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You Are Not Broken

327. Bladder Matters, Leakage and What To Do

You Are Not Broken

Kelly Casperson, MD

Medicine, Health & Fitness

4.81.1K Ratings

🗓️ 20 July 2025

⏱️ 56 minutes

🧾️ Download transcript

Summary

Episode 327: Bladder Leakage Is Common, But That Doesn’t Mean It’s Normal — with Dr. Alex Rogers I’m joined this week by my brilliant colleague and fellow urologist, Dr. Alex Rogers, for a candid, informative conversation about something way too many people silently struggle with: bladder leakage. We’re two urologists talking all things pee — from stress incontinence to overactive bladder, and everything in between. Whether you’re dealing with a sudden urge to run to the bathroom, leaking when you laugh or sneeze, or you’re just confused about what’s going on down there, this episode is for you. We break down the two most common types of bladder leakage — overactive bladder and stress urinary incontinence — and explain why they require totally different treatment approaches. We also talk about the huge impact of hormones on bladder health, especially in menopause (yes, estrogen matters here too!). Dr. Rogers and I dive into: Why bladder leakage is so common — and why we shouldn’t normalize it The real science behind overactive bladder Why Botox is an underutilized but super effective treatment option How pelvic floor therapy fits into the bigger picture What’s new and exciting in urology (hello, neuromodulation and telehealth) The frustrating role of insurance in limiting access to care How to find a provider who actually knows what they’re doing when it comes to bladder health This isn’t just a “deal with it” issue — it’s a quality of life issue. And the good news? There are solutions. Real, evidence-based, life-changing options. But only if we talk about it. So let’s talk. Takeaways: Bladder leakage is common but under-discussed Hormonal changes play a huge role in bladder function Overactive bladder ≠ stress incontinence — and treatments vary Botox is a powerful and underutilized option Telemedicine and new tech are changing the game Education empowers patients to advocate for better care Insurance hurdles are real — and we need to fight for better access Find the right specialist — not all care is created equal Let’s stop suffering in silence and start empowering ourselves and our patients with facts, not shame. 🎧 Listen now and share with someone who needs to know they're not alone — and that bladder leakage is treatable. https://www.bladderboutique.com/ Want more honest, empowering conversations like this one?⁠⁠⁠Preorder my Next Book⁠⁠⁠ share this episode, and leave a review to help others find this important work. Let's stop leaving women out of the conversation—especially when it comes to sex, health, and healing. 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 Explore and expand pleasure with resources, advice, and the most exciting pleasure products with Good Vibes, and save 10% with coupon code NOTBROKEN10 at goodvibes.com/menopause 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

Transcript

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0:00.0

Welcome to the You Are Not Broken podcast. I'm your host, Dr. Kelly Casperson, a board-certified

0:09.9

jurologist, thought leader, and conversation starter on midlife living, hormones, and sexuality.

0:16.6

Enjoy the show.

0:18.2

Bladder leakage, stress incontinence, urge incontinence, surgical options, medical options,

0:22.3

and don't forget the pelvic floor physical therapists.

0:24.5

We're here today to talk about bladder leakage with my good friend, Dr. Alex Rogers,

0:28.7

another bad-ass female urologist.

0:32.0

Thanks for joining me, Alex.

0:34.0

Oh, Kelly, such a pleasure, the queen.

0:37.2

We love what you're doing. We're like just cheering you on,

0:40.1

all the female urologists out there. And yeah, I love talking about the leakage.

0:45.3

Dude, it's incredibly common and not talked about. Yeah, it's in a black box. How do we get it

0:50.9

out of that black box? Is there too much shame? I think there's more shame to

0:54.5

leakage than sexual dysfunction. I don't know. Yeah, no. I think people talk about dry vagina.

1:00.5

They talk about hot flashes. They talk about breast care. Now we can Botox her faces without

1:05.9

shame, right? Why do no women talk about how many pads they're buying and that they can't make to the bathroom on time?

1:13.3

And they don't even know what they have when it comes to leakage, right?

1:15.8

They just come in and they're like, I don't know, I leak.

1:18.1

Right, right.

1:18.6

And it's an entire aisle in the grocery store, which tells you how big of a problem this is.

1:23.8

Yeah, I think there are more adult incontinence products going into landfills now than baby diapers.

1:30.7

Ah, I heard, I heard, this was years ago, I heard Japan was the first country to sell more adult

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