasm Gap - as written by men
Testosterone is not associated with increased cardiovascular risk and associated decreased risk of breast cancer.
P Agrawal and others, Testosterone Therapy in Females Is Not Associated with Increased Cardiovascular Risk – A US Claims Database Analysis, The Journal of Sexual Medicine, Volume 20, Issue Supplement_1, May 2023, qdad060.014, https://doi.org/10.1093/jsxmed/qdad060.014
Sexual Boredom in long term relationships contributes to low desire.
L De Oliveira and others, (055) Sexual Boredom and Sexual Desire in Men and Women in Long-term Relationships: A Latent Profile Analysis, The Journal of Sexual Medicine, Volume 20, Issue Supplement_1, May 2023, qdad060.053, https://doi.org/10.1093/jsxmed/qdad060.053
An obituary of Jaqueline Gold
Our Podcast Sponsor is Firmtech – use code “NOTBROKEN”
FirmTech’s rings help improve performance and sexual experience for all men not just those with ED. https://myfirmtech.com/
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213. You Are More Than Just Your Breast Cancer - Hormones and Breast Cancer
You Are More Than Just Your Breast Cancer - Hormones and Breast Cancer
Dr. Corinne Menn is a board certified
OBGYN and North American Menopause Society Certified Menopause Practitioner.
She has a special interest in areas often
neglected in women's health: Perimenopause and menopause, the unique needs of
female cancer survivors and those at high risk for breast cancer.
Dr. Menn tells us her story of breast cancer dx at age 28, going through menopause three times and is now a pro-hormone educator.
Dr. Menn discusses taking systemic hormones and her journey and how it has changed her life.
Why are doctors and patients so afraid of hormones?
Doctors are so risk adverse – but let’s talk about the risks of not treating menopause.
The myth that estrogen causes cancer.
How Tamoxifen works.
Breast cancer nomenclature – estrogen positive – this doesn’t mean estrogen caused the cancer – we clarify.
The nuance of being overweight and risk of breast cancer.
The number one killer of women with history of breast cancer is heart disease.
Safety of systemic hormone replacement therapy in breast cancer survivors
Article in Breast Cancer Research and Treatment · January 2022 – Dr Bluming
- "Twenty-five studies of HRT after a breast cancer diagnosis, published between 1980 and 2013, are discussed, as are the 20 reviews of those studies published between 1994 and 2021. Only 1 of the 25 studies, the HABITS trial, demonstrated an increased risk of recurrence, which was limited to local or contralateral, and not distant, recurrence. None of the studies, including HABITS, reported increased breast cancer mortality associated with HRT. Even in the HABITS trial, the absolute increase in the number of women who had a recurrence (localized only) associated with HRT administration was 22. It is on the basis of these 22 patients that HRT, with its demonstrated benefits for so many aspects of women's health, is being denied to millions of breast cancer survivors around the world."
The problem with the HABITS trial.
Why are we scaring women so much about breast cancer?
Who is the right breast cancer survivor to start hormones? A good candidate?
Are we overtreating with aromatase inhibitors?
Podcast partnership today: Always Discreet
https://www.instagram.com/alwaysdiscreet/
Bluming AZ. Hormone Replacement Therapy After Breast Cancer: It Is Time. Cancer J. 2022 May-Jun 01;28(3):183-190.
Young Survival Coalition https://youngsurvival.org/
Vaginal Estrogen for people with a history of breast cancer: https://www.acog.org/clinical/clinical-guidance/clinical-consensus/articles/2021/12/treatment-of-urogenital-symptoms-in-individuals-with-a-history-of-estrogen-dependent-breast-cancer
Dr. Menn is an Alloy Health Medical Advisor and Prescriber www.myalloy.com
https://www.instagram.com/drmennobgyn
https://www.tiktok.com/@drmennobgyn
https://www.facebook.com/drmenn
212. Sex Med and Urology - Top Takeaways at the 2023 AUA conference
Low hormones in men and women — can increase risk for cardiovascular disease
Women have a decreased risk of heart attack and stroke when started on hormones in the safety window of menopause (first 10 years)
The Traverse study paper coming out in two months - can’t wait!
Testosterone is not a gendered hormone
All bones need testosterone
Women in early menopause should be on hormones at least until natural age of menopause to decrease risk of cardiovascular disease, osteoporosis (NAMS guidelines and this indication has FDA approval).
Equality in healthcare
Three new oral testosterone pills on the market for men, not for women
We need to focus on brains and bones health in women just as much as we do for men
Treat women the same in healthcare
Did you know the UK is requiring doctors to talk to their patients at age 50 about menopause? Amazing!
If hormones are so dangerous, why don’t we stop estrogen in trans women after the age of 50 - a thought exercise on how we think about giving hormones to all bodies -
Is staying on hormones during menopause gender affirming care?
Oral DHEA supplements — what’s the deal?
Bulkamid — urethral filler for stress incontinence
ECoin training
Prolapse repair in premenopausal women
Should we offer it or no?
Male infertility is associated with shorter life expectancy
Marijuana affect sperm
Using testosterone for maintenance of vaginal health
Michael Pearlman balance scale of desire
More about Addyi (filbanserin)
Importance of elastin and collagen
Very small percentage of women have cervical orgasms - but it matters.
New technology that @mysteryvibe is releasing to help with period cramps
211. Feeling Broken In The Bedroom? What You Need To Know About Your Sexual Health
Feeling Broken In The Bedroom? What You Need To Know About Your Sexual Health - With Dr. Kelly Casperson
This is an interview I did with Lesley McShane for her podcast “Redesigning Midlife” and it was just such a good interview I asked her if I could share it again.
1. Basics: a. Menopause means it’s been one year and one day since your last period. b. The average age of menopause is around 51. and c. for ten years prior to menopause, women go through peri-menopause, where hormones are doing a reverse puberty.
2. A lot of women stop or have pain during penetrative intercourse during this time due to a decrease in natural lubricant and collagen, but this can be easily treated.
3. Even if you don't have menopause symptoms, if you are over the age of approximately 51, you have gone through it.
4. The most sexually satisfied people aren’t young people, it is people in their 50s, 60s, 70s.
5. Great sex is not a passive thing. It’s an active process, just like someone that is physically fit. It has to be prioritized.
6. Use of lube increases your success of orgasm by 70-80%. Silicone based lube is best because you don’t absorb it like you do the water based.
7. There is no “how long” should I use Vaginal Estrogen cream. The use of it is like using sunscreen or wearing a seat belt.
8. You don’t need a “sex drive”. We do things because they are awesome. If you aren’t having awesome sex, don’t wonder why you don’t desire it.
9. We feel entitled to a spontaneous sex drive that has been sold to us by media. And when we don’t achieve that, we end up feeling broken.
10. Putting something in the vagina only leads to female orgasm 30% of the time so special focus need to be paid to the female body. Your largest sex organ is your brain.
11. Don’t sit passively by waiting for spontaneous desire to happen. Get dressed up and go to the party even if you don’t think you want to. Chances are you’ll have a good time once you get there.
12. Control of stress and cortisol levels in our bodies will help us desire more intimacy.
13. If there is a desire mis-match in your relationship, normalize it by talking about it.
14. Communication with our partner about menopausal symptoms and what we are going through is important to our relationship.
15. Get educated on hormone replacement therapy as an option. When women start thinking about how they want to live as they get older and get educated, then they see how beneficial HRT could be for them.
16. Women between the age of 50-60 that are on hormone therapy live 3-4 years longer than women in the same age group not on hormone therapy.
17. For our young adult children that are starting their own sexual lives, the biggest thing they need to know from the start is about consent.
18. They need to be aware of is orgasmic equality.
19.We have to educate our girls that pleasure is for everybody.
Lesley McShane's podcast: https://podcasts.apple.com/us/podcast/redesigning-midlife-workout-motivation-over-50-weight/id1549596974
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210. Desire, Mindfulness, and Better Sex - With Dr. Lori Brotto
Better Sex Through Mindfulness – Dr. Lori Brotto
Dr. Lori Brotto is a psychologist and Director, UBC Sexual Health Laboratory
Canada Research Chair in Women’s Sexual Health Professor, Department of Obstetrics & Gynaecology, UBC Executive Director, Women’s Health Research Institute
“Sex is not just a deficiency in a hormone” – KJC
Dr. Brotto tells us how she started her sex research career by studying rats.
Do stressed out rats want sex?
“Stress is antisexual” – Dr. Brotto
“So many people don’t even know that they are stressed.” - KJC
Dr. Casperson tells her story about finding mindfulness
How Dr. Brotto discovered mindfulness for helping manage pain, anxiety, and desire
Mindfulness During sex.
How anxiety and depression affects our sexuality. And mindfulness can help!
We talk about medications for low desire in women. Filbanserin specifically.
Beliefs are key! We discuss the role of beliefs on our sex life. Mindfulness helps us “see” our beliefs more.
Anorgasmia – how common it is and what is the most common cause.
How to suss out asexuality versus low desire.
Obligatory sex – how to navigate discrepant desire.
The myth of penis and vagina sex and why it excludes so many people.
Mindfulness for sexuality after prostate cancer.
The role of communication with your partner. Do they even want your erect penis?
Better Sex Through Mindfulness https://amzn.to/42bchpj
Better Sex Through Mindfulness Workbook: https://amzn.to/42abTYc
https://www.instagram.com/drloribrotto/
https://www.cancersexnetwork.org/
https://www.drannekatz.com/
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209. “The Cervix is Dumb” and I Disagree – April Live
“The Cervix is Dumb” and I Disagree – April Live
Giovannetti O, Tomalty D, Gilmore S, Pattison A, Komisaruk B, Goldstein S, Hannan J, Goldstein I, Pukall C, Adams MA. The contribution of the cervix to sexual response: an online survey study. J Sex Med. 2023 Jan 14;20(1):49-56. doi: 10.1093/jsxmed/qdac010
Cochrane review on Cranberry for UTI
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001321.pub6/full
Kisspeptin is a protein that is essential for reproductive hormone secretion and fertility
Male kisspeptin study https://pubmed.ncbi.nlm.nih.gov/36735255/
Sexual Tipping Point
Oral versus Vaginal DHEA
Vaginal DHEA is awesome – it is a prescription
DHEA oral is a supplement – over the counter
- DHEA oral safety - lack of efficacy good enough reason to not take it?
Dehydroepiandrosterone replacement in women with adrenal insufficiency N Engl J Med 1999 Sep 30;341(14):1013-20. doi: 10.1056/NEJM199909303411401. 50mg oral for 4 months – decreased HDL and total Cholesterol Conclusions: Dehydroepiandrosterone improves well-being and sexuality in women with adrenal insufficiency.
Double-blind treatment of major depression with dehydroepiandrosterone Am J Psychiatry 1999 Apr;156(4):646-9. doi: 10.1176/ajp.156.4.646.
Conclusions: These results suggest that DHEA treatment may have significant antidepressant effects in some patients with major depression. Further, larger-scale trials are warranted.
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208. Better Sex Through Lifestyle Changes – Diet, Sleep, Hormones, Exercise – The Galveston Lifestyle
The Third time Dr. Haver is on my podcast!
The role of sleep, diet, exercise and body image on sex is real.
Dr. Haver’s story – she shares her journey of stress, grief and menopause and how “workout more and eat less” wasn’t working for her.
How female body composition changes in peri and menopause
Diets may change hot flashes
Can you measure inflammation?
Fatty liver – goes up in menopause – treatable with diet changes
Anti-inflammatory diet resource: arthritis.org
Supplements for peri/menopause
- Fiber, mag, vit D, omega 3 - - ? DIM ? DHEA
Role of continuous glucose monitors
The loss of estrogen increases gut permeability – role of gut microbiome in bone heath –
Tiktok: drmaryclaire
IG: https://www.instagram.com/thegalvestondiet
Website: https://galvestondiet.com/
The Galveston Diet Book: https://amzn.to/433AsGZ
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Better Sex Through Lifestyle Changes – Diet, Sleep, Hormones, Exercise – The Galveston Lifestyle
Try not to eat like shit.
The role of sleep, diet, exercise and body image on sex is real.
Dr. Haver’s story – she shares her journey of stress, grief and menopause and how “workout more and eat less” wasn’t working for her.
How female body composition changes in peri and menopause
Diets may change hot flashes
Can you measure inflammation?
Fatty liver – goes up in menopause – treatable with diet changes
Anti-inflammatory diet resource: arthritis.org
Supplements for peri/menopause
- Fiber, mag, vit D, omega 3 - - ? DIM ? DHEA
Role of continuous glucose monitors
The loss of estrogen increases gut permeability – role of gut microbiome in bone heath –
Tiktok: drmaryclaire
IG: https://www.instagram.com/thegalvestondiet
Website: https://galvestondiet.com/
The Galveston Diet Book: https://amzn.to/433AsGZ
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207. Emergency Department Care of the Menopausal Female
Emergency Department Care of the Menopausal Female
Dr. Pam Dyne is a Professor of Clinical Emergency Medicine at UCLA David Geffen School of Medicine
Common things midlife women go to the ED for – irregular bleeding and prolapse
Heart attacks present differently in women than in men.
How to work up abnormal vaginal bleeding – questions to ask.
Do ED docs know how to do a pelvic exam?
Indications for a pelvic exam and optimal positioning
Recurrent UTIs, and estrogen possibly 1st line rx so something to keep in mind
Asymptomatic bacteruria - if doc says you have a UTI but you have no UTI sx, question whether abx indicated, pending the urine culture
- change in cognition in elderly human – don’t just treat for a UTI?
Elder abuse – what is it – when to suspect it?
Cardiac symptoms in perimenopause
Heart attacks present differently in women than in men.
“Sometimes a doctor’s job is to tell you what it isn’t” – workups that don’t show anything dangerous.
How to use a tennis ball to do myofascial release for muscle pain
The devastating effects of a hip fracture.
www.instagram.com/drpdyne
Pelleton: singerpam
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206. Increasing Penile Length, How Long Sex Lasts, and Urology YouTube Rockstar Rena Malik, MD
Increasing Penile Length, How Long Sex Lasts, and Urology YouTube Rockstar Rena Malik, MD
Dr. Malik is an associate professor of surgery in the Division of Urology and director of Female Pelvic Medicine and Reconstructive Surgery at the University of Maryland School of Medicine. She has published more than 60 peer-reviewed articles and book chapters.
She has 1.48 Million YouTube subscribers
We go over her most popular videos – most of these questions are “am I normal” questions.
27M views – Scientifically proven ways to increase penile length
Why are men so obsessed with penis size and do women care?
11M views – How long does sex last on average?
10 M views - What exactly is the G spot?
9.4 M views – Can you masturbate too much?
8.9 M views – Can you increase your semen volume?
5.8 M views – Can ejaculating more frequently reduce risk for prostate cancer?
5.7 M views – How to increase testosterone naturally
5.2 M views – Explaining the difference between showers and growers
4.3 M views – Does prostate massage have any health benefits?
3.5 M views – Does science support “no nut November”?
Dr. Malik's Youtube: https://www.youtube.com/channel/UCV66hp0qxx2Xq273N0bo7uQ
https://www.instagram.com/renamalikmd
https://www.tiktok.com/@renamalikmd
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205. Hormone Therapy Position Statement of The North American Menopause Society
www.menopause.org/docs/default-source/professional/nams-2022-hormone-therapy-position-statement.pdf
1) For women aged younger than sixty years or who are within ten years of menopause onset and have no contra indications the benefit risk ratio is favorable for treatment of bother some vasomotor symptoms and prevention of bone loss for women who initiate hormone therapy more than ten years from menopause onset.
2) We discuss safety
3) We discuss decreased mortality in women 50-60 in the WHI trial.
4) We discuss the absolute risk reduction for: all cause mortality, fracture, diabetes, and breast cancer in women aged younger than sixty years
5) Their statement on compounded and pelleted hormones
6) Vasomotor symptoms are assoicated with diminished sleep quality and reduced quality of life
7) Hormones for genitourinary syndrome of menopause
8) We discuss cognition and weight gain
9) The critical window or "healthy cell" hypothesis
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episodes.
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204. Sexual Intelligence: What we really want from sex and how to get it
Joining me for the second time on the podcast is world renowned sex therapist, Dr. Marty Klein – Author and sex therapist to Silicon Valley.
If you want our first episode together check out Episode 169 – where we discuss his book “His porn her pain”
Today we are discussing his amazing book: “Sexual Intelligence: What we really want from sex and how to get it”. This book is 10 years old and still completely relevant. And he is still being interviewed about it!
What is sexual intelligence and why did it need to be written about?
“For a lot of people, sex is an opportunity to fail” – Dr. Marty Klein
How do you navigate when one partner wants something and the other doesn’t – oral during a period, PIV sex, kink?
What is your opinion about the “low desire” epidemic and the meds for low desire.
“Most people leave sex for when they are too tired to do anything else” – Dr. Marty Klein
“In a world that is filled with ice cream and Netflix….why would anyone want sex?” – Dr. Marty Klein
You say in the book PIV has symbolic meaning for hetero people – can you talk about why this limits us?
What to do when sex is boring?
What to do with a partner who won’t communicate about sex? Stonewalling?
26:13 Why Dr. Klein doesn’t like the term erectile dysfunction.
I’m not attracted to my partner any more – they gained weight or are getting older – any help?
Tips for desire discrepancy. Communication and more touch.
https://www.martyklein.com/
Dr. Klein’s book: His Porn, Her Pain https://amzn.to/3IYvIsF
Dr. Klein’s book: Sexual Intelligence https://amzn.to/3WLfYi0
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And get on the wait list for the upcoming "adult sex education master class"
203. March Live - Obligation Sex, Hormones and More
202. Sex Doesn’t Exist In A Bubble – Be Hard To Kill
Dr Jaime Seeman aka Doctor Fit and Fabulous is a board certified OBGYN. She has a passion for fitness, preventative medicine and empowerment not only in her medical practice but in her own life. She has a podcast called The Fit and Fabulous Podcast with Dr Jaime Seeman and a book called Hard to Kill: Master the Mindset to Maximize Your Years
She was last here episode 148: march 2022: - I Want to Be Hard to Kill! - Mindwork with Dr. Jaime Seeman, MD Welcome back! What she has been up to since our last interview. The connection between sex, body image, feeling good, being strong and confidence. How to get a lot done. Finding non-sexual passion in your life. Confidence is built though action – body and intimacy Why our internal language is so important. Muscle is the organ of longevity. Fat makes hormones – why low fat is bad. Helping hypothyroidism with diet. Red meat a more taboo topic than sex? Why do aging people need more protein? The role of collagen, and what supplements are okay? Why does alcohol make you easy to kill? Hard to Kill Manifestohttps://www.doctorfitandfabulous.com
Hard to Kill Book: https://amzn.to/3QiFGst
https://www.instagram.com/doctorfitandfabulous
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201. Sexual Fantasy with Dr. Lehmiller
Why research Fantasy?
Should we normalize fantasy? So many people feel shame or like they are cheating.
Are there hormones correlated with sexual fantasy?
What are Americans Fantasizing about?
Shame about fantasy – and who feels more ashamed.
Our our fantasies actually truth and should we act on them?
The difference between fantasy and desire.
Just because you have a fantasy about a threesome – should you do it?
Humans are poor predictors of future emotional states – Justin Lehmiller
What do people mean when they talk about “getting the spark” back. And is there a role for fantasy.
Sex quality versus quantity.
In his book Dr. Lehmiller talks about self disclosure and building trust….but it can seem fraught with backfire potential.
Should you share your fantasy with you partner? How do you know if it is safe?
Novelty – seems so simple but people have the same sex week in and out. Research shows couples who engage in the most acts of novelty tend to be the most sexually satisfied and the most successful at keeping the passion alive.
The most common fantasy and the one that doesn’t work out well when done in real life – threesomes.
Tell Me What You Want: The Science of Sexual Desire and How It Can Help You Improve Your Sex Life amzn.to/3ZkDW5K
Sex and psychology podcast
podcasts.apple.com/us/podcast/sex-and-psychology-podcast/id1505460817
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200. Talking about Sex and Menopause Is An Act Of Rebellion – With Dr. Gilberg-Lenz
Episode 200!!!!
Suzanne Gilberg-Lenz, MD works at the Women’s Care of Beverly Hills, an obstetrics and gynecology practice that has locations in Beverly Hills and Redondo Beach, California.
Dr. Gilberg-Lenz is involved in women’s empowerment and public education and frequently appears as an expert in women’s health and integrative medicine on TV, in print, and online.
Her book Menopause Bootcamp: optimize your health, empower your self, and flourish as you age is out now.
Why is talking about menopause an act of rebellion?
How many doctors know how to treat menopause and how to find an expert?
We discuss the role of communication and how it builds intimacy.
Normalizing how varied sex can be and getting out of the heteronormative narrow view of penetrative sex.
The role of declining estrogen and giving less fucks.
How can menopause be an opportunity?
Mainstream medicine has a woman problem – and the painful truth is that science fails us.
Why we do not recommend pellets?
How to talk to your doctor about menopause?
Why does no one care about heart disease?
https://www.menopause.org/
https://www.instagram.com/askdrsuzanne
https://www.instagram.com/themenopausebootcamp/
Menopause Bootcamp: Optimize Your Health, Empower Your Self, and Flourish as You Age https://amzn.to/3m5ZJzn
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199. Man Up – For Your Other Half – Men’s Sexual Health
Dr. Dubin is a fellowship-trained urologist and andrologist focusing on men’s health. He cares for men with fertility problems, sexual issues (erectile dysfunction, premature ejaculation, delayed ejaculation, etc.), Peyronie’s disease, low testosterone, testicular pain and other problems involving men’s genitalia.
He wants to help men understand that the issues they face are normal and help them find solutions that fit their lifestyle and life goals.
In addition to providing individualized patient care, he is also passionate about providing helpful information to the community. He co-hosts a podcast, “Man Up — A Doctor's Guide to Men’s Health,” in which he discuss various men’s health topics.
Why don't men go to the doctor?
Where do men get most of their sex ed from?
Figuring out the difference between erections, orgasm, ejaculation (and refractory time) and desire.
The five things you need to get a good erection.
The role of testosterone and libido and erections.
Taking testosterone can cause infertility in 60% of men.
Once you take Testosterone are you going to be on it forever?
When a man goes to the doctor for Viagra, should the doctor ask about the partner?
We need more people talking about intimacy without an erect penis.
And if you are comfortable - what to do when you penis doesn't work - I hear over and over about men being able to orgasm with a soft penis and I need some info on this! Are you the person? So many people think sex is over when the penis doesn't work and I need someone to tackle this difficult topic.
Dr. Dubin did a study looking at women getting blamed for their partner’s erectile dysfunction. 1 out of 7 women were blamed.
Tips for when your male partner doesn’t want to talk about intimate issues.
What is with products that make you make more semen?
What is with penis enlarging procedures?
Social media inaccuracies with men’s health – sperm retention!
Does ejaculating decrease prostate cancer?
Does vasectomy cause prostate cancer?
https://www.instagram.com/themanuppod/
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198. "Use It Or Lose It" Needs To Die and February Live Podcast
Is bigger always better?
The “use it or lose it” myth needs to die.
Vaginal atrophy is a hormonal issue.
Are orgasms good for you?
Can I use vaginal estrogen more than twice a week?
Tips and tricks for vaginal estrogen.
Can you still get BV and yeast infections after menopause?
Painful sex and low libido after a LEEP procedure.
Hi I have a question! I just saw my gynecologist , she has me on vaginal estrogen. I asked if I can go on the estrogen patch she advised me that I don’t need to be on the patch that the tabs are what I need! I’m sorry I should have said explained i had a hysterectomy in my 40’s they left my ovaries a year later I was told I was in full menopause! I’m 60 now and only started vaginal estrogen a year ago due to me complaining about painful intercourse. Should I also be on the estrogen patch.
I’m only 22 and suspecting a stage 3 prolapse . I’m pretty sure I’ve unintentionally caused it due to straining on the toilet,etc. I wanted to know- can I still get pregnant? And can my prolapse heal itself?
Who needs systemic estrogen versus only vaginal estrogen?
The multiple reasons we are undertreating menopause.
I’m a 62 year old guy. Married to a beautiful soul for 40 years. I’d love to get her your book. But, I don’t wanna come off as being “that guy.” Do you have any suggestions?
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197. 2023 Hormone Education 101
Hot off the back of the New York Times Magazine Feb 1st on Menopause Hormones - I gave a lecture to my local medical society about hormones. It is a nice overview and I hope you enjoy it!
2) treatment of vasomotor symptoms
3) treatment of premature ovarian insufficiency (going into menopause prior to age 40)
4) GSM
how did we get to the point where we thought estrogen caused cancer? what does hormone therapy help? the longer you go without estrogen, your arteries develop a fatty streak or plaque who can’t be on HRT who can be on HRT Best practices for hormone replacement therapy Non oral estrogen vs oral estrogen Unanswered questions we have about hormones
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196. ChatGPT and How to Get My Partner to Have More Sex with Me
Happy ONE MILLION DOWNLOADS!
So I asked ChatGPT to help me write a podcast episode, and I think AI nailed it!
How can iIget my partner to have more sex with me?
1. Communicate openly: Have a conversation with your partner about your needs and desires. Share your feelings and listen to their perspective. It's important to approach this conversation in a non-confrontational and non-judgmental way.
2. Understand their perspective: Your partner may have different needs or desires when it comes to sex. Try to understand their perspective and see if there are any underlying issues that may be affecting their interest in sex.
3. Show affection: Show your partner that you care about them and appreciate them. This can help build a stronger emotional connection and make them more likely to want to be intimate with you.
4. Be spontaneous: Surprise your partner with a romantic gesture or plan a special date night. This can help reignite the spark in your relationship.
5. Look at your relationship: Reflect on your relationship as a whole and see if there are any factors that may be affecting your partner's interest in sex, such as stress, fatigue, or relationship issues.
6. Seek professional help: If you and your partner are unable to resolve the issue on your own, consider seeking the help of a couples therapist or sex therapist. They can provide guidance and support to help improve your relationship.
7. Be patient: Remember that change takes time, and it's important to be patient and supportive of your partner.
It's important to remember that every relationship and every person is different, and what works for one couple may not work for another. Communication and mutual understanding are key to addressing any issues in a relationship, including sexual intimacy.
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195. 8 Truths About Hormones
I get so many hormone questions! So I needed a podcast to refer people to.
I hope I did okay covering the basics and deep diving into some more complicated details.
Enjoy!
1. Sex and Menopause
2. Systemic versus Vaginal Hormones
3. Estrogen Doesn't Cause Cancer
4. We gendered hormones and how this hurts women
5. Natural is a weapon waged to keep us in our place
6. Pellets and compounds are to be avoided if better options are available
7. You never need to stop hormones
8. The FDA will not help us (the two cases of Testosterone and Alzheimer's disease).
(bonus) I hate the word "balanced" when discussing hormones. Pro tip - people are probably just trying to sell you something.
Paganini-Hill A, Henderson VW. Estrogen deficiency and risk of Alzheimer's disease in women. Am J Epidemiol. 1994 Aug 1;140(3):256-61
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194. Blaming Her For His ED, UTIs on Social Media, Sex Toys in the Middle East, Female Testosterone Guidelines and More - January Live Podcast
Blaming Her For His ED, UTIs on Social Media, Sex Toys in the Middle East, Female Testosterone Guidelines and More - January Live Podcast
Vanessa and Xander Marin’s survey – over 54,000 people - their Sexual Frequency Report
They were on my podcast # 181 – sex talks with social media’s sex educators
Justin Dubin’s paper on Blaming women for erectile dysfunction
Examples of misinformation found on YouTube and tiktok videos regarding urinary tract infection
Sex toys in the middle east
Mindfulness with Female Sexual dysfunction
Clinical practice guidelines for use of T in Women
https://www.tandfonline.com/doi/epdf/10.1080/13697137.2021.1891773?needAccess=true&role=button
Justin M. Dubin, MD, W. Austin Wyant, MSc, Navin C. Balaji, BE, Iakov V. Efimenko, BSc, Quinn C. Rainer, BA, Belen Mora, BA, Lisa Paz, PhD, Ashley G. Winter, MD, Ranjith Ramasamy, MD, Is Female Wellness Affected When Men Blame Them for Erectile Dysfunction?, Sexual Medicine, Volume 9, Issue 3, June 2021, Page 100351
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193. Why Good Sex Matters Author Nan Wise, PhD
I have the good fortune of talking with Dr. Nan Wise, PhD, author of "Why Good Sex Matters"
https://amzn.to/3GaubA5
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192. Happy Third Birthday and New Year's Resolutions!
Happy Third Birthday and New Year’s Resolutions
- Will hit 1 million in January!
New year’s wishes
- Male birth control
- Say no and have it be okay
- Vaginal E for everyone who wants it
o Good Rx
Estradiol 0.01% 42 G tube
o Amazon Pharmacy – 28.13
Interlude – get interlude
20 off your first order
- Decreased fear around estrogen
o Peter Attia podcast Episode 42interviewing Estrogen Matters Dr Avrum Bluming and Carol Taveris Phd
https://peterattiamd.com/caroltavris-avrumbluming/
2021 update from the authors
- :the WHI has walked back virtually all of their early alarmist findings. In recent publications, they reported that estrogen does not increase “all cause mortality” or deaths from heart disease and cancer. Actually, they said, it increases longevity, most notably when begun within ten years of the last menstrual period. It is the best preventative for osteoporotic hip fracture. It is safe and effective when applied vaginally for local symptoms. And, in the most striking about-face from their 2003 headlines that HRT “did not have a clinically meaningful effect on health-related quality of life” for women in menopause, they stated in 2019 that “Hormone therapy is the most effective treatment for managing menopausal vasomotor symptoms.”
- Desire mismatch is not a problem
- Orgasmic equality
- Hope is not a game plan
o Wishing your desire was different does nothing – it does worse than nothing
o Resisting reality, resisting what is
- Healthy relationship with your body
o Speak kindly
o Sleep, exercise, food
o Stop shoulding all over your body
- Healthy relationship with sex
o Stop shoulding
o Stop doing it for other people
o Be present
o It is okay to fail, to not feel like it
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191. Discovering the snake clitoris, start your hormones early, and the Economist talks about sex
Happy December live podcast.
I talk about snake clitorises, human clitoris nerve endings, why the American Heart Association wants you to start hormones early, and sex has gone mainstream as the Economist talked about it!
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190. Sex Ed for health care providers 101 - a Dr. C Lecture
I know you are an advanced audience and can handle graduate level work!
Enjoy!
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189. Sex and Grief - Common Myths
Krista St-Germain is a Master Certified Life Coach, Post-Traumatic Growth and grief expert, widow, mom and host of The Widowed Mom Podcast. When her husband was killed by a drunk driver in 2016, Krista’s life was completely and unexpectedly flipped upside down. After therapy helped her uncurl from the fetal position, Krista discovered Life Coaching, Post Traumatic Growth and learned the tools she needed to move forward and create a future she could get excited about. Now she coaches and teaches other widows so they can love life again, too.
The brain love interpretation and drama.
Tell us your story of how you became a coach for widowed moms.
How to define grief – a natural response to perceived loss.
When sex is appropriate while grieving?
How does grief work?
Grief is not golf.
How to respond to someone experiencing grief.
“Feelings are not problems to solve” – Krysta St. Germain
8 myths about sex and grief
- You just want physical touch, not sex
- If you want sex again it means you didn’t love your person of loss
- The first year is the hardest/you shouldn’t have sex the first year
- If you don’t want sex there is something wrong with you
- You should wait for sex until you are done grieving
- If you want sex then you must be trying to escape your grief
- Escaping your grief is wrong
- You can have sex again until it is “the one”
- You aren’t ready to have sex until you don’t have strong emotions
Sex after a health diagnosis
https://www.instagram.com/lifecoachkrista/
coachingwithkrista.com
https://podcasts.apple.com/us/podcast/the-widowed-mom-podcast/id1468127632
https://www.facebook.com/coachingwithkrista/
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188. Making Sex More Awesome: Interview With A Sexological Body Worker
Meet Sylvie B – a sexological body worker in training!
Many people struggle in their intimate relationships, whether because of pain,
perceived dysfunction, loss of libido, mismatched libido and, most pervasively, shame. Many people have also experienced trauma, low self-esteem, and frustration over the limits to their pleasure.
Somatic sex education is about exploring our sexual challenges through breaking down the
autopilot and the worn out old patterns we rely on for whatever reason, which limit our erotic pleasure and full self-expression.
Good sex more than just the absence of pain.
Why do people come see a sexological body worker?
What is Somatic Sex Education and sexological bodywork?
Not many people are used to being asked how they would like to be touched. Some people get really frustrated because they realize they just don’t know. And that they have never looked too deeply into that. That can bring up feelings of guilt or shame.
Tips for squirting
How do you want to feel during sex?
Tips for tuning in to the very subtle frequency of what people actually desire.
What to do when people feel numb?
How do we emerge from shame and trauma?
How do we set and communicate boundaries as women in our relationships?
The pleasure of the soft cock – what to tell men with ED. What to do.
Let’s talk about this problem – middle age pelvis – menopause versus viagra
Find Out More
https://somaticsexeducator.com/
https://www.instagram.com/s3xandsensibility/
https://mysexandsensibility.com/
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187. Sex After Breast Cancer
Dr. Becky Lynn is back! Previous on Episode #44 and #43 where we talked about vaginismus and endometriosis and sex after breast cancer (44) and hormones (43). So check them out!
She is the founder of Evora Women’s Health in Missouri
Dr. Lynn recently authored the paper: Low Sexual Desire in Breast Cancer Survivors and Patients: A Review
- Sexual dysfunction is 30-100% of women with breast cancer. And low desire is 5-87%
- What happens when we do surgery on the breasts
o Does it matter if we had radical mastectomy versus lumpectomy, with or without reconstruction?
- Role of Chemotherapy on sexual function
- Role of anti-estrogen meds on sexual function
- Role of couples therapy
- Data on vaginal moisturizers on sexual function
- Role and safety of vaginal estrogen after breast cancer treatment – ACOG statement paper
- Trial of Bupropion – open study shows improvement – randomized controlled trial versus placebo pending
- Role of vaginal testosterone cream in pts on Aromatase Inhibitors – lowers estrogen in the body
- There is a study looking at intravaginal DHEA on sexual function in breast cancer
- Abstract at ISSWSH on Addyi (filbanserin) in breast cancer population
- Role of hormones after breast cancer
Dr. Lynn is a proponent of medical marijuana for better sex 34% OF WOMEN WHO REPORTED USING MARIJUANA BEFORE SEXUAL ACTIVITY SAID IT INCREASED THEIR SEX DRIVE, IMPROVED ORGASM, AND DECREASED PAIN.Luo F, Link M, Grabenhorst C, Lynn B. Low Sexual Desire in Breast Cancer Survivors and Patients: A Review. Sex Med Rev. 2022 Jul;10(3):367-375.
website: https://evorawomen.com/
FB/IG @evorawomenshealth
TikTok: @dr.beckylynn
FB/IG Becky Kaufman Lynn, MD
YouTube: search Dr. Becky Lynn
YouTube: search Evora Women's Health
Twitter: @Becky Lynn
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186. A Banned Book, Helping the Next Generation, and Closing the orgasm gap by 2040
Dr. Carrie Leff is a practicing Internist and Pediatrician in Michigan. She is passionate about Adolescent and Women's health. Dr. Leff is on a mission to educate teens about their bodies and to help parents become more comfortable with difficult conversations with their kids. She is the mother of 3 daughters, a professional multi-tasker and a believer in the power of women.
Dr. Leff co-wrote Celebrate Your Body 2: The Ultimate Puberty Book for Preteen and Teen Girls in 2019. It is a #1 Best seller in in Teen & Young Adult Health Books on Sexuality & Pregnancy on Amazon.
We met at the ISSWSH conference March 2022 in Texas – we were both giving lectures.
“Mommy, I feel like you wrote this book just for me” – Dr. Leff’s daughter
Why she wrote this book and created a program about puberty?
How puberty is like menopause.
She discusses when puberty starts and what first signs are.
What does an all-American puberty education in a public school look like?
“Talking to your kids should be 30 one minute conversations, not one 30 minute conversation” – Dr. Leff
“Our kids aren’t connecting puberty and sex unless we make that connection for them” – Dr. Leff
If you can’t/won’t discuss puberty with your kids then you are teaching them that you aren’t a resource for this information.
I love how you call private parts “personal parts” – why is this important?
So many middle aged women have body shame – when does this start?
How she found out her book was banned.
Consent – example of trying a shirt on at a store - - so important – many middle age women don’t practice consent.
How to close the orgasm gap by 2040 – her plan
A golden question, “how will you know you are ready to have sex?”
Moms buying teens their first vibrators – thoughts and her experience
You didn’t bring up birth control – when to bring it up, how to bring it up, resources for adults.
You wrote an op-ed for the Washington post about your book getting banned: “Some parents believe that telling children the truth about sex and our bodies will spoil their innocence. But innocence and ignorance are not the same.”
Celebrate Your Body 2 Book: https://amzn.to/3dLZzc7
https://turningteen.com/
https://www.instagram.com/drcarrieleff/
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185. Scream Cream, Hormones as Prevention, and How Many Nerves the Clitoris Has - NOV LIVE PODCAST
So Many good topics in the November Live Podcast!
USPSTF opinion on hormones for primary prevention of disease.
https://jamanetwork.com/journals/jama/fullarticle/