363. Mesh, Vaginal Estrogen, Female Urology and More with Dr. Una Lee

You Are Not Broken

Kelly Casperson, MD

Medicine, Health & Fitness

4.8 • 1.1K Ratings

🗓️ 22 March 2026

⏱️ 51 minutes

🔗️ Recording | iTunes | RSS

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Summary

In this episode of You Are Not Broken, I sit down with urologist Dr. Una Lee to talk about what women actually need in midlife care — and why the system still makes it so hard to get. We dive into the importance of patient-centered research — studying what truly matters to women: quality of life, sexual health, urinary symptoms, and comfort. If we don’t measure those things, we miss the point. We also discuss the removal of the boxed warning language on vaginal estrogen and how correcting misinformation has already improved prescribing and access. Fear limited care for years. Data changes that. We cover: Why education on vaginal estrogen and GSM is essential The research gap in testosterone therapy for women The importance of pelvic floor physical therapy as first-line care Informed consent and nuance in surgical conversations Ongoing barriers to hormonal access The big theme? Women are living longer — and our healthcare system needs to evolve with them. 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 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 You Are Not Broken, the podcast that challenges everything we've been taught about midlife, hormones, and sexuality.
0:09.8	I'm Dr. Kelly Casperson, board-certified urologist, author, and a leading voice in women's sexual and hormone health.
0:15.9	Enjoy the show.
0:17.5	Hey, everybody. Welcome back to the You're Not Broken podcast.
0:19.8	I have my good friend Dr. Una Leon today, another female urologist. Yay, thank you for coming.
0:25.1	Hello, hello, everyone. Thanks for having me. It's actually my first time. We've talked about it before, but I'm taking the leap.
0:31.8	We've been talking about you getting on this podcast for like years. I'm a little, not that I'm shy. I'm not shy and I'm not introverted,
0:39.7	but I'm reserved. I'll say that. And I have a lot to say, but I feel very strongly that it
0:46.1	should be said in a way that's meaningful and authentic and in the right space and the right time.
0:52.6	Oh, well, thank you for picking my podcast as the right space for all of your knowledge.
0:56.6	This is fantastic.
0:58.0	When did we meet?
0:59.0	I feel like, have we met before Sufu, which is the Society for Uranomics and Female Urology,
1:06.0	2000?
1:07.5	We met before the pandemic was happening.
1:10.6	Maybe I, like, you're just imprinted in my brain at that moment because that's when like the shit went down with the pandemic and we were all in Scottsdale, Arizona at a Sufu meeting. Yeah, we definitely met before that. We've been in parallel circles. Do you remember that though? Because like CNN was like, this nursing home in Seattle. Mm-hmm. That was the beginning of the pandemic. Yeah. Well, how many years have you been in practice? Have you been out of... Or the 14? This year 15? I graduated from residency 2012. Yeah, so we're in the same cohort. I've been in practice 15 plus years, yeah. Yay. How long have you been in Seattle? Same amount of time. We're even more
1:46.3	alike in this podcast. We are basically the parallel. Oh, we're the same cohorts. I love it.
1:51.8	So you've been in academics this whole time at Virginia Mason. Yes. And you are now, I'm going to put it
1:57.6	into your mouth. You are now the program director. Section head physician lead. So I don't lead the residency and the fellowship, but I do
2:05.0	help lead the fellowship. I lead the department and I lead urologist across the system of
2:10.8	Virginia Mason-Francican health. That's big. The cool thing most recently is that I quoted your paper when I was talking at HHS.
2:21.7	To catch anybody up who has been under a wooden box, I was at Health and Human Services.
	...

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