You Are Not Broken – Ep. 360: ISSWSH 2026 Review

Host: Dr. Kelly Casperson, MD
Date: March 1, 2026

Episode Overview

In this episode, Dr. Kelly Casperson delivers a rapid-fire solo rundown of highlights from the 2026 annual meeting of ISSWSH—the International Society for the Study of Women's Sexual Health. Casperson shares major news, research, clinical pearls, memorable moments, and her characteristic mix of humor and clarity all focused on women’s sexual health, hormones, and quality of life in midlife and beyond. She brings special attention to advocacy, sexual education, breakthrough research, and practical tools for both clinicians and the women (and people who love them) whom they serve.

Housekeeping & Announcements (00:01–13:42)

Upcoming Conferences & Events

• ISSWSH 2027 Preview:
  • The next annual meeting will be February 2027 in Vancouver, Canada.
  • Casperson: “I think you guys should come too…women’s testosterone is normalized…you’re not fringy, you’re not weird.” (02:30)

Educational Offerings

• ISSWSH Fall Course (Intro to Female Sexual Health):

  • Recommended for beginners; didactic and hands-on, usually in Arizona every November.
  • Annual meeting is more academic; intro days available for newcomers.
  • Casperson recommends: “I did the fall course two or three times before I went to an annual meeting, and I’m glad I did—because you’re kind of drinking out of a fire hose.” (04:48)

• M Factor 2.0 Documentary:

  • Sequel to PBS’s “M Factor” (on menopause); this one focuses on perimenopause.
  • Casperson hosts Seattle and Bellingham screenings and Q&A (March 18th, March 22nd).
  • “Tickets will be available by the time this podcast is live… don’t delay!” (08:08)

• Vibrator Release:

  • “Explorer” vibrator co-created with Laura Pack of Elixir Play, Sydney, Australia—non-penetrative, vulva-focused, for midlife women especially.
  • Sold out quickly; preorders open, code “notbroken20” for discount. (10:35)
  • Designed to “bring blood flow to the entire clitoral vulvar complex.”

Thanking ISSWSH Leaders:

• Special shoutouts to Dr. Sarah Signa, Dr. Tammy Rowan, Dr. Heather Quayle, and Dr. Samina Rahman for outstanding leadership and advocacy. (13:00)

New Courses & Advocacy (13:43–20:50)

• Sex Ed for Adults Course (Commune):

  • “It’s doing really well, people are really liking it… Things you were never taught.” (14:33)

• Alcohol & Mindset Webinar:

  • On living alcohol-free in a drinking culture; feisty, science-backed.
  • “The point is to not numb your life… become the person who feels the feelings and doesn’t numb yourself.” (16:58)

• Is it Too Late for Hormones?

  • On safety of estrogen as we age and the nuanced benefits/risks. (18:49)

• Clarifying Evidence-Based Medicine:

  • Shoutout to Dr. Corinne Menn: “The actual definition of evidence-based medicine is three things: data/published literature; experience of the clinician; wishes, informed consent and input from the patient. All three things.” (19:40)

• Advocacy Updates:

  • Vaginal estrogen OTC: “Marty Makary was just talking about this on CNBC last week… they’re listening.” (21:05)
  • Deregulating testosterone for women and correcting stigma.

Q&A & Rapid Fire Clinical Pearls (20:51–29:20)

• Post-Menopause Books:

  • “Menopause is one day, every day after that is post-menopause.”
  • Her own book, The Menopause Moment, covers all phases.

• Telehealth vs. Clinic Care:

  • Telehealth is mass transit. “We need it…” but some will need “a car to go down a road mass transit doesn’t go down.” (23:45)

• Upcoming Podcast Teases:

  • “Heated Rivalry” (HBO Max series) and female desire—the dynamics and impact among heterosexual women.
  • “My vibrator plus Heated Rivalry—heart-shaped emoji.”

ISSWSH 2026 Annual Meeting Highlights (29:21–58:10)

Major Regulatory News (29:30)

• FDA Updates:
  • Boxed warning removed on six estrogen products—a big win for access and reducing stigma.

Sexual Health Research & Clinical Insights

• Sex After Breast Cancer (31:00):

  • “About one half of breast cancer survivors have [problems] with their sexuality...worse if younger at diagnosis.”
  • Chemo and younger age at diagnosis predict worse outcomes.

• Sexual Shame & Purity Culture (33:20):

  • New studies highlight persistent shame and misinformation from "purity culture".

• Book Translation News:

  • You Are Not Broken will release in Spanish (Spain July 2026, US/Mexico October).

Alcohol Advice & Gender Bias (34:00)

• Notable Statistic:
  • “The more that clinicians are trained in sexual health, the more likely they were to say, ‘have a glass of wine’—to women, not men.” (36:12)

Medication Updates — Sildenafil, Testosterone, Hormone Therapy (37:23)

• Female Use of Sildenafil (Viagra):

  • Helps with orgasm latency and intensity; topical formulations upcoming (Dare Pharma).
  • “Women taking it daily did better than on-demand.”
  • Note: daily PDE5i (sildenafil) also linked with lower dementia risk.

• Combination Therapy:

  • Oral testosterone + sildenafil increases sensitivity to sexual cues.
  • “Testosterone seems to help with arousal, desire, and concordance—your experience writes the play.” (45:16)

GSM Guidelines & Hormone Science (41:30)

• Dr. Rachel Rubin on Genitourinary Syndrome of Menopause:

  • AUA 2025 guidelines are out and free.

• Memorable Quote:

  • Dr. James F. To: “Penises are prolapsed clitorises. Seriously, make me a T-shirt.” (46:51)
  • “Hormones set the stage. Your experience writes the play.”

Sex Education as Social Change (47:30)

• Key Takeaways:
  • Comprehensive sex ed reduces trauma, violence, and misinformation.
  • “Comprehensive sex education is a tool for equity and well-being.”
  • By age 16–17, 43% of Canadian students report intercourse; trauma and adversity increase dysfunction risk.

Cultural & Social Dimensions of Sexuality (50:24)

• Superwoman Schema (Black women's sexual health):

  • Obligation to manifest strength, resist vulnerability, suppress emotions.

• Faking Orgasms:

  • Motivated by a wish to “protect the partner’s ego,” self-silencing pervasive.

• SSRIs & Sexual Dysfunction:

  • “Especially when started early in adolescence… can have more sexual dysfunction.”
  • Tease for upcoming Dr. Mark Horowitz interview on deprescribing.

• Women’s Right to Distress:

  • “Some women don’t know they have the right to be distressed.” (Memorable moment.)

Pornography & Relationships (54:30)

• Gender Differences:

  • 90% of men use porn weekly, women far less.
  • For women, porn use can “increase desire towards both the actor… and their partner.”

• Porn Jealousy & Disclosure:

  • “If partners discuss and disclose porn use, it can be a positive thing.”
  • 35% consider porn use infidelity; cisgender women had most jealousy.

• Camming:

  • Distinction from static porn; fosters relationships and boundaries.

Sexual Pain, Body Image & Cancer (56:16)

• Sexual Pain (Dyspareunia):

  • Endometriosis, venous congestion, clitoral adhesions (“23% of sexually active women have clitoral adhesions”), and post-mastectomy syndromes discussed.

• Body Image:

  • “Body image is an embodied experience; how you experience your body.”

• Hormones after Cancer:

  • Debate on “soft and TEXT” trials, duration of aromatase inhibitors tied to benefit/risk.
  • “7 in 10 cancer patients will survive more than 5 years”—shifts focus to quality of life.

• Upcoming RCT in the UK:

  • MENO ABC trial on systemic hormones after breast cancer (details pending).

Social Constructs of Menopause (57:55)

• Menopause as Social Construct:
  • In France, menopause used historically to limit women’s rights—biologically real, but socially used to “control women”.

Other Notables

• Pharmacy Barriers:

  • Calls for better pharmacist education re: hormone safety, as access remains an issue.

• “One woman’s experience is not all women’s experience.”

  • Diversity of symptom expression, responses to menopause, and needs.

Quotes & Memorable Moments

• On Evidence-Based Medicine:

  • “Evidence-based medicine is actually data, expertise of the clinician, and discussion with the patient on what their risks, benefits, and wants are.” (19:54)

• On Hormones and Context:

  • “Hormones set the stage. Your experience writes the play.” (Dr. James To, 46:54)

• On Wine as Advice:

  • “The more clinicians were trained in sexual health, the more likely they were to say, ‘Have a glass of wine’… They tend to say it to women. We don’t tell men with erectile dysfunction to take a shot of alcohol.” (36:25)

• On Faking Orgasms:

  • “Women do this to suppress emotions of disappointment and frustration, to protect the partner’s ego…” (51:38)

• On Porn Use:

  • “Heterosexual women use the least amount of porn. Male use may lower desire towards their partner, but women’s use often increases it.” (54:39)

• On Perspectives:

  • “One woman’s experience is not all women’s experience.” (58:06)

Final Thoughts & Reflection

Dr. Casperson wraps up acknowledging that this was a whirlwind of some “key awesome takeaways”—not comprehensive, but packed with actionable insights for clinicians and women alike. She plans to attend ISSWSH 2027 in Vancouver and encourages listeners to check out her website for speaking engagements and courses.

“Let me know if you want more solo episodes… I literally probably left out 70% of the conference, but those were just some interesting facts that I thought I’d take down.” (58:25)

Useful Links

• Dr. Kelly Casperson’s website: kellycaspersonmd.com
• Elixir Play Vibrators: elixirplay.com (use code “notbroken20”)
• ISSWSH: isswsh.org

Topical Timestamps

• 00:01 — Introductions & Housekeeping
• 02:30 — ISSWSH 2027 Preview & Fall Course Recommendations
• 08:08 — M Factor 2.0 Documentary Events & Details
• 10:35 — New Vibrator Announcement (Explorer)
• 13:00 — Leadership Thank Yous
• 14:33 — Sex Ed for Adults Course
• 16:58 — Alcohol & Mindset Webinar
• 19:40 — Evidence-Based Medicine Clarified
• 21:05 — Advocacy: OTC Vaginal Estrogen, Testosterone Deregulation
• 23:45 — Telehealth vs. Clinic Care Analogy
• 25:30 — Heated Rivalry Podcast Tease
• 29:30 — ISSWSH 2026 Main Takeaways Start
• 31:00 — Sex After Breast Cancer Data
• 33:20 — Sexual Shame, Purity Culture, Book Translation
• 34:00 — “Have a Glass of Wine”: Gendered Clinical Advice
• 37:23 — Sildenafil & Hormonal Therapies for Women
• 41:30 — GSM Guidelines
• 46:51 — “Penises are prolapsed clitorises”
• 47:30 — Sex Ed as Social Change, Canadian Data
• 50:24 — Superwoman Schema & Faking Orgasms
• 52:00 — SSRIs, Sexual Dysfunction, Right to Distress
• 54:30 — Porn Use & Relationship Dynamics, Camming
• 56:16 — Sexual Pain & Body Image
• 57:55 — Menopause as Social Construct
• 58:10 — Conference Wrap-Up & Reflection

For more in-depth discussion, commentary, and listener Q&A, tune in to the next episode or visit Dr. Casperson online. Remember: You are not broken!