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- [00:02]
A
Before we dive into today's episode, I have a big invitation especially for my Pacific Northwest people. If you're anywhere from Vancouver, British Columbia down through Seattle and Portland, I want to see you in Bellingham, Washington on March 22nd for a live screening event for the M Factor 2.0 documentary. Before the pause, we'll be at the beautiful Mount Baker Theater. Doors open at 1:00pm Program starts at 2:00pm March 22nd. This is a Sunday. We'll watch the documentary together and I'll be on stage for a live conversation with some of my favorite perimenopause experts, including Drs. Ifo Sullivan and Rachel Bole, a sex therapist talking about what women actually need to know about midlife hormones and sexual health. And I'm going to ask a favor of you. When we did this two years ago, the number one complaint was I didn't know about it. So if you're listening to this right now, share this, send it to friends, post it, text it, tell your book club, tell the women you lift a weights with. If you're local, please share it with your community. Let's fill the theater with women who deserve better information about their bodies and the people who love them. Men are welcome too. If you can't make it in person, the docum premiere will be on PBS on March 19, so you can still watch it from home or you're with your book club. And for those coming to Bellingham, our wonderful local bookstore, Village Books will be in the lobby selling books before and after the show. You can grab tickets through the Mount Baker Theater website or go to these podcast show notes or my event page on www.kellycaspersonmd.com. all right, now let's get into today's episode. Welcome to youo Are Not Broken, the podcast that challenges everything we've been taught about midlife hormones and sexuality. I'm Dr. Kelly Casperson, board certified urologist, author and a leading voice in women's sexual and hormone health. Enjoy the show.
- [01:47]
B
Hey everybody. Welcome back to the youe Are Not Broken podcast. This is the most people we've ever had on a podcast in one day. There's five of us and we're very excited because what we're doing today is we're getting the word out about a amazing documentary that's up now on Paramount plus called the Pink Pill. And everybody here is involved and I'm so excited everybody's here on the podcast to generate awareness and interest. So do you guys just want to go around and introduce yourselves and like how you're involved in this documentary and then we'll get into it. We'll start with Julie. I'll call on you. It'll be easier.
- [02:17]
C
So I'm one of the executive producers on the project and I work with these other gals here. And, you know, we started this project about two and a half years ago, and we're thrilled that it's going to be out to viewers shortly.
- [02:30]
B
Amazing. Thank you. Abby, welcome.
- [02:32]
D
Hi.
- [02:33]
E
Thrilled to be here. I'm Abby Greensfelder, one of the EPs of the project and helped develop this project, working on it for many years. Learned about Cindy through Dr. Ruben, who I know is a friend of yours, and we're thrilled to get this film out to the world.
- [02:48]
B
I love it. Ash, how about you?
- [02:50]
D
Hi, my name's Aisling Chin Yi. I'm the director, co writer, AP for this film as well. And, yeah, very, very excited to finally launch this baby out into the world and to see what kind of reaction we get, what kind of ground swell we get.
- [03:08]
B
Amazing. And last but not least, last for a reason. Cindy, welcome.
- [03:12]
F
Hi, I'm Cindy Eckert, the founder of the Pink pill and sprout, Dr. Casperson. We go way back, but how lucky am I that I'm here only as the subject who got these remarkable women who, you know, cold, called me one day and said, we'd like to go tell this story to the world. And I think it's so aligned with your work. You started by saying, all of us are involved in the film. I think you too, in terms of a leading voice in the change that we're creating in the conversation on women's sexual health.
- [03:41]
B
Amazing. So for people who don't know, this documentary is basically taking us through the history of getting flibanserin or Addie, FDA approved for hypoactive sexual desire disorder in women. And it's phenomenal historical record because it's like multiple presidencies. What I was so shocked by is how long people were on this journey
- [04:02]
F
for 15 years of this. Right.
- [04:04]
D
Of just.
- [04:05]
F
And I think that was. It's interesting when these great women you're meeting today approached me about the film. I think I'd never really allowed myself to go back. You know, it was hard for me to go back. I think I was so traumatized by it and all candor, I think it was tough to live through. And for 15 years, I just told myself, look forward, keep moving, make progress. And so this journey for me has actually been quite therapeutic in that, you know, when you revisit the past, you can break A whole new future wide open. It's been a long time in the making, right?
- [04:38]
B
I mean, you think, you know, we're put here to do whatever work we're put here to do. And I think looking at you and they say this in the film of, like, you were in the Viagra world, right? Like, Viagra didn't exist then. It existed and then it exploded. And you were involved in that culture. So you're like, 90% of men are heterosexual. Who is taking care of the people that are supposed to be sleeping with the people we're giving Viagra to is always my talk. So the energy behind Viagra and then to be thrust into, like, let's just have some access for women and then to kind of have the door slammed proverbially, or not metaphorically. Do anybody want to speak on that?
- [05:16]
D
I mean, it was really fascinating for me to come into this process after this had all. After this had all gone down, you know, but also still having never heard of Addie. It's never been. I've never had the questions posed to me from my doctor about how my sex life was going. If I had even brought it up, I know they would look at me with, like, horror on their faces before they ushered me out the door. Being allowed to ask, like, two questions, and then you gotta go. So it was really revealing that you had gone through this entire journey. And it was obviously very publicized when it happened, but. But it's still not part of the cultural lexicon like Viagra is. And so why is that? Why are we still so resistant to talk about women's sexual health or to talk about sexual function more openly in any context, if it's not about a penis getting rigid?
- [06:10]
E
Yeah.
- [06:11]
C
And, you know, as filmmakers, we went down to show this to Cindy, which is a very terrifying moment as a filmmaker. It wasn't that Cindy had editorial control or could make any changes, but we went down to rally and we showed her the film. And after we showed the film, there was complete silence. Also not the kind of reaction you want to get after you've been working on something for a few years. But Cindy said, which is just a testament to, you know, her strength and her adaptability. She said, it's just so hard to see that. It's so hard to see that fight that happened. And I'm not the same woman as I was then. And I really, at that moment, understood how kind of gargantuan that was and completely understood how it would be so difficult and take so much courage to actually revisit that and then to trust the process and the filmmakers to put this story out in a way that Cindy could continue to look forward. So again, it's having a subject that's as courageous as Cindy has really been
- [07:14]
F
a gift to pass the love here. I said it at the beginning, like, how lucky am I that the women who are sitting on this zoom right now with me would tell that story? And I think that was what really spoke to me so deeply, is that we are kindred spirits in the impact that we want to see in this world. And I think for maybe the first time ever, when I sat down across from journalists, having no control, you know, at all on what's going to happen here, I was met with neutrality. And that was unbelievable to me because all they wanted was the truth. And I think it's so lovely to hear, you know, Julie's experience sitting in the room with me. I'm getting like, I'm tearing up right now because I think my experience. I walked into that room and, like, the pink armor was on. I was just like, don't react. Don't just sit. Just sit. And I probably was like, biting my tongue as hard as I could the whole time so that I didn't reveal, you know, but I think probably I was about maybe two minutes in and I could feel, you know, my eyes, like, just welling up with tears because I was transported back to it. And that's what I think is so powerful for people watching this, is they get to go back and be in the room with the people who made it happen and the remarkable women who stood up and stood, you know, at the FDA and said, do better help me. And that's what's so potent in this. And I think the takeaway message for everyone who watches it, why you fight for what's right.
- [08:47]
B
Yeah, I mean, I think the women's stories of the ones who were in the trial, who went to the fda, who testified, who said, like, I don't
- [08:56]
A
have the money to be doing this,
- [08:58]
B
but I believe so strongly in this that it's life thriving, life changing for people that I'm here.
- [09:06]
A
I think they're the heroes of the story.
- [09:08]
B
I mean, these are your everyday. I don't know where they're from, but they could be living in Kansas, right? Tennessee, anywhere. People who live lives like the rest of us. And they came to fight for this medication. It's like, you don't see that with like, a high blood pressure medication. Right. Like, it's pretty moving. And I think they. That you told Their stories so beautifully that I was like, these are the heroes of this. I mean, Cindy's obviously the hero because it wouldn't exist without you. But the women's stories, they're incredible.
- [09:39]
E
And I think when we were developing this story, one of the things I did was to go to isswitch and meet Erwin Goldstein. And he was the one that said that he had these videos of women that he had done for the trials, which are in the film. And Ash and team tracked those down, which was challenging, and then tracked down some of those women who now, all these years later, could tell their story. And I thought that was, like you, Kelly, an incredibly powerful message to see also the authenticity of these women in the moment who had really been struggling. And once they were on this medicine and trials, it changed their lives. Then they couldn't get it.
- [10:21]
A
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- [11:13]
E
This is a story about perseverance. And it would have been easy then to just say, oh, well, let's let it go. Let's not take it to market. At so many moments. It would have been easy. But I think that was part of what Cindy said in the beginning when we were developing this project, is those women were the people who inspired her to continue the fight. And it is. It's like as women, we have to fight for our own care sometimes. That's what these women did. But it's. Their stories are very relatable, I think.
- [11:43]
B
Yep. I agree. The other thing, like to contrast the heart of the women's stories with the science that was brought to the fda. Because what shocked me was Cindy and Sprout and the companies. They kept giving the FDA what the FDA was asking for. They're like, here's the data.
- [12:00]
C
Here's how it works.
- [12:01]
B
Here's the safety. That, like, every time the FDA said, here's a bar, they met it and they kept going back. And then the FDA kept still being like, well, I don't know, though, really kind of portraying it, like, at the end of the day, it was up to their opinion instead of up to facts and science, which is what the FDA should be using to approve drugs. And that was, like, so jarring for me to be like, they did it. They proved the science. They brought the data every time. And then the FDA was still like, yeah, but we're not sure if we just should. And I was like, that's not your job to be judgmental on a product. It's to evaluate the science and the data. That was jarring for me, being the scientist, coming from, like, I thought there was, like, protocols and rules and, like, facts that they were judging this stuff on. Anybody want to speak to that?
- [12:50]
E
That showed the bias. Right. Inherent. Which is why the story is about the fight for Addie, but it's also a women's health story writ large, because the same things were with vaginal estrogen, or we've. Kelly, you've talked about testosterone, but whatever it is, if it's a drug for women, somehow we have a higher standard. It's more roadblocks and harder to get access. And so that's why the story is something that has so much resonance for us now, because we're still, in various ways, still fighting this fight for access.
- [13:26]
D
I agree.
- [13:26]
B
I mean, when Viagra came out, correct me if I'm wrong, but when Viagra came out, some people had heart attacks having sex and died.
- [13:33]
F
Right.
- [13:33]
B
Like, that happened and then. But the media didn't take it and be like, this is killing men. Nobody should have access to it. Like, the spin of the on people's choices for their bodies is so stark. And what your film does is. It kind of lifts the veil to that. Right. Is like, listen, we're asking for equality here. We want to be judged at the same that Viagra and men's products get judged and have access. And I think a lot of people still don't see the bias inherent in the system.
- [14:04]
D
Absolutely. I mean, it's a control issue at the end of the day. And these systems are built through a patriarchal lens. Right. So it's always going to look at women as untrustworthy. It's always going to not. It's going to dismiss our pain or not completely believe what. What we're saying is accurate to what we're experiencing. It's going to be in all, you know, all in your head, you know, diagnosis that is so insidious into all parts of our lives. And you know, it's the old adage of like you have to work twice as hard to get half as far. Like that's literally what the FDA was like. No, the roadblocks were or not the roadblocks, but the goalposts are, we're pushing them further down because we're just don't want to approve this. And so we have to keep moving those goalposts. And that's how insidious this types of misogyny exists in our culture, that it bleeds into systems of science or, you know, the people that are the arbiters of scientific. Scientific.
- [15:05]
F
The gaze keepers.
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D
Yeah.
- [15:06]
F
Really? Right.
- [15:08]
B
The decision makers.
- [15:09]
F
Ultimately, yes. I think this is eye opening too, you know, Kelly, you know it, you live it. Watch the film. But watch it as the cautionary tale of what repeats itself in women's health. If we don't get involved, if we don't advocate. I believe there's a ten year truth horizon in women's health. I believe a new idea comes to the world and we resist it for 10 years. Watch the operative words, the so called, the controversial, the risky, the things that exactly as you said did not appear in those headlines with viagra. And then 10 years later we wake up and we go, oops, sorry, right?
- [15:48]
B
It's just so obvious now.
- [15:49]
F
All that was wrong. And we starved a decade of actually helping people because of our bias. And now we're going to do what we can't, give them that decade back. And so that's at least my hope for the film is like, this is pervasive in women's health. We are just an example of this that I think is an eye opening one for everybody to, as you say, hold up the mirror and examine if you too have your own bias, conscious or unconscious of it.
- [16:17]
B
Yeah. I mean when Viagra came out, doctors weren't like, but is like, is your
- [16:21]
A
soft dick all that bad? Right?
- [16:23]
B
Like, is it, is it really a problem? It's like laughable that we would question a man's interest in helping his sexual function. Right? Like, because it's so ridiculous that we'd be like, oh, you have issues with directions here. Now we have options. But with women we're like, is it really that bad? Like you can have sex without really wanting it. It gets so cringy so fast. We don't hold up that same sort of, like, judgment. I'm like, who's the FDA or a doctor to say if your sex life is satisfying or not? Truthfully, we don't take women's words for it. We doubt them when they dare to speak. But we're never like, is your penis actually that soft? Like, is low testosterone actually a problem man?
- [17:02]
F
Right.
- [17:02]
B
Like, we. It's, like, laughable that we would question them.
- [17:06]
C
I think the really. One of the really interesting things to me, as we were going through the process of making the film was the idea, really, that we call it the little pink pill. But it's so different, actually, from Viagra in terms of the way it works, obviously. And the idea, really, that women want to. Want to have sex is really at the root of this conversation about how this works. And I think that just the. And this comes up in the FDA chapter of the film as well, is that the basic understanding of desire and women and low libido and having to want to want to have sex is very different than men's experiences, which it's about, you know, having a hard dick, as it were. So it's. I think that is. That, to me, was important to understand that that's what we're talking about when we're talking about women and sex and sexuality and the want to want to have sex, which I think is at the center of this.
- [18:03]
B
Yep, absolutely. So I got to watch it in the room at Ishwish. So it was like kids at a candy store.
- [18:10]
A
The people who were in the film
- [18:11]
B
were in the room. Everybody there was massively supportive. We all knew what the end was gonna be, right? So, like, it was just, like, bubbly joy. It was so fun to watch it in that group. And my question is, when you're premiering it in different cities, what are the women saying who are coming in, like, not knowing this story? Are they, like, blown away that this was that long and complicated? Like, what does the, like, uninitiated person think about this story?
- [18:39]
D
We've only shown it in at docnyc so far with an audience, so we will find out most of these answers tomorrow and for the rest of our lives, I guess. But. But I will say, in New York, it ran the gamut of people who had some understanding, maybe some bias before they came in in one direction or another. But you really do see, for the average viewer, the evolution that they go through. That may be skeptical. Maybe I'm being sold something to the point where once it becomes very clear, and I know the point happens in the movie, it's when Sue Goldstein is like, you either believe in a biological solution or you believe that you shouldn't have a biological solution. And that's the light bulb moment that I have watched people's faces go, oh, it's about choice. It's not my. It's not for my opinion to tell someone else what to do with their body or how they should feel about their body at whatever stage they are in their life. It's their choice to do that. And why are we holding that back from them? And that's the point. I always find that the average person who maybe have certain thoughts about drug taking drugs or not taking drugs, that's when it clicks into them that it's not about my what I think about it for this person.
- [19:54]
B
Yeah, I love that. Abby, what were you gonna say that
- [19:57]
E
in the Times, both DOC NYC and a couple sort of impact related screenings we've done. PEOPLE AUDIBLY GASP like, there's a moment where Josephine Terente, who's the lawyer who is working on the so called sex appeal.
- [20:11]
B
Oh, God. Where Addie loved, loved her.
- [20:14]
E
She's amazing. And part of the reason she's amazing is she says it's like, just the facts, boss. Like, she gives you just the facts. But she does a great job of distilling some of the FDA responses. And there's a moment where she's describing the FDA and their response to the side effects and that men both the fact that they didn't want women to take this drug and then drive their kids to school, but also that women were they wanting more sex because they were falling asleep. And this whole notion of sex that was biased and patriarchal, whether they were men or sometimes even women, actually. Which was really interesting too in the film, each time we watched that in AUDIENCE PEOPLE GASP these days, I'm all
- [21:07]
A
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- [22:07]
E
other great thing that Ash did as the director and filmmaker in this is that you sort of go on an emotional roller coaster. I think by the end. The other thing that people have told me is that they're angry and then in the end they're inspired. You know, it's like, how can this be shock? Gasp. Oh my God, this is effing crazy. Why is this like this? I've been deprived, like Cindy said, 10 years of something I could have gotten. And then it's inspired. Like these people stood up and did something about it. Cindy stood up, fought multiple times, got her company back to make sure that women could get access. So I think people leave feeling like, oh, what in my life can I do to fight the fight in some small way or large way to make a difference? And it's fun to see that arc. Watching the film.
- [22:58]
B
I love that. What are the men saying?
- [23:01]
F
I think they're equally. It's eye opening for them.
- [23:03]
E
Right.
- [23:04]
F
Like, it's interesting to sit like, this is something. Gather your girlfriends, gather the men in your life. I think if you are a woman or you've ever loved a woman in any way, your mom, your daughter, your niece, your friend, you should watch this, even if this isn't your lived experience. Because I think it is important.
- [23:21]
B
Everybody's reception is similar no matter what their gender or background is.
- [23:25]
A
Yeah.
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D
I also think that it's relieving for men too. And lots of the husbands that we spoke to who felt like there's so much shame. Our society and culture gives so much shame around sex and about whose fault and who's supposed to perform in a certain way and yada, yada, yada. And a lot of for the heterosexual couples that they felt like, oh, she doesn't care for me anymore. She doesn't love me anymore, she doesn't want me to touch her. That it was their fault. And of course the woman is internalizing is like, oh, this is my fault. I am not feeling this way. I can't perform how he wants me to. And just opening up that as a conversation that can be had in a very like, neutral and loving and safe environment rather than something that feels maybe more uncomfortable and Maybe a bit charged. But I showed the film to a physician friend of mine, or I had her watch it, and she was watching it with her husband. And he, the whole time in the first beginning was like, when are you going to take this drug? When are you going to get this drug? And she was like, I'm turning it off. I'm watching it without you, because I can't watch this movie with you right now. You can watch it on your own. And she really, really responded very well to it. And the next day she told me, or maybe two days later, a patient came in and was asking her about her sex life and how it was used to be there. And she was like, well, there's this drug named Addie, you know, so it's. It's interesting how it's, like, become bigger part of the conversation, but I think it should be empowering for men that there's a con, there's. That there's an open conversation that can be had whether you're talking about a drug or not. But to actually just be talking to your partner, whatever gender they are, about how they're feeling in this moment, and if they want something better, how can they achieve that together as a couple? Which I think is really a great step forward.
- [25:13]
B
I love that. I think the lack of conversation in the realm of sexual health paralyzes people. They don't know how to start, and then they realize they don't. They didn't die talking about it. And, like, I have to think for this film, like, it's the same thing, right? If people are like, oh. And once they start talking about it and they're angry and they're energized and they're empowered, like, there's this big, I guess, energy behind people. When people watch this film, what are your hopes? What do you want them to do after they watch this film?
- [25:42]
F
Own their pleasure. In the bedroom, in your relationship, in your life, own your pleasure. And if anybody ever dismisses it, underestimates it, overlooks it, fight back. This is, we've got this one life. How are you going to live it? And I think this is just a love story to people like you, Kelly, in the sexual health community who have fought back, who have made this be the mainstream conversation it deserves to be, because sexual health is a basic human right, and it is part of your overall mental and physical health as well. So why is it still in the shadows? I hope this brings it out from
- [26:21]
D
there, and I really hope that it validates how you're feeling, whatever that is to know that you should be able to have these conversations with your doctor, with your partner. You can demand more for your own self. It's about, you know, I hope it brings self knowledge, self respect, self power. And you know, we live in a very, very like complex and hard times right now. If we can remember that pleasure is super important way to continue existing and thriving in this world, then we're going to be in a better place. So I hope it's, I hope it's uplifting at the end and it will also give people the tools of what they can go into their doctor's office and have these conversations if they want to have them with their doctor.
- [27:06]
E
Yeah.
- [27:07]
C
And just to add to that, I mean we always talked about the fact that the ability to. Let's talk about sex, which is what we're doing right now. And it's so important. And I think one of the other things that we've talked about is the fact that if you've got the ability and you feel empowered to ask hard questions like this, get educated like this, it has an impact in your, in the larger way that you are as a woman. You can, you can have a hard conversation with your partner, you can have a hard conversation with your doctor. Hopefully you can have a conversation with your employer. Whatever it is that you need and want, it's the, you know, it's the ability to watch in this film how so many people stood up and fought for something and how we need to do that in our lives in general.
- [27:49]
A
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- [29:06]
B
I love that. Abby, do you want to take us home? What are your final thoughts?
- [29:09]
D
Sure.
- [29:09]
E
I'd say I'm loving what everyone's saying and it's making me feel excited to watch this film again as women being our own champions too. I realized as I was hearing everyone talk. I mean, I think, Cindy, that's what you did. The patients did that. They were vulnerable. They said no to shame and yes to being the champions of their own health and their own story. And I think this film is kind of a love letter to that too. How can we claim back our own story narratives and be our own champions for whatever it is that we want to achieve? And saying yes to pleasure and no to the stigma is part of that.
- [29:46]
B
I love it. Everybody, thank you so much for your time for coming on this podcast to help raise awareness for this amazing topic, the amazing people that fought for these women. And until next time, thank you for all of your work.
- [29:59]
E
Thank you. Watch on Paramount plus gang.
- [30:01]
B
Watch on Paramount plus out now.
- [30:04]
E
Thank you.
- [30:04]
D
Thank you Dr. Ken.
- [30:05]
F
Thank you.
- [30:06]
E
Thanks Kelly.
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A
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