Podcast Summary: You Are Not Broken

Host: Dr. Kelly Casperson, MD
Episode 337: Author Q&A #2 – The Menopause Moment
Date: September 28, 2025

Overview

Dr. Kelly Casperson hosts a dynamic Q&A focused on her new book, "The Menopause Moment: Mindset, Hormones and Science for Optimal Longevity." This interactive session with preorder fans dives deep into mindset, hormone replacement therapy (HRT), societal narratives around menopause, and evidence-based strategies for thriving in midlife. Dr. Casperson uses humor, candor, and clinical experience to challenge misconceptions and empower listeners, blending science, practical advice, and positive psychology.

Key Discussion Points & Insights

1. Community Opening & Book Talk

• Shout-outs to attendees’ locations create a welcoming vibe.
• Dr. Casperson discusses her reading preferences and learning methods, noting the benefits of listening and reading simultaneously for deeper learning.
• The book's official release is mentioned (01:30), with encouragement to get copies and participate in ongoing discussions.
• Dr. Casperson promises to post these Q&A sessions to the podcast, making the information accessible for all.

2. Mindset: The Foundation of Transformation

Timestamps: 07:15 – 32:35

• Central Message: Mindset is crucial for successful midlife transformations; hormones are part of the foundation, but mindset is what allows you to thrive.
• Metaphor:
  • "Hormones are the bricks of the house, but they don’t make a home. You need family, dishes, rugs—mindset is what turns bricks into a home." (09:41)
• On Mind Work:
  • Many people see thoughts as fixed facts; real change comes from recognizing thoughts as optional and practicing different ways of thinking.
  • "If you've never been told that your thoughts matter—get ready to have your mind blown.... You give way too much power and attention and authority to these non-existent things that are on repeat in your brain." (12:43)
• Change Process:
  • Physical health (e.g., through hormones) sometimes needs to come before mind work, but transformation requires both.
  • "You can get your gurus, books, hormones, best physicians… but nobody is going to do this for you. It’s not the same work if somebody did it for you versus you doing it for yourself." (27:06)
• Barriers to Change and the Superpower of Choice:
  • Many resist accepting their personal power due to fear of the unknown: “What would you do if you realized you had unlimited power over what you wanted to do with your life?” (18:30)
  • Steps to Start:
    1. Awareness of thoughts
    2. Observing dominant thoughts and related feelings
    3. Noticing whether you feel in control
• Role of Role Models:
  • Not all women have vibrant role models for later life; modeling positivity is powerful even if you don’t know the person.
• Resource Recommendation: Martha Beck’s "The Way of Integrity" for exploring authenticity and purpose.
  • "Do you know what you truly want? Are you living the life you should be living?" (22:30)

3. Dismantling the "Broken" Narrative

Timestamps: 32:35 – 38:20

• Dr. Casperson discusses persistent societal and medical labeling as “broken,” especially for women with chronic or menopausal symptoms.
• On Identity:
  • Many argue for their own brokenness due to longstanding narratives or miscommunication in healthcare.
  • "Why do you want to identify as that? ...All of us are here for a reason and none of us need to fight for our worthiness or good enough-ness." (34:25)
• Diagnostic labels (like interstitial cystitis or anxiety) are often carried as lifelong burdens, sometimes unnecessarily.
  • "Why put a label on somebody? And furthermore, why carry that label around?" (36:42)

4. The UTI/Menopause Connection & Normalization of Menopausal Symptoms

Timestamps: 50:22 – 54:30

• Sex is a common UTI trigger pre-menopause, and the risk increases with menopause as estrogen declines. Vaginal estrogen and supplements like Jenna MD are discussed for UTI prevention.
• Dr. Casperson addresses the misconception of menopausal symptoms as simply “normal aging,” asserting that common does not mean untreatable.
  • "Just like teeth, ovaries only live a certain length of time. But we replace the teeth, the eyes, the hearing… with hormones, we're told oh, it's normal. Like it's common, but it doesn’t mean we can't do something about it." (53:13)

5. Q&A: Hormone Therapy, Mindset, and Clinical Nuances

Timestamps: 57:00 – End

Hormone Therapy (Testosterone, Estrogen, Progesterone)

• Start Low, Go Slow:
  • Quick increases in hormones can cause side effects (e.g., hair loss).
  • "You shock hair follicles in a woman, you piss her off. Don’t do that." (58:40)
• Symptom-Based Dosing:
  • There is no universal "ideal" total testosterone; it’s about symptom benefit and absence of side effects, typically aiming to stay below 150 (ng/dL).
  • "One woman’s happy at 40, one at 120. I’m not trying to get you to a level..." (1:00:15)
• Hormone Therapy after Breast Cancer:
  • Highly nuanced; women need to educate themselves (books like "Estrogen Matters" recommended) and find prescribers open to risk analysis and shared decision-making.
• Progesterone for Post-Hysterectomy:
  • Progesterone has benefits beyond uterine protection, especially for mood and sleep.
• Transdermal Estradiol Patch:
  • No current higher-dose patches, but desire for them is acknowledged; safety discussed (1:16:19).
• Older Women & Access:
  • No age cutoff for starting HRT; a surge in treatment options for women well past menopause is expected in coming years.
  • "There's no age cutoff for...transdermal estrad...if there is a risk, it's lower than any antidepressant or statin you’re on." (1:21:05)

Labels, Diagnoses, and Medical Misinformation

• The medical system often over-labels or pathologizes normal transitions, and many women internalize or fight these labels.
  • "If you own the label, if you own the brokenness, it can be a lot harder to get rid of that." (36:21)

Sleep, Weight Loss, and HRT Nuances

• Testosterone’s effect on sleep varies per individual; take it in the morning if it’s energizing.
• Initiation of HRT can affect thyroid function—monitor and adjust in coordination with a clinician.

Decision-Making & Advocacy

• Women may experience “learned helplessness” after repeated medical dismissals ("poo-pooed")—advocacy through self-education is crucial (1:13:50).
• Find empowered, up-to-date clinicians (Heather Hirsch’s directory suggested) and consider online clinics as this field grows.

Menopause, Mindset & Manifestation

• Dr. Casperson ties back to mindset: "What you tell your brain to focus on, it will focus on...your thoughts create your world." (53:55)

Notable Quotes & Memorable Moments

• Mindset is Everything:
  "If you think that you can’t or it’s too hard or you're too old, that’s true. And if you don’t think that, that is also true." — Dr. Casperson (09:10)
• On Medical Labels:
  "Medicine gives people diagnoses...useful for learning and billing, but what happens when you tell a 21-year-old they have anxiety and don’t explain it might not last forever?" (36:02)
• On Advocacy:
  "The amount of women who don’t use their voice to advocate for themselves is like fingernails down a chalkboard for me...learned helplessness." (1:12:31)
• Manifestation and Focus:
  "With skiing, don’t look at the tree if you don’t want to hit the tree. If you want to find positive, amazing friendships, put that out there." (54:31)
• Hormones & Prevention:
  "There will never be a medical society nor FDA approval saying women should take this for prevention…You gotta advocate for yourself." (1:10:11)
• On Role Models:
  "You don’t have to know the person to have them be your role model. This is where books come in." (1:06:31)

Timestamps for Important Segments

• 01:00 – 04:00 — Community welcoming, book/media preferences
• 07:15 – 32:35 — Mindset discussion
• 34:25 – 38:20 — The "broken" narrative and labeling in medicine
• 50:22 – 54:30 — UTIs, menopause, and debunking normalization of symptoms
• 57:00 – 1:31:15 — Hormone therapy Q&A, clinical pearls, and patient advocacy
• 1:19:00 – 1:21:15 — Access to care for older women, online clinics, and patient info

Final Takeaways

• Mindset isn’t static; it’s a trainable power that underpins all life and health changes.
• Hormones are foundational but not magical; combined with intentional thought work and lifestyle, they enable optimal longevity.
• Labels and negative medical narratives can be replaced with empowering, agency-focused perspectives.
• Self-advocacy, ongoing education, and community support are the most powerful tools for midlife women navigating health and wellness.
• You are not broken—embrace the data, question assumptions, and reclaim your midlife vitality.

For those seeking an empowering, evidence-based, and uplifting look at menopause, hormones, and the mind's power, this episode—and Dr. Casperson’s work—is both practical and inspiring.