This topic has been shrouded in fear and stigma and all these myths and so that also adds

to the allure of like, dude maybe everything you think about menopause and hormones is wrong.

Welcome to the trailhead of trailrunner nation. We go on virtual trailruns every week. We're glad that you joined us because frankly, we have a lot of miles to put in this week and we have a great conversation. Today, we're talking with Dr. Casperson and we're covering the topics hormones, running, endurance, performance. I mean this is one you'll want to lean into and even refer to a loved one or a friend. Trailrunners, how many packs have almost worked but bounced around, couldn't hold your gear or just didn't fit right. That's why John G created the Revy Pack, the most technical and versatile day pack yet designed to take you farther. Its bounce proof thanks to a 4-point adjustable system and stoleable elastic waist belt. The Revy has pockets for everything too. It can haul over 20 pounds without flinching. Its weather-resistant materials high contrast citrus lining and John G's signature sustainable design makes this pack the one you'll reach for again and again. 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You can actually see the data in full sun without squinting. Let's talk about battery life. Scott, have you noticed this? 27 days on typical use or up to 180 hours in GPS max mode. You can go on a multi-day trek without packing a charger. Check it out at amazfit.com slash trail and right now you can get 15% off the T-Rex 3. Welcome to another edition of Trail Reignation. My name is Don Freeman. I'm Chrissy Mail. And I'm Scott War. This is another edition of the aging athlete. What does it mean to be a trail runner in your 20s, 30s, 40s, 50s and beyond? How did decades of movement shape your body, our minds and our identities? This is the second episode in our aging athlete mini-series here on TrailRunnerNation and it's co-hosted by our friend and legend, Chrissy Male. She's a two-time UTMB champion. She's the youngest woman to claim the grand slam of Ultra running. She's a coach. She's the author of Running Your First Ultra. She's the race director of the storied Chuck-Nut 50K and spent decades pushing boundaries on the trails. Chrissy, thanks for joining us. Today's expert is Dr. Kelly Kasperson. She's a board-certified urologist. Host of the acclaimed You Are Not Broken podcast and founder of the Casperson urology and hormone clinic in Bellingham, Washington. Chrissy, you brought a Kelly into our knowledge here. Tell us a little bit about Dr. Casperson and why we hope to learn from her today. I am so excited. Do you want us to call us Dr. Kelly Casterson. Where has to be Kelly's fine after the intro so like I'm always like they know why I saved why I say things Okay, she went to med school now you can call me Kelly Thank you for being with us Kelly Kelly is one of the resources that I found when I talked about it on some of our previous episodes of of aging athlete noticing things changing in my body. I'm like, hey, what's menopause going to do to this athlete bit and to come to find out my hormone cycle has been a big part of my whole athletic career. Just didn't know it as well. So finding resources and people that have been putting a lot more intention on specifically women's health. We're going to broaden the topic today. We have endurance athletes of all genders that listen here and we want to tap your resources on that. You may have noted in Scott's intro, Kelly and I are both from Bellingham, Washington. So like extra stars that, oh my gosh, she's local. Like we have one of these awesome resources right here in Bellingham. I went to the emfactor where you did the opening and hosting for that night. It's an awesome documentary if people have not seen that yet. I highly recommend the emfactor Kelly is featured in there as well. And the You Are Not Broken Podcast is prolific. I have not been able to listen to all of the episodes, but definitely in my mainstream of listening. So super honor for me to have you here today. And I love your open approach to how you talk about hormones and sexual health and how that can be an indicator of overall health. And how do we wanna get this really? I have so many questions. Go ahead Scott. I'm curious, what is the M factor? I have never heard of that. Is that a conference? No, so it's a documentary. It's a PBS documentary done by an award-winning documentary and who's done amazing work. And basically it's kind of uncovering or telling the story of how bad it is right now. And the kind of the culture of medicine that dismisses women in not feeling well in midlife. And kind of how the culture and the fear of hormones has really created a normalization of suffering. And my bit, my bit in it, I'm the like sex med testosterone guru and had some patients who were gracious enough. So the documentary team actually came to Bellingham, filmed me, filmed me talking to my patients, kind of telling their stories of what life was like before they started hormones and then how their life got better. So it's about an hour long on PBS. It just got international rights. This documentary has been shown in over 30 countries now. Like it is literally, it took off. Because it just strikes a nerve for so many people of like, yes, this is the lived experience that is happening right now. And everybody goes through that phase at some point. If we're lucky enough to be around that long, it's a common path for everyone. Yeah, struck me is that it got credit for continuing education credits for medical. And I was like, but a documentary, there's not much out there for doctors even to learn. So this documentary is got that status as well, which I think is also telling of how much information is out there. Yeah, I mean, we lost two decades of physicians being trained in hormones because after the women's health initiative

blew up in 2002

Everybody just got incredibly afraid

And it turns out that it was bad science. It was bad science. It was bad marketing It was media going for big attention grabbing and the actual truth of the study

Which is free online for anybody to read they can actually go read the study it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like it's not like anybody to read. They can actually go read the study. It's not like it's behind a vault. And to realize like, actually, it wasn't that bad. It was more the misinterpretation and the like dogma of fear that took over. And so we literally have two generations of healthcare providers that don't know about how to treat women in menopause. So we have 80 million women over the age of 40 in the United States alone. This is a big problem. Kelly, I want to thank you already. This may be the first episode of our 727 episodes or 30 episodes that she's going to listen to because she was just talking to me the other day and saying it's crazy Why there has been no research medical research that has included women and We know so little about women. How did you get started on this journey to where you are today? Yeah. Why did you decide to take this route? The universe. I was in Bellingham for seven years. I private practice urologist for people who don't know urologists are surgeons of the genital urinary tract. So kidneys, ureters, bladders, testicles, scrotum, u rethera. I do a lot of female bladder leakage

and vaginal prolapse work in seven years in. I don't know if anybody's heard of the seven-year itch. I got the seven-year itch. I'm like, what did I do all this training for? I'm bored. I've just repeating myself 20 times a day. I was really like, is this all there is to this career? And I had a patient come in who I was very bonded with and she was crying about her sexless marriage and it's a lightning struck my brain and I was like I don't know how to help her. Does anybody know how to help her? Did the gynecologist know how to help her? Here I am giving Viagra and testosterone to all the men, 90% of men are heterosexual who's taking care of the people they want to be sleeping with.

Right, so it was this big aha. And so dove into female sexual health, started the podcast, started the Instagram, wrote the book, and then people said, yeah, but you know what happens to your sex life with menopause. And I'm like, I know, but in the kept saying, well, you know what happens to your sex life with menopause? and I'm like, no.

And people keep saying it enough,

and I'm like, listen, I'm staring down the barrel too.

Like I should probably figure out what happens

to your sex life with menopause? And I'm like, no. And people kept saying it enough, and I'm like, listen,

I'm staring down the barrel too.

Like I should probably figure out what happens

to your sex life with menopause,

and started to research like, what's the role of hormones and sexual health and what does happen? And is it over for sure? And why are people afraid of hormones? What's this women's health initiative thing?

So it was really like my innate curiosity

of peeling off the layers of the onion.

And so I always joke sex got me into menopause

because that was the reason why. And now I'm like, there's so much misinformation and fear that you have to get over that. You can't just say like, everybody should take hormones because people don't know what a hormone is. They don't understand that it's not trying to kill you. So there's this big, like, zeitgeist of fear that you have to crack through, but it's like the most rewarding part of medicine ever is to hear people say, I feel like myself again. That is the best thing that I can get out of my day. And so I basically changed my whole practice to be, like, sex, met, and hormones. That's all I do now because it is my favorite thing to help people with. Are you saying that for a typical person, sort of the majority of people, should they be taking supplemental hormones? Is they good through that transition? Yeah, it's a good question. And no menopause expert will ever say everybody should. That's like very strong wording in our world to say everybody should. This is where my stance is because people say they're like, do you just want everybody to be on blah, blah, blah. And I'm like, no, I want people to have the education so that they make the decision if they want to be on blah, blah, blah. And that education is what is a hormone? How does it help the body? Because right now, people's understanding of menopause is you can't get pregnant anymore and you're done with periods. That's what people think menopause is. And what menopause actually is is you are out living your ovarian function. Overeas make testosterone, estrogen, progesterone. Those are the main commercially available hormones, right? And those hormones, all hormones are our communicators. And organ makes a communicator, it travels somewhere else in the body and it communicates and it helps cells function. And we're talking cellular function like on the mitochondrial level. And this is nerves, this is muscles, this is bone, this is joints. And so what you are basically outliving the life of the ovary, which many, many animals do. That's the other myth of humans and three whales are the only things that do have been, that is not true. Especially if you put the mammals in, what I call aging in captivity, which is what we're all doing. We have clean water, we have safe lives, we can treat trauma and cancer pretty well. So we're all aging in captivity, and you take any mammal and you age them in captivity. There's a harbour seal in the Portland Aquarium right now that's like 49 years old. In real life, they live to 18, right? And so that's what humans are doing. We're aging

in captivity. We're, you know, we're really good at infectious disease. We're really good at trauma care. We're really good at, you know, clean water. So we're living as a society way longer than what we used to. Average age, if you were lucky, you could make it to like 60. You could make it to like 65.

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