Episode 369: Dr. Kelly Casperson, interviewed by Sara Reardon What happens when a urologic surgeon who has spent years treating women's bladder and sexual health sits down to answer every question she wishes her patients had asked sooner? You get this episode. In a role reversal from her usual hosting chair, Dr. Kelly Casperson is interviewed by Sara Reardon for a wide-ranging, myth-busting conversation on perimenopause, hormone therapy, and what it actually means to advocate for yourself in a medical system that has historically under-served women. No gatekeeping. No fear-mongering. Just the science, the nuance, and the permission to want more. Perimenopause is not just hot flashes. The hormonal shifts of perimenopause and menopause affect your bladder, your sleep, your joints, your skin, your mood, and your sex life — often years before your period stops. Kelly breaks down what's actually happening biologically and why so many women are told their symptoms are "just aging." Local estrogen and systemic HRT are not the same thing — and you may need both. Vaginal estrogen treats the tissue. Systemic hormone therapy treats the whole person. Kelly explains the difference, who benefits from each, and how to have an informed conversation with your provider about what's right for you. DHEA and testosterone belong in the conversation. These hormones are not just for men. Kelly covers the evidence for testosterone and DHEA in women's health — including delivery methods, indications, and why so many women are never offered them. Finding a knowledgeable provider is hard. Here's how to do it. Not every clinician is trained in hormone therapy. Kelly talks about how to identify providers who are, and how to self-educate enough to advocate effectively in any appointment. Gut health, exercise, and alcohol all matter — but not instead of hormones. Lifestyle strategies can amplify hormone therapy; they're not a replacement for it. Kelly cuts through the supplement noise and explains what the evidence actually supports. Gender bias is real, and naming it is the first step. From the Women's Health Initiative fallout to the way women's pain is routinely minimized, Kelly addresses the systemic forces that have shaped (and limited) what women are offered — and how to push back. 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 To learn more about Via vaginal moisturizer from Solv Wellness, visit ⁠⁠via4her.com⁠⁠ and get 20% off your first order. For an additional $5 off, use coupon code DRKELLY5. Clinicians can request patient materials or samples at ⁠⁠hcp.solvwellness.com⁠⁠. 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