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Welcome to the youe Are Not Broken podcast.
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I'm your host, Dr. Kelly Casperson, a
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board certified urologist, thought leader and conversation
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starter on midlife living, hormones and sexuality. Enjoy the show.
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Hey everybody. Welcome back to the you Are Not Broken podcast. I am Dr. Kasperson. I am on Instagram, I am on podcast. Maybe more YouTube in 2025. We'll see. So today I'm going to record. First of all, I'm going to review some things because I don't have an events page up on my website yet and it's time. So for the time being, this gets to be my event page. So January 29, Bellevue, Washington, M Factor documentary screening, followed by me on stage chatting a little bit and then doing Q and A. That is sponsored by Cary Grann and other amazing menopause organizations. Check out my show notes or check out the link in the Instagram bio for that. January 29th in Bellevue, Washington. Next one is March 1st. Sydney, Australia. We just announced. The surprise is out. We just announced Dr. Mary Claire Haver is joining us. Yay. So that it was about halfway sold out anyways and we're only two months away and now it's going to go. So if you are near Sydney, Australia for March 1st and want to see us at the Sydney Opera House, please come. It'll be amazing. Next one is May 16th and 17th in Miraval, Arizona. I'm doing a retreat. I will be joining Dr. Ellen Gendler and Dr. Lauren Stryker. So urologist, gynecologist and dermatologist walk into a five star resort and we're gonna talk about all the things, sex, skin, hormones, midlife muscles, probably hair, probably 50 seats for that. That is all comers. You do not have to be a medically related person. There is no cme. If you are a medical person, you know what that is and there isn't that there. And then if you do want more, how do I prescribe? How do I take care of patients? How do I get CME? For this knowledge, come to my retreat in Sedona, Arizona, October 17th through 19th. Done with Ascend retreats. She's amazing. So you can go to Ascend retreats on Instagram or my bio or link here. Somebody just said, are you coming to Florida? I actually got a DM today about coming down. So I. So Florida's calling because I actually got a message from a acquaintance in Miami this week who wanted me to fly down for February and I'm like, dude, February is like tomorrow in my land. I book out things ahead of time. So I said no to Miami and then I, and then I just somebody From Tampa just DM'd me about doing some podcasts and I said, let me learn, learn more, see what's up with Tampa. So stay tuned for that. Nashville. Always, always. I'm always manifesting Nashville and I love Boston a great deal. I'm on the West Coast. There's not going to be much LA and California happening for a while. Highly, unfortunately. I hope you guys are safe and know that we're thinking of you. Shout out to my brother who is a amazing podcaster. He's number seven on Spotify and Science Today, number 17 on Apple and Science with his podcast called the Hotshot Wake up. Because he is basically the news for W line firefighters. And LA is needing all the news on what the amazing work that the firefighters are doing. So shout out to my brother and keeping people with accurate information on what's going on with the California fires. So that's the story. The topic of today's podcast, Things I Wish would change. I have 14 things that I Wish would change. We'll see if you guys have any, if any more pop into my brain by the end of this. But why don't we try to get through 14 things I wish would change. And this is through my lens of physician, urologist, sex med, hormone expert. So the US adopting the metric system is not on there. It is not in my top 14, although it's probably in my husband's top three. All right, so number one, this is in no particular order by the way. This was like thought download order. So you can order these as you want, but in no particular order. 14 things that I wish would change. Number one, hormones after breast cancer. I'm pro choice. I'm pro choice. And what I mean by that is your body has been cured from cancer. Your quality of life sucks. You made it through something horrific. You should be able to choose if you want to take hormones. And by the way, data doesn't support that hormones make cancer come back. So I also think you shouldn't drink alcohol after. Ooh, alcohol. Is alcohol on my list? Let's add. We're gonna do 15 things. Look at that. Okay, number 15 added. So number two, female dosed FDA approved testosterone product. Plug for the testosteroneproject.org if you want to go to the website to learn more about that or testosterone, the Testosterone Project on Instagram and follow that because that is our nonprofit group for getting the testosterone things done. So the Testosterone Project. I know that there is companies working on a female Dose testosterone, FDA approved testosterone product. I think it's going to be in a pink box and be 500 and I'm probably still going to compound and use the cheaper stuff anyways. But that's not the point. The point is that we have data, we have safety data, we have efficacy and it legitimizes the use of the hormone for women. So I'm very excited to do it. And some people's insurance will cover it. It'll be cheap, it'll be great. Number three, hormones after the age of 60 or greater than 10 years post menopause. Listen to my episode 291 with Corinne men where we discuss Susan Davis's amazing paper breaking down the actual risk. And this was oral estrogen because that was the biggest study. The actual risk of oral estrogen in greater than 10 years post menopause. It's not that risky. And now we use even safer medications called transdermal estrogen. I'm talking about systemic. Obviously anybody can use vaginal estrogen at any age, but I'm talking about systemic hormones greater than age 60. I think in the next five years that's going to be big, big, big, big. Number four, free hormone therapy. British Columbia did this. I think Ireland did this. The UK's hormone therapy is like 30 pounds a year. It's dirt cheap. So what we know, we know that people who take hormone therapy are on less other prescription. They get less heart disease, they have a decrease of basically all neurologic disorders. We have several papers on that keeps people in the workforce. So it's actually like saving the system money by giving free hormone therapy. So I would love to see that. Number five, penis and vagina sex should not be the only type of sex. When we say sex, we shouldn't assume penis and vagina sex. Penis and vagina sex should be noted that it's just one type of sex, not the most type of common type of sex that actually has a woman orgasm or desire more sex. So putting penis and vagina sex in its place, I'm not saying get rid of it, I'm just saying it's one thing of many. All you have is like buttered noodles every single night for dinner. You might not know there's other things on the menu and you might be like, I don't really like dinner anymore. So just saying. Number six, get the boxed warning off of vaginal estrogen. For anybody who wants to petition the FDA for that, go to letstalkmenopause.org, it's called unboxing. Estrogen. You can sign up whether you're a healthcare provider or not. And a letter goes to the FDA because at the end of the day the FDA works for the people. That's who's paying their salaries. And the black box warning says probable dementia, heart disease, blood clot risk and cancer. And it is all wrong again. Vaginal estrogen is not absorbed into your body. It is skincare. The boxed warning from the outdated Women's Health Initiative study needs to come off of a product that was never studied in the Women's Health Initiative study. It makes no effing sense. Number seven, get the DEA restriction off of testosterone. So testosterone was not restricted, it was just a prescription medication. It became restricted Class three. It's class two in New York. Very strict in New York. Class three dea, which is in the same category as ketamine and Tylenol with codeine and requires you to have every six month doctor appointment is being threatened. Restricted meds are being threatened by the telemed restrictions. So that's only good through 2025 right now. And the might the restricted meds might not be allowed to be prescribed via telemed. We know that women use telemed for hormones more than men, probably because they're busier. So getting the restriction off. The restriction went on because of the Anti Doping act of 1991 by Congress. It literally will take an act of Congress to take it off again. Testosteroneproject.org to help petition. We're working on a federal level. I tried Washington state level. They said no, this is a federal issue, we're not going to take it. So anybody who's interested in legislation, who knows the senators who can get stuff done. I'm working with what I can in for the Washington state, but this is restrictive for patients, it's restrictive for doctors. It's more work to prescribe, it's expensive. It's about $1,000 for a DEA license on top of your medical license. In addition, it perpetuates the myth that something your body naturally makes is dangerous and it just is not dangerous. Can Canadians write to the fda? You can write letter to whoever you want. They might not listen to you at all. But go for it. I'd love that. Number eight, healthcare costs. You guys, dramatic pause for healthcare costs. I'm getting out of insurance based medicine. That's probably an entire podcast in and of itself. But we employed five, five to six people just to do billing to deal with the amount of insurance companies who were want to prohibit you from receiving care. Your doctor thinks is medically necessary. The amount of insurance companies that just don't give you care for a product you pay exorbitantly out of the asshole for is absolutely insane. The system is completely broken. So I just, I need it for my own mental health, sanity and to spend more time with patients. Because what I truly, truly like is getting to know you. I can't do 25 people a day anymore. I needed to get out.
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Yeah. Do I think we need insurance? Yes. Car accidents and cancer? Absolutely. But should you be paying a premium insurance price for catastrophic care with a $10,000 deductible? No, that's catastrophic care insurance, not healthcare insurance. Best thing you can do, don't get sick. It sounds kind of flip, it really does. But all of us harping on like diet, exercise, sleep, stress reduction, don't drink alcohol, don't smoke, all that stuff of like, stay as healthy as you can. Because the system is hard to navigate even if you're in it, even if you're a physician in it. It's very hard to navigate and it's very expensive. So that was number eight, number nine, four day work weeks for healthcare providers. Healthcare providers. It's like a brand new stinking concept that healthcare providers should actually take care of themselves and that in taking care of yourself, you're a better healthcare provider to other people. But the culture, the culture of like you're always available, you're always on, you can always be reached. Patients call me at like 8:30 in the morning for Viagra prescriptions on weekends. Like it's an abuse of the system. Physicians need to not be available all the time because they're burning out, they're quitting medicine. We can't be available all the time for not emergencies. So that was my four, my four day work week for healthcare providers. Number 10, orgasmic inequality. I want that to end. It persists. We've got a couple decades worth of studying of orgasmic inequality. It's worse in heterosexual couples. The woman has the least amount of orgasms. Surprisingly, she likes sex less. Shocker. Orgasmic equality is more present in same sex couples. For anybody who hasn't heard me talk about this study, there's this amazing bisexual study where they have a bisexual woman and they basically say, how many times do you orgasm when you're partnered with a man? How many, how frequent do you orgasm when you're partnered with a woman? So same woman, same body parts. She orgasms way more when partnered with a woman. So thus one of many things, proving that women's orgasms are not mysterious or challenging or difficult. It's just they're not prioritized. I just read that segment in your book last night and I literally orgasmed after reading that. Using my vibe. Yeah. Own it. Okay, number 11. Sex education for all. Sex education now in the United States of America is worse than it was in the 90s. We know we have great data to show that abstinence only education does not decrease pregnancies or sexually transmitted diseases. So that didn't work. We experimented. Congratulations. Didn't work. And so many adult people feel broken because they don't know how desire works. They don't know how their body works. They don't know to prioritize orgasms for all get a little greedy. And if you don't get it when you're a kid, get it when you're an adult. I have a sex ed course on my website if you want to take it. I've got a TEDx talk called why all adults need sex ed. Education is empowerment. Education fixes most I'm broken people's problems. It's very useful. The good news is so many more clinicians are getting into discussing sex med and desire and the hormones and the medications. But like if they just start with like here's a med but you don't know the clitoris needs to be prioritized or that you need to care about your wife's orgasm or 1 through 7, you're going to fail the med and then you're going to be a med failure and that's. That makes you feel even more broken. So sex ed for all number 12 in things I wish would change this one. I probably have the most control of over everybody's is I would like a national Casperson clinic. My vision is I'd like to Casperson clinic in Bellevue next. Then I would like one in Santa Barbara. I'm picking Aspen. Like Aspen just needs a Casperson clinic. And it's really like a place to go to feel heard, to feel seen to be listened to in midlife. Optimizing your hormones and your sex life. I just love it. I just think I just don't understand why there isn't a Casperson clinic in every major city. Nashville obviously, probably Miami. Don't you think? Somebody just said Boston. Boston. You guys are above average anyways, aren't you? Like come on. So what we need is we need a investor. So anybody know an investor who wants to open high end Caspersin clinics worldwide manifesting. Okay, number 13. Breast cancer patients get vaginal estrogen for pre Treatment. I was talking to my good friend Dr. Corinne Men about how shitty breast cancer survivors have it in access to vaginal estrogen. Not even, like systemic estrogen. I was like, well, you know how they, like, do the pretreatment caps for the hair loss so that you, like, have less hair loss? Don't you think we should do that for the vagina and the vulva and the bladder and just say, hey, like, let's start cancer treatment. Here's your vaginal estrogen as like a pre treatment plan. So I actually think they're the people who write and there are the thought leaders in breast cancer are going to start thinking about incorporating that because it's a heck of a lot easier to not get genital urinary syndrome of breast cancer treatment than to try to reverse it. And why suffer in the first place if we know it's incredibly common to have pain with sex? Dryness, burning, tearing, bleeding, overactive bladder, recurrent urinary tract infections with aromatase inhibitors. I just got a message from somebody who got pelvic radiation and started on vaginal estrogen as a pre treatment and said she never had any vaginal radiation symptoms. So I'm like, that needs to be studied. Who wants to study that? Somebody said, can I get on the wait list for Nashville? You might be waiting a while, my friend, seeing as I have yet to fully open the Caspersen Clinic in Washington state. But I like how you think that's the best way to think ever. I love it. Yes, please be on the wait list for the Nashville Casperson Clinic. I need an investor. Okay, number 14, hormones for preventative medicine. They're not going to say it. The United States Preventative Services Task Force said, don't use hormones for preventative medicine. National Menopause Society also supports that statement. Keep in mind the United States Preventative Services Task Force used the WHI as their biggest study to say that the benefits don't outweigh the risks. So that's not useful. And remember, it's already FDA approved for. Oh, good, we've got two people on the Nashville waiting list for the Casperson Clinic. This is getting hilarious. It's already FDA approved for osteoporosis prevention. So, like, when people are like, don't use hormones for prevention. But then we were like, but we have it FDA approved for prevention of osteoporosis. I read a study today. It's an older one. Women who are on systemic estrogen have. Have a longer time to their first heart attack. Not that everybody's gonna Get a heart attack. But you know what I'm saying? Decreases the risk of having a heart attack, decreases heart disease, decreases heart failure, decreases neurologic disorders. Vaginal completely prevents GSM, decreases bone fracture by 50%, even if in women who don't have diagnoses of osteoporosis. So that's pretty amazing. So somebody says, I wish there was a press release to blow up the WHI study and the mess it's made for women. I mean, not fear. Doesn't sell, right? Like, oops, sorry, we were wrong. Doesn't sell. There's been many, many published papers saying the WHI doesn't apply to the average woman. The meds we use now are safer. Like it's come out. But if you're not fearful following that, like, you're not going to know about it. What's the estrogen dose to prevent osteoporosis? So there's very low dose systemic hormones that have shown bone improvement. So hard to say, is that going to be the same for prevention, but it doesn't require a lot. Some people will say you need a higher level of estrogen for bone protection. But we've got papers that show very small doses, like the.025 patch, they doesn't exist anymore, but there's like a 0.017 patch. Like even like half of a 0.025 patch. Like, really low doses help bones. All right, number 15 in things that I wish would change. I blew through these guys. Can you handle like 15 things in a half an hour? The surgeon general came out and said that alcohol should have a cancer risk warning on the label. Apparently it's gonna take an act of Congress to change the alcohol label. I don't know why I need to read more into that, but that seems like a pretty big ask. And why would you have Congress who aren't medic. There aren't medical people, they're not scientists, they're not doctors. Why are they deciding? You're making it a political thing of, like, which of my constituents have breweries in their town. And like, are motivated by the business aspect of alcohol consumption and the tax base aspect of alcohol consumption over the actual health. So to me, I'm like, I don't think it should be an act of Congress. I think if the surgeon general says there's enough evidence and he laid it all out, you can read it. It's free online, then it should be on there. So we'll see if it actually, if alcohol causes cancer, actually goes, interestingly enough, vaginal Estrogen does not cause cancer and has a warning label that says it does cause cancer. So the tale of two government warning labels, basically. Can you recommend a telehealth site for perimenopausal women? Like, is MIDI health safe? What's safe mean? Off the top of my head, I can't tell you. If all of them treat perimenopause, I would check out midi, I would check out my alloy. You can get vaginal estrogen on getinterlude.com, evernow. I think treats perimenopause. So I would try all of them. They might be on their frequently asked questions on their website. Do you think estrogen patch would be enough for urinary system or should you really be on both? Better data on vaginal estrogen for gsm, which includes bladder issues, than systemic. So some, there's some papers showing systemic hormones actually increase incontinence. We don't. We don't really know what that's all about. How often can you use vaginal estrogen? That is standard is twice a week. Many people use it more. It actually used to be standard more than it is now. So right now it's 1 gram twice a week. But if you don't think that's enough, then that's a discussion with your clinician to decide to go up on your dosing. And you have to dose it pretty high before you need progesterone coverage. Should I consider progesterone with no uterus? Oh, sure. Progesterone receptors are all over our body. It's great for the mood, for anxiety, it's great for sleep. So somebody's saying standing up for women's health. I wish we had someone like you in the UK. Hello. Dr. Luis Newsome. She's like, bigger and better than me. She does research, she's got. She has multiple clinics. I want multiple clinics. Louise Newsom's amazing. Okay. How does estrogen impact the ureter? That's a good question because I'm a urologist, thanks for asking. I don't know risk of kidney stones in pregnancy is equal to risk of kidney stones. Not pregnant. So in my book, you are not broken. You mentioned bupropion may help with libido. What's the optimal dosage to help? That's a meet with your clinician person. Especially if you're going to dose on top of another ssri. That is an individual question that I would want you to do on Natesto. Natesto is the nasal testosterone. Did that go off of the market? Or is that still on the market? Some people would dose natesto because it's very, very short acting. It raises your testosterone levels really fast. They'll dose intesto like right before sex. Off label. Off label. Oh, here's an interesting fact. Men and low libido and testosterone. They have, I just checked this, they have like 500 studies on it. We all know testosterone helps men with low libido and it's not FDA approved for low libido in men. So any man using that is using it off label. That's just a shout out to people saying we can't use testosterone in women because it's off label. Is a lot of a large amount of men use testosterone off label. Thoughts on Biot pellets? Many thoughts. Go to oprah daily.com and read my Oprah daily op ed on testosterone pellets. It will explain everything you need to know. I think I do, I think I do a good job of being very pro and con on there. Optimal testosterone level in menopause and in compounded cream you start at 5 milligrams a day. Compounded cream, that's 1 10th the male dose. Optimal range is in high, high double digits. 40, 50, 60, 70, 80. If we see you in your clinic, can any meds prescribed be covered by insurance? Yeah, if your insurance covers them. That's the bullshit. It's not up to me if your insurance covers them or not. But you're not buying them from me. Do I recommend biased cream? No, I do not. I recommend estradiol. There's no data. Biased cream is a made up combo cream. I'm not saying it doesn't work. It does. I have lots of happy women on it. I just don't see why it's necessary. I haven't seen any data on it. Can vaginal estrogen help for low libido in your early 30s? Okay, so estrogen is a libido hormone. If you're in your 30s you should have fine estrogen. Unless you have, unless you're on birth control or something like that. Fixing any gsm, this. So this question is specifically vaginal fixing any GSM or pain certainly can help libido because your libido can come back when sex is pleasurable. But it's not like get on vaginal estrogen to help your libido. It's not that easy. It's not that simple. It's not that click baity. All right, I hope that helped. Please clone yourself. We need you everywhere. I don't know if investors can clone me, but they can help me put clinics everywhere. Does testosterone help with osteoporosis? Oh, I love that question. We have several studies looking at estrogen. Testosterone together has better bone density improvements than estrogen alone. That's published data. But testosterone is nowhere in osteoporosis guidelines, my friends. But we know it helps men. Our bones are not that different. Why are doctors hesitant to give large doses of progesterone? We make high amounts and many women need it. Maybe because of the medroxyprogesterone acetate. Nasty synthetic type from the whi. When starting estradiol cream, I'm assuming you need vaginal. Should you use daily the first week? I don't. I don't do a loading dose. I'm actually writing that in my second book. Oh, guys, I gotta show you something. Hold on. This for people who can see right now. This is book number two.
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Queen Carvania stood haloed by the morning sun.
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An army hung on her every word. My champion, I have sold my chariot on Carvana. Twas a lovely suv, an inexplicably queenly offer. They're even coming to the castle to collect it. Tonight we feast. An offer you can feast on. Sell your car today on Carvana. Pick up. Fees may apply. Hey, it's your ceiling vent. So I'm dripping. Could be the rain, could be the upstairs bathroom.
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Yikes.
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You could hire the guy your neighbor recommended, but I'm pretty sure that's just his cousin. Do we know if he's licensed or does he just stone a ladder? Listen to your home go with thumbtack. Upload a photo or voice note, and we'll diagnose your project and match you with the right pro for the job. Thumbtack we know homes hire the right pro today. Locked, loaded, sealed and delivered. You like how I'm introducing that on, like, minute 30 of my podcast. This is a hundred thousand words. So now a blog post is really easy. It's a hundred thousand words, all about hormones, midlife, testosterone, alcohol, exercise. Mindset changes the fricking whi should you do a loading dose of vaginal estrogen? What the heck is genital urinary syndrome of menopause? Sex tips. One pro tip that's in this book is have sex during the day. Don't save it till the last thing at night. So we have gone about over a half a year trying to figure out a name to this book because, like my first book, you are not broken is Chef's Kiss of attractiveness, of COVID and name. And so we. I don't know. We don't know. We're gonna call it after the Ovary, which I kind of liked. Radical Midlife, which I kind of liked. We'll see. I'm not sure I can announce the name at this point, but the book is coming out. All right. Any concerns with MTF, HR gene and estrogen gel? No. We need more Dr. Caspersons. In this world, you're our rock star. You guys are so sweet. Best question to ask when going in for testosterone consult. I would ask, do you prescribe testosterone for women? Are you comfortable with that? If they're not and they're not willing to learn, good luck. What level is considered testosterone overdose? Minus 340. That's high. That's not considered low in men. It is in some men, but not the lab value.
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No.
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Vaginal estrogen does not help Bones. You need systemic estrogen to help Bones. Is vaginal estrogen safe with aromatase inhibitors? Yes. I'm not sure if libido is damaged or if men are getting worse. Honey, don't blame yourself for all of this. It might be the second. We do know this orgasmic equality is not getting better. You do the math. Just read your op ed for pellets. Thank you. Yes. Oprah Daily op ed about pellets. If you just go to Oprah Daily and search testosterone, it'll pop up. When do I have time for sleep and life? You're so amazing. I slept till six today. The puppy. The puppy is sleeping until six. That was a big win. Can you use the vaginal applicator for vaginal estrogen or just our fingers for the outside? Both. They like after the ovary. Okay, so the book people, they're like, after the ovary. Sounds like a downer. It sounds like surgical menopause. It sounds like people are going to be confused and not know what that means. And I'm like, you guys don't know my people. My women are very smart. I have very smart women. They're not going to be confused by what after the ovary means. We'll see. Book comes out probably in October. My doc said goal on testosterone is 125 to 225. Good range. I think that's high. All right, a couple more questions and then we will wrap it up. Importance of vaginal estrogen for dementia patients. Well, I think dementia. It's tricky in dementia, you lose the cognitive ability to urinate on demand. Right. So there's a lot more incontinence. I think there's a Lot more tension. There's a lot more bladder issues. So it does increase your risk of urinary tract infections. It gets a little tricky with dementia patients. And is somebody comfortable putting a cream in their vagina? Because the dementia patient isn't going to be the person who's on top of putting their own cream up their vagina. That's where the role of estring really comes in. That is a ring that's in the vagina and you just have to change it out every three months. So it's really nice just to. And the nurses in a clinic can do that. So that's how I think about patients on dementia. With dementia. Hey, anybody in America who thinks it's hard to get hormones and to be addressed about menopause, The Middle east effing sucks. Very hard to access it. Very hard to access it. So shout out to just. When you think it's bad, it's worse in other places. Rocking your life after the eggs. This is good. They're not going to like that one. Joy beyond the Ovary. Whatever the damn book title is, I hope you buy the book. Whether even if it's an uglier stepsister to the Pretty, pretty, you are not Broken. Here, hold on. Just so for anybody who can see, this is how pretty the first book is. Get this. Get the. You are not Broken. Stop shooting all over your sex life. It's so pretty. It's just such a pretty book. So we'll see. You have, like, a beautiful kid and then you're like, well, hope the second one turns out okay. All right, guys, I love you. That was my. This is my podcast episode of 15 Things that I Wish would change. Tell me what you. What I forgot to add because I'm probably, like, missing something obvious, but, yeah, you are Not Broken part two. They're definitely not going to go for that title. All right, if you want the you Are Not Broken book in Spanish, you need to write me that so that I can send it to my. The book people. They will not translate things into other languages without known interest. Will I do any talks in Canada? Yeah, I'm actually in the talk with somebody in Montreal right now, so we'll see what happens. All right, guys. Love you to the moon and back. Until next time. You are not Broken.
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Thank you for listening to this week's episode of youf Are Not Broken. If you want to dig deeper with me, sign up for my adult sex education masterclass where you learn adult things like communication skills, anatomy lessons and desire types and how to talk to your doctor about sexual health concerns. If you want the Adult Sex Education Masterclass for free, join my monthly membership for more in depth exclusive content, more time with yours truly. A private podcast, coaching and educational empowerment and you can watch my interviews live and get them immediately without advertising. Head over to www.kellycaspersonmd.com for the membership and Adult Sex Ed Masterclass members. Get the Masterclass for free. This podcast is presented solely for educational, entertainment and informational purposes only. I am a doctor but not your doctor in this format and all of my platforms and guests including on this podcast are not giving individual medical advice or practicing medicine. See and consult with your own care team for your individual needs and concerns. This podcast is not intended as a substitute for the care and advice of a physician, therapist or other qualified professional. This podcast does not constitute the practice of medicine, in case you were curious about that and no doctor patient relationship is formed. But I still love you. Using the information on this podcast or any of my platforms is at your own risk. Until next time. Remember you are not broken.