Podcast
You Are Not Broken
Hosted by Kelly Casperson, MD · EN
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 partners through science, mindset, and a whole lot of humor. Whether you’re navigating perimenopause, rediscovering desire, or just curious what’s possible, this show will remind you: you are not broken. (No medical advice here, just truth bombs and good conversation.)
67episodes
Episodes
Newest firstAll episodes
373. Sexual Health: Cervix, Vulva, and Vulvodynia Research
4d ago00:56:14Summary readyFrom 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
Summary372. Deprescribing Antidepressants
2w ago00:47:22Summary readyIn this episode, Kelly interviews Dr. Mark Horowitz, a psychiatrist and author, about the long-term impacts of antidepressants, the challenges of coming off these medications, and the future of deprescribing. This conversation sheds light on why many people remain trapped on these drugs and what can be done to change this reality. Key Topics: The origins of Dr. Horowitz's involvement in deprescribing and his personal experience The widespread use of antidepressants in America and the long-term health risks How withdrawal symptoms can be mistaken for a need to stay on medication The insidious side effects of antidepressants, including weight gain, sexual dysfunction, and increased risk of fractures The lack of long-term studies and regulatory oversight on the effects of antidepressants The importance of informed consent and alternative treatment options How marketing and legal factors influence prescribing habits Strategies for safe tapering and support resources for deprescribing The evolving awareness and cultural shift regarding antidepressant risks Deprescribing book https://markhorowitz.org/ 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
Summary371. You Could Be Having Better Sex
3w ago00:43:48Summary readyWhat if the secret to better sex isn't a new position or a fancy toy — it's simply showing up as yourself? In this episode, Kelly sits down with Nicole McNichols, a sexuality researcher and educator whose work bridges the gap between what science knows about female desire and what most of us were never taught. Together they unpack why women lose desire in long-term relationships (hint: it's not broken — it's biology meeting culture), what "heated rivalry" actually means for female attraction, and why spontaneous desire is more myth than reality for most women. This is the kind of honest, research-backed conversation your sex ed class should have been. The "heated rivalry" phenomenon — how competition and social comparison can actually activate female desire, and what that tells us about our evolutionary wiring Spontaneous vs. responsive desire — why waiting to "feel like it" may be the #1 intimacy killer in long-term relationships The taco metaphor — a reframe on why novelty matters for sustaining desire (you'll never think about tacos the same way again) Female anatomy 101 — the internal clitoris, female erections, and the structures your doctor probably never mentioned Hormones and midlife sexuality — how perimenopause and menopause reshape desire, and why hormone therapy can be genuinely life-changing Pleasure as medicine — the neuroscience of why pleasure regulates your nervous system and supports overall health Flow states and intimacy — how to cultivate the focused presence that makes sex feel connected rather than performative The mental load problem — why unequal household labor is a libido killer backed by actual data What college students are actually doing — Nicole's research on porn's influence on sexual expectations and the urgent case for comprehensive sex ed Communication as foreplay — why the conversations before, during, and after sex matter as much as the sex itself You Could Be Having Better Sex book https://www.instagram.com/nicole_thesexprofessor/ 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
Summary370. Microbiomes & Menopause: What’s Really Driving Your Symptoms?
4w ago00:47:20Summary readyThe Gut-Brain-Hormone Connection in Midlife with Cynthia Thurlow - Explore how hormonal shifts, the microbiome, and lifestyle factors intertwine to impact women's health during midlife. Cynthia Thurlow shares insights on gut health, hormone therapy, and debunks common misconceptions. This episode offers practical advice for optimizing wellness through personalized approaches. Key Topics: The emerging importance of the gut microbiome in menopausal health How hormones like estrogen influence colon cancer risk and overall health The role of lifestyle factors (diet, stress, antibiotics) on microbiome integrity Advances in hormone therapy, including the potential for microbiome restoration The impact of medications like GLP-1 agents on inflammation and weight Strategies for improving digestion, stool health, and addressing SIBO The myth of genetics being destiny—hormones as a modifiable factor Predatory practices in vaginal health treatments and how to ensure informed choices The significance of fiber: how to increase it safely and effectively Practical daily habits to support gut motility and overall wellness Menopause Gut Book IG for Cynthia Thurlow, NP 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
Summary369. Perimenopause, Testosterone and AMA with Dr. Casperson
May 301:06:36Summary readyEpisode 369: Dr. Kelly Casperson, interviewed by Sara Reardon What happens when a urologic surgeon who has spent years treating women's bladder and sexual health sits down to answer every question she wishes her patients had asked sooner? You get this episode. In a role reversal from her usual hosting chair, Dr. Kelly Casperson is interviewed by Sara Reardon for a wide-ranging, myth-busting conversation on perimenopause, hormone therapy, and what it actually means to advocate for yourself in a medical system that has historically under-served women. No gatekeeping. No fear-mongering. Just the science, the nuance, and the permission to want more. Perimenopause is not just hot flashes. The hormonal shifts of perimenopause and menopause affect your bladder, your sleep, your joints, your skin, your mood, and your sex life — often years before your period stops. Kelly breaks down what's actually happening biologically and why so many women are told their symptoms are "just aging." Local estrogen and systemic HRT are not the same thing — and you may need both. Vaginal estrogen treats the tissue. Systemic hormone therapy treats the whole person. Kelly explains the difference, who benefits from each, and how to have an informed conversation with your provider about what's right for you. DHEA and testosterone belong in the conversation. These hormones are not just for men. Kelly covers the evidence for testosterone and DHEA in women's health — including delivery methods, indications, and why so many women are never offered them. Finding a knowledgeable provider is hard. Here's how to do it. Not every clinician is trained in hormone therapy. Kelly talks about how to identify providers who are, and how to self-educate enough to advocate effectively in any appointment. Gut health, exercise, and alcohol all matter — but not instead of hormones. Lifestyle strategies can amplify hormone therapy; they're not a replacement for it. Kelly cuts through the supplement noise and explains what the evidence actually supports. Gender bias is real, and naming it is the first step. From the Women's Health Initiative fallout to the way women's pain is routinely minimized, Kelly addresses the systemic forces that have shaped (and limited) what women are offered — and how to push back. 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
Summary368. Brains and Hormones
Apr 2600:49:55Summary readyUnlocking Brain Health: Insights with Dr. Louisa Nicola. Explore the fascinating world of neuroscience and preventative health with Dr. Louisa Nicola, a neurophysiologist dedicated to understanding and combating neurodegenerative diseases like Alzheimer’s. This episode dives deep into brain biology, the impact of hormones, lifestyle factors, and cutting-edge research on neuroprotection. Top takeaways: How neural networks and algorithms sparked her love for the human brain The critical distinction between dementia and Alzheimer’s disease Recent advancements in understanding amyloid beta and tau proteins The role of lifestyle, hormones, and genetic factors in preventing dementia The influence of sex differences and hormone levels on neurodegenerative risk The impact of sleep, inflammation, and infections like shingles on brain aging Emerging research on preventative strategies, including vaccines and supplements like creatine https://www.instagram.com/louisanicola_/ 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
Summary367 - Brick House Bones - How to strengthen bones with PT
Apr 1900:42:39Summary readyIn this episode of You Are Not Broken, Dr. Kelly Casperson sits down with physical therapist Dr. Lisa Moore, an expert in bone health, for a conversation that reframes how we think about osteoporosis—from something to fear… to something we can actively influence. If you’ve ever been told to “be careful” or “avoid injury” without being given a clear path forward, this episode is your antidote. Dr. Moore brings clarity, science, and practicality to a topic that is often clouded by confusion and limitation. Why physical therapists are essential to bone health Physical therapists are uniquely trained in the musculoskeletal system—bones, muscles, and joints. Dr. Moore explains how this expertise allows them to guide patients not just in recovery, but in building strength, resilience, and confidence in their bodies. Working with women undergoing breast cancer treatment, Dr. Moore saw firsthand how certain therapies increase the risk of osteoporosis and fractures. Instead of accepting this as inevitable, she pursued deeper education and now empowers women with actionable strategies to protect and rebuild their bone health. Why balance training is non-negotiable Most fractures don’t happen because bones are weak alone—they happen because people fall. Dr. Moore shares why dynamic balance training (not just standing on one foot) is critical, and how practicing real-life movement scenarios can dramatically reduce fall risk. The underrated power of… power training Strength is important—but strength plus speed is what keeps you from falling. Power training helps your body react quickly and effectively, which is essential for maintaining independence and longevity. Why your starting point doesn’t matter as much as you think Dr. Moore emphasizes the principle of initial values: those starting at a lower baseline often see the greatest gains. Translation? It’s never too late to start, and your body is more adaptable than you’ve been led to believe. How to stay active without rigidity (even while traveling) Fitness doesn’t have to mean perfection. Dr. Moore shares how she balances structured workouts with joyful movement like hiking and swimming—reminding us that consistency over time matters more than any single workout. The truth about osteoporosis: it’s not fixed One of the most empowering takeaways—bone health is dynamic. With the right interventions, you can improve bone density, strength, and function. This is not a one-way street. YouTube: https://www.youtube.com/@DrLisaMooreDPT Instagram: https://www.instagram.com/drlisamooredpt/ 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
Summary366. Coaching, Training Trauma, and Becoming with Dr. Smith
Apr 1200:56:30Summary readyIn this episode of You Are Not Broken, I sit down with Dr. Sunny Smith — physician, coach, and fierce advocate for women in medicine — for a conversation that felt both deeply personal and urgently necessary. We talk about the transformative power of coaching and why so many high-achieving women still struggle with self-doubt. If you’ve ever downplayed your accomplishments, hesitated to speak up in a room full of men, or questioned whether you’re “expert enough,” this episode is for you. Dr. Smith and I share personal stories from our own careers that highlight the subtle (and not-so-subtle) gender dynamics embedded in medical culture. We explore how women physicians are often socialized to overwork, over-give, and under-claim their authority — and how that conditioning impacts not only our careers, but our health. This conversation is about agency. It’s about recognizing that your thoughts create your feelings, your feelings drive your actions, and your actions determine your results. If you believe you’re “not ready,” you’ll play small. If you believe you belong, you’ll act differently — and the world will respond differently. We also talk about: Why coaching works (especially for high-achieving professionals) How women are conditioned to minimize their expertise The cost of self-abandonment in medicine Gender bias in healthcare — both as physicians and as patients What it actually means to advocate for yourself Why questioning limiting beliefs is a radical act The ripple effect of empowered women physicians This episode isn’t about blaming the system. It’s about understanding it — and then deciding who you want to be inside of it. Because when women own their expertise, take up space, and stop apologizing for their ambition, everything changes — for us, for our patients, and for medicine itself. You are not broken. You are powerful. And you’re allowed to act like it. Dr. Smith's Empowering Women Physician 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
Summary365. The Awakened Brain
Apr 500:49:20Summary readyIn this episode of You Are Not Broken, I sit down with Dr. Lisa Miller — psychologist, researcher, and author — to talk about something we don’t discuss enough in medicine: spirituality as a measurable, protective force in women’s lives. Not religion. Not dogma. But spirituality — the innate human capacity to feel connected, guided, and held in meaning. And friends… this one is powerful. Dr. Miller shares the science behind spirituality, including data showing that an active spiritual life can dramatically reduce the risk of depression, substance use, and hopelessness. We talk about how spirituality isn’t fluffy — it’s neurologically real, biologically protective, and especially alive in women. I loved this conversation because it reframes struggle. So many of us think our hardest seasons mean we’re broken. What if they’re actually the doorway? We discuss: Why every woman is a Ferrari — powerful, finely tuned, and built for depth The research showing spirituality cuts depression and addiction risk How crisis can become spiritual awakening The concept of “high counsel” — the guidance that is available to us when we’re willing to listen Why engaging with our feelings (instead of bypassing them) is the path forward The unique spiritual intelligence women carry Why men often struggle differently in their spiritual development Post-traumatic spiritual growth And how to cultivate your innate spirituality without subscribing to anyone else’s rulebook One of my favorite takeaways? Spirituality isn’t something you earn. It’s something you remember. We talk about how women are often socialized to disconnect from their inner voice — from intuition, from knowing. Reconnecting to that voice is not indulgent. It’s medicine. This episode isn’t about telling you what to believe. It’s about reminding you that you are wired for meaning. And that you are never alone in your becoming. If you’ve been walking through something hard… If you’ve felt unmoored… If you’ve wondered whether there’s something more… This conversation is for you. The Awakened Brain by Dr. Miller 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
Summary364. Marriage, Midlife and Staying Connected with the Whites
Mar 2900:57:34Summary readyIn this episode of You Are Not Broken, I sit down with Dr. Kate White and Jay White to talk about something we don’t discuss enough: what actually happens to marriages in midlife. Because midlife isn’t just hot flashes and hormones. It’s identity shifts. Career pivots. Aging parents. Changing bodies. Evolving desire. And if we don’t talk about it, it can quietly unravel connection. We explore how hormonal changes — especially in perimenopause and menopause — can significantly impact intimacy, mood, and relational dynamics. When libido shifts or sex becomes uncomfortable, couples often misinterpret it as rejection instead of biology. That misunderstanding creates distance. We talk about how communication — real, vulnerable, scheduled communication — is essential. Not just “How was your day?” but “How are we doing?” So many couples assume the other person should just know what they need. They don’t. Curiosity is a skill. We also discuss: Why midlife is often framed negatively — but can actually be deeply transformative The common pattern of women initiating divorce when they feel unseen or unheard The difference between sex and intimacy — and why emotional closeness fuels physical connection How counseling can create a safe space to untangle resentment and rebuild trust Why adapting to change — instead of resisting it — is key to long-term partnership One of the most powerful themes of this episode is that midlife doesn’t destroy marriages. Silence does. When couples understand what’s happening — hormonally, emotionally, relationally — they can respond with compassion instead of blame. Marriage in midlife requires evolution. It requires honesty. It requires both people staying curious about who their partner is becoming. And when that happens? Midlife can be a season of deeper connection — not disconnection. https://www.headsandtailspodcast.com/ 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 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
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