Sex, Love, and What Else Matters - You Are Not Broken with Dr. Kelly Casperson

Episode Date: February 24, 2024

Episode 93.  In this episode, Kristen and Luke are joined by Dr. Kelly Casperson, Urologist, Sex Educator, and Podcaster. She is also the Author of the book, “You Are Not Broken.” Dr. Kelly Casperson talks about the importance of people being empowered to their own health and sexuality through education. They discuss the lack of education around sex, must-ask questions for your partner, myths around sex, and so much more! Kristen and Luke get vulnerable about their relationship and have a conversation they’ve never had before! Tune in now.  Sponsors: Nutrafol is offering our listeners $10 off your first month’s subscription and free shiping when you go to Nutrafol.com and enter promo code Doute Get started with EveryPlate for just $1.49 per meal PLUS $1 steaks for life by going to EveryPlate.com/podcast and entering code 49doute Follow us: @kristendoute @luke__broderick Email us: [e-mail] Learn more about your ad choices. Visit megaphone.fm/adchoices

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I'm here. Not always, but this time, and I would not miss this one. Don't miss this one. We're very excited. So we have a guest today, Kelly Kaspersten, MD, Dr. Kelly Kaspersten. So Kelly is a urologist, sex educator, wife, and mom, self-proclaimed on her book, author of, I'm obsessed with this title, Kelly, by the way, the author of You Are Not Broken, Stop Shooting All Over Your Life. Girl, it's fun to say. It really is fun to say. Luke and I were in

Hawaii, so we did not get the book until we got home yesterday, and I just went ham on it, as I just told you before we started recording. I went through this book, I read most of it really quickly. It is hilarious. I just, I vibe with it. It was such an easy read for someone who's not a doctor like myself. That was the whole point. Like I read all the books and like when PhDs write books, man, it is, it can be painful. It's like have bigger margins people.

But like I didn't, I did, I did never read the book that I wanted to exist, which is like, actionable, short and funny. It's like, you should be able to finish a book in a weekend. It's no, it's phenomenal. And what I really liked because I wanted to, obviously, I read the back of the book, I always read the, you know, like your table of contents, but your introduction immediately told me why you wrote this book as a urologist. And that's what I found so fascinating right off the bat.

I want you to tell a story for our listeners, but you had a bladder cancer patient. Do you want to tell the story? Yeah. So I got into sex med and hormones because I was a urologist for like seven years. You get good at your job, you know, you know what you're doing, you get a little bored. Like the seven-year itch that everybody gets in their career, right? And I had a patient I was very bonded with and I think that's why it was so important because she came in and I loved her already and then she presented this problem, you know, the sexless marriage,

feeling so sad, feeling sad for him, not knowing what to do. And I was handing the box of clinics across the room, and the lightning struck my brain of like, you don't know how to help her. Urologists kind of take care of the penises. We are the boner experts. And at that point, it was like, why are we giving all these men Viagra if nobody's taking care of the like target of the Viagra? And like, really, my world got exploded of like, wow, our inequality and how we care for especially heterosexual sexual relationships in medicine. I mean, I just assumed all the gynecologists were taking care of it. I mean, I just assumed all the gynecologists were taking care of it. Turns out they're not. They didn't get female sexuality either.

So it's a huge, huge void. No, I literally, I couldn't agree more. And this is sort of, I guess it's a question, not question, but I was just talking to my, I call them my gay best friend, Zach, on the. And we were discussing the stigma around just essentially talking about sex. And I think this interview with you for me is going to be the most fascinating because for me, it's very full circle for when Luke and I started our podcast. Because for me, it was, I stand by like this quote that I've said for years is that you shouldn't be having sex if you can't talk about sex. And I don't mean you have to write the book

or speak into a vacuum that is a podcast, well, the non-vacuum that is a podcast, but with your partner, if you cannot talk about your boundaries, your wants, the exploration, your concerns, just everything about it, even in the health especially as well, then it shouldn't be happening. And that was a huge overall that I got from your book as well. And I think it's really freaking important.

And so what my friend Zach was saying was he truly felt there was a lack of in sex education from doctors, but also sex education in schools for women and for the LGBTQ community. And what I loved about your book is that you always referred to PIV, penis and vagina sex, which is the way I was brought up. That was sex. There was nothing else that you find out about sex until I was honestly like close to 30,

which blew my mind. I didn't know it was that long. So when I was in school, they talked about safe sex and that's about as far and I mean anatomy and condoms and dental dams and birth control And that's it. That's all they covered. Mm-hmm. Yeah. Yeah, we call it the disease and pregnancy prevention plan Which is not sex ed. No, right? It's not like and I think like for me I had a Catholic sex education growing up. To me, we didn't learn external female genitalia though. It was fallopian tubes, ovaries, and uterus in my memory of this is what the feet, and I was like, dude, those parts aren't even involved in sex.

Not at all. But that's what we have. How many people don't know what a vulva is? Doesn't know where the clitoris is. We're literally lacking words for the sexual organs that we need to communicate about. No, 1 million percent. I feel like there's almost secrecy. It's like a secrecy thing about it that we were brought up. And I don't know the way that it is now for this new generation, the Gen Z, whatever they're calling the people younger than that. But I feel like even they're mostly getting their knowledge from the social media and the TikToks, which is

also not correct. So I just think it's... Yeah, there is some data that in America, sex ed now in the public school system, sex ed now is actually worse than sex ed was in the 90s. And so I'm like, oh, we're in trouble. And I mean, the other thing about the internet is like, especially, I mean, I hang out on Instagram, but it's like, you're not allowed to say the body parts. Like it's considered violating a term and condition because it's a vault. And it's like, dude, our elbow isn't a vulgar word, right? But like, if you can't say the body parts, they don't exist. It's an excellent point. And the way that I'm wording it, I'm just owning this myself, the way Zach, my gay best friend and I were wording it, it's like, one part of the human race, which are the straight males, that that's what we're aware of is like, again, just to go back to the penis and the vagina, that equals sex. That is how you get pleasure. And if it doesn't work, one of my favorite things you talk about in the book is like, then you're broken is the way that we think. I mean, I have so many parts of the book I want to

go over with you if that's okay. But you asked women what they want and you were met with a blank stare. And I think that is fascinating because I truly believe if I had been asked by a doctor or even my therapist or anyone years ago, I would have given the same blank stare. Like, what do you mean? What do I want? I don't even know what you're asking me. Yeah. I mean, so many women, they come to my office because like, they, what they want, I wouldn't say this is what they want, but it's like what they're coming in for because it's what their partner says is the problem is like, I just need to put a penis in my vagina and I can't right now because of pain or hormones or whatever. The penis isn't going in and I need to make it go in. And I'm like,

well, do you want that? And then there isn't usually a yes after that question. I'm like, okay, so you're here for something, but you're not even sure you want that thing. We got to step back. But when Hollywood just tells you what sex is from the heteronormative penis and vagina, that's all you see. Like that's what sex is and it's never been great. I mean, one of the, in my education on this, one of my biggest ahas was, I was talking to this expert who was an expert on low desire in women,

and they were talking about that. And I'm like, but you're assuming the sex is good, right? You're assuming the sex is good, she just has low desire. And he's like, well, of course I'm assuming the sex is good. That's right. And I'm like, who's first? I'd say most men's egos assume that, yes. Right?

And I'm like, oh, you think the sex is good? Like, step back. You don't desire melted ice cream. You don't desire mushy broccoli. Yes. Right? And I'm like, oh, you think the sex is good? Like step back. You don't desire melted ice cream. You don't desire mushy broccoli. Right? Like you have to have something worth desiring. Yeah.

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I love that you speak about desire being both a noun and a verb, which seems so simple, but kind of blew my mind a little bit. If you wouldn't mind talking about that. Well, yeah, I mean, I love the topic because it's like, you know, again, it goes, I think it goes back to the question of like, what do you actually want? Right. Cause so many people are like, I think they, what they want is that Hollywood,

like unbridled, can't keep my pants. Like they want what they see. The rom comes. And I'm like, the, yeah, it's the rom comes leading to like past PG 13. Your shoes aren't off. So you're like falling over, trying to, because the pants are off, but the shoes aren't. Yeah. You know, like, and I'm like, do you actually want that in your life right now?

Like, do you actually want that? Right. Well, no, I actually like my monogamous long-term relationship where it's kind of routine. Like I picked that, but then I think I want this, this newness, this Hollywood freshness. And it's like, it's not how the brain works though. So I think a lot of people don't actually know what they want. And when you talk to them about it, it seems like they want good sex. And then the desire is like, yeah, OK, well, we can plan to have good sex. Sex is kind of like going to the gym, right?

It's like, if you want it in your life, prioritize times for it to happen. And so I was telling Luke, well, we talk about this often, though, because I will say, for me, I used to think we talk about this often though, because I will say for me, I used to think spontaneous sex was the way to have sex. And Luke, as my partner, is all about communication, that we know that that is the basis for a healthy sex life is communicating, and that it is okay to plan it. You wouldn't, you wouldn't believe, I guess you probably would believe, but how many times Kristin said, I don't want to plan it. You wouldn't believe, I guess you probably would believe,

how many times Kristen said, I don't want to plan it. We can't just like say after we get back from dinner in the movies and then we walk the dogs, then we're going to have sex. She's like, I don't know if I'm going to be in the moment. And I'm like, well, we can't, I mean, otherwise you're never going to be in the moment. I don't know, like if we don't set aside time where the distractions are pushed away,

when is it going to happen? Yeah, I was that girl Yeah, like it needed to be spontaneous like knock my socks off rock my world in the moment and if I wasn't there in the moment, then we just couldn't have sex and It's just like reading your book was like reading my diary I'm like, yeah, no, this is this is what's happening And I think that is a huge thing. Because our sex ed is so crappy. Of course you think that way.

Like everything you've ever watched tells you it's that way. Like country music tells you it's that way. Like everything tells you it's that way. And then you're like, oh, but brains don't work that way. And like, I mean, I think back to like whatever, the Dark Ages or the 1800s, or like, there was nothing to do after the sun went down except to have sex. Like, sex was about the most interesting thing you could do, right?

It's like, fast forward to now. It's like, dude, we've got Hagendas ice cream. We've got unlimited social media. We've got any movie you could ever want, and you could lay on the couch, which is a lot easier than like having sex. It's like, dude, sex is up against some legit competing dopamine at this point. Oh, and the comfort too. It's just like, you actually have to go outside of your comfort zone to have intimacy with your person is kind of where it is now because you can be so comfortable in your little corner of the couch and put something on until you're ready to go to bed instead of engaging with

each other. Scroll on your phone, do any of these things that are dopamine releasing. I mean, everyone knows how addictive your phone is, the blue light, etc. Everyone can scroll for hours. I know. Sex is competing with like ice cream and TikTok now. Like, you know, like, think back. Like, this is the, this is, it's amazing.

Anybody has sex. No, it's really, has sex. No, truly. It actually like does take work. And going back, this is so wild to me that you brought up like the dark ages and that's all they had to do because when I was on the phone with my best friend, Zach, he, one of the first things he said was like,

back in the dark ages, like sex was what you did. And whether it was, and his POV was like the Victorian era, when rules became a thing, like this is the way that it needs to go. He was like, all these archaic rules and views on sex is when sort of things started to change. And then to back what you and Luke are both saying, now we have technology and all these other things.

But the fact that you just said that, and it was just a conversation I was having, that it kind of like blows my mind a little bit. Like why aren't we having more sex? And maybe it's because we don't know about it or people don't know about it. And that's so important, clearly. Yeah. I mean, the communication thing you talk about is huge because it's like, if you can't talk about sex when it's good or like going okay It do having that skill is gonna set you up for when like now there's a newborn now

There's a health issue now you have a mom that moved in like there will be hiccups And if you are already not used to talking about this, it's just gonna compound. Yeah, so with your patients friends Yeah. So with your patients, friends, family, partner, whatever, do you typically push communication, education? All of these things are in your book. But like, what is kind of your MO, I guess? Because trust me, I'll talk about your book for the rest of the podcast. It's fascinating. And I think there's pieces in here that people really need to know about. But I'm just curious, like, your whole sort of overall. I think education is huge because it's like people are smart. They just don't have the

information, right? And it's like, if you give them the knowledge, a lot of like their fear will come crashing down or like, you know, like sex is this big taboo thing. And then you start talking about it. It turns out everybody actually does want to talk about it. Once you're like, oh, you kind of talk about like the weather or like going to the gym. It's like, well, yeah, now it's a lot easier to talk about, isn't it? So to me, it's education is so empowering. And then for people to be like, what do you actually want? The other big communication thing for couples, you guys have probably already done this. But like asking your partner what sex means to them, people will like go through entire relationships and not know what sex means to them, people will like go through entire

relationships and not know what sex means to them. And like I was in my relationship for like over 10 years before I was like, what does sex mean to you? And he told me and I was like, no shit. No, honestly, that's a question that we haven't talked so many aspects of it. Like, you know, what turns you on? What is the like pinnacle of sex and pleasure for you when, you know, we're doing these things, whether it's oral, you know, what turns you on? What is the, like, pinnacle of sex of pleasure for you when, you know, we're doing these things, whether it's oral, you know, all these other things.

We've got a toy box as well. But we haven't gotten into what it means to each other. Never. I've never even considered that question, to be honest. Like, that's an amazing question for people. And then the second one is, like, do you have to feel connected to have sex? Or do you have sex to feel connected? And usually you'll have one of each living in the house and then that's why they never have sex, right?

Or like why one's chasing the other one to get the sex but the one doesn't feel connected because they have like opposite needs from that. For sure. And like when you figure that out, that's like super empowering. So what sex means, I believe, to me, let's just get into it, right? Let's have this conversation. Here we go. I think I really identify with what Dr. Casperston said

as in sex is feeling connected. It's like when I feel disconnected, that helps me reconnect with you. I'll tell you, that's what it means to me. And I believe exactly what Dr. Casperston just said is that you're the opposite. You need to feel connected to be able to have sex. Yeah.

So that's our disconnect. You're totally right. Isn't that huge? Yeah. Like just knowing that is like, oh, I see his pitch or his request, if that might be for sex, means something to him, right? That's how he gets connected.

And if she doesn't feel connected, she doesn't feel comfortable having sex. So what does everybody need to do? I think it just creates so much compassion for each other to realize like, do you feel connected? Okay. Right. Just to make it clear for our listeners, it's not that I'm not connected to Luke, but it is that my head gets in my way. My day to day stressors, the dogs, my plans, my ADHD, my whatever it is, that all gets in the way from me feeling connected sometimes in the moment where I'm going, okay, can we leave it later? Because I have all these things on my mind. And he's like, well, if we just connect right now, trust me, you're going

to feel good. And he's literally 110% right all the time. Never not correct. We got that recorded. I've got it documented. I'm right 110%. You know what? You know that's true. You know it's true. I'm like, yeah, you were right. And then we have sex and he goes, don't you feel better? And I'm like, absolutely, you were absolutely right. But I don't know if it's just a me thing. I had to have a lot of friends. So I will say it is a woman thing as well.

But the head gets in the way of the libido for me. Yeah, totally, totally normal, very common. You are not broken. Yeah, exactly. I'm not. I am not broken. Do you want to talk about I'm not broken? Yeah. Well, I mean, the name of the podcast came first. The book came after. And the naming of the podcast, You Are Not Broken, came very naturally because the more I started just talking

to women in my clinic, like, I've never had an, there've been a sexual relationship for over a decade and she's never had an orgasm. Oh, well, 10% of women have never had an orgasm. You're not broken. Right. I have pain after menopause or pain while I'm breastfeeding, all these pain issues that come up. Very common, very treatable, you are not broken. People think their issues are like personality flaws or like defects unique to them because of our lack of education. Or that they're permanent, that they're not fixable, right? And that they're permanent and not fixable, right? Yeah. And so it just kept like the more I just educate and be like, oh yeah, no, that's it. That's a thing. Oh, you don't have an orgasm by putting a penis in your vagina. 70% of women don't. You are not broken,

right? So it was just like over and I was like, Oh, yeah, that's definitely the name of the podcast in the book. Yes. Because it is true. I even, I think that in something that I really love that you wrote about as well in the book was kind of going back to what you're saying, like the Hollywood stigma or like the idealistic of what it was is like our bodies. Cause that's something that I've definitely struggled with where it's like, I'm not feeling great about myself. therefore he must look at me in a certain way and definitely not want to have sex with me. Therefore our sex life is fucked in the moment, not forever. But I think that's another like you're not broken.

Super common. Yeah. And I think that's the one thing that has decreased my libido or it could be my age, it could be hormones, it could be a trillion things. It's your body confidence. But my body confidence, correct. Yeah. Yeah, it's huge. Because women tend to be in our society, we're always checking to see how we match up to

what the perceived ideal is and keep in mind that perceived ideal changes all the time. So it's like you are literally, if you're socialized as a woman in our culture, up against an insurmountable challenge. But the solution there is to see that and to be like, oh, I'm comparing and despairing again. Like, he loves me for who I am. I can be sexy at any age, any shape, any blah, blah, blah. And really like taking that societal bullshit and just making the decision that I'm not gonna let that come into my life, come into my bedroom, blah, blah, blah. But over and over women will say like, I dealt with my body image issues,

my sex life got so much better. Yeah, it's not about what he actually thinks or your partner in general actually thinks. It's about what you're comparing. I like how you said compare and despair. because it really is whatever's been put into my head that I'm not realizing. Even though I'm like a really smart girl and I know better, it's just there. Did I send you that meme?

Yeah. I saw the other day. What meme? It said it was to help with body confidence. Okay. It said even if 99% of the people in the world don't find you attractive, that 1% is still over 100 million people. That's so cute.

That's so cute. All right, ladies, you hear that? Listen up. And men, and men, all people listen up. All the bodies. Yeah, all the bodies, because I know there are men who feel that way too. We're not denying you of your feelings. Absolutely. Yeah. And I think, again, as the Hollywood sex ed is only certain people are entitled to sex lives, which is a huge myth, but it discredits gender fluid, people with different bodies, people with different ages.

We really have so many biases against who society perceives as being worthy of being a sexual being. Oh yeah, absolutely. And then this is, I think, if you don't mind me talking about another part of your book that I found extremely fascinating. It was in the Society Got It Wrong chapter, but you call them fact, like the facti beliefs. And these are beliefs. You have 22 beliefs that we literally consider facts. And as I read through them, I'm like 100% at one time or another. Prior to having a sex podcast,

I have thought these were true facts. And I think it is mind-blowing how many people aren't even aware that these are just beliefs that you've kind of grown up with. So I'm just curious, like, if you want to talk about some of them, I can read some of them, but... Oh yeah, run them down. I definitely don't have a memory.

No, it's fine, but I just think it's fascinating that it's like, even number one, heterosexual, we kind of talked about this in the beginning, but like heterosexual sex is the correct way to have sex. And then your like, your kind of point A is like, if there even is a correct in quotes way to have sex, the correct thing I think is phenomenal to think about because people really do feel that way. This is not the right way to have sex or you even talk about losing your virginity.

Where did that even come from? How did we even think that that was a thing? That a P in the V means you are not a virgin, therefore you're not pure, you're not this, you're not that. What comes from the hymen that is... But that's also not even true. Is it not true? It's not, yeah.

No. Well, I mean, there's a hymen. There is a hymen. And it can be broken. There is a hymen, that's a fact. And it can be perforated with a tampon. Right. It can open up just because your body's growing.

Like, there is nothing unique that a penis does to a woman that changes the woman. Nothing. It is a societal creation. Yes. And monogamy is the only way to be in a sexual relationship. Boom. I was looking at the thing about, yeah, I was looking at, I'm very interested in aging and hormones and what people perceive as natural. So I was going through longevity data and humans from recorded history till now like we didn't really live past 40 There were some outliers But if you made it past infancy you didn't live past 40 and they said the average length of a marriage was seven years

For many many many many decades, right? And so it's like we take this this monogamy thing like maybe that was like a thing when you were going to be married for five years until somebody died Then you've got the new person or something, but I'm like, dude, we're talking like 60 years monogamy We've never done that before and I'm not saying we should or we shouldn't but who how do we know what is right? We're like we've never lived this long. We've never been married like me right now. Monogamy is for me That's what I choose We've never lived this long. We've never been married this long. Like me right now, monogamy is for me. That's what I choose. I have people that I know, friends, that monogamy is not for them.

Doesn't mean it's wrong. That's just for them. It's not for me. It's that simple, whatever your preference is. Another thing you say is sex means, well we said this a bunch, but sex means penetrative vaginal sex exclusively. Again, we know this is a giant myth. Men should be sexual

at all time and women are not allowed to be. But then when they aren't, they have a low desire and that's also a problem, which is bullshit. All a problem. Yeah, like we're the problem, we're the problem. Yeah. Yeah, the other thing that's very interesting when people get stressed about is desire mismatch, right? And I think their belief that people who are coupled to people should have the exact same amount of desire all the time. And it's like, well,

they don't have the exact same amount of anything else all the time, like food, working out, how many hours they should sleep. Literally nothing is perfectly matched forever. And then we take sex and make it so unique. You guys need to have the exact same amount of desire otherwise somebody's the problem and usually in our society the woman's the problem because we use the man as the default right and Then the woman either has too high of a desire or she has like where did high desire and low desire come from? It's got to be to some default right so usually it's the woman who's either too low or too high compared to the male default in the relationship. Yeah, she's either too horny or she doesn't want sex enough. And that's going to be an issue. Like I've heard, I for sure hold, and this is not like against men,

we're not against straight men guys. But as a 41, oh my God, I'm 41 now. I just had a birthday. As a 41 year old woman, I've definitely felt that pressure. I can remember back to when I first started having sex around 16, 17 years old, really having sex in my 20s, but just feeling like, do I want this too much? Does that make me a slut, a whore? A bad whore? It's a bad, yeah.

Or I don't want it enough enough so something's wrong with me, even though it was just probably the partnership that didn't work out, or we were just on different levels, end of story. Totally. Or you hit, I know, I haven't gotten, Doven, your book quite like Kristen, as you hogged it all day.

I do. But I know that in relationships, there is maybe a parabolic kind of curve that goes with your initial infatuation and then your sex, maybe not as much desire for everybody, but how much frequency, how much intimacy you have always there's a fall off somewhere in most relationships, I feel like. Yeah. If you look at the brain, when does the brain think something's no longer novel?

And that is about six months. And so they're like, if you're in a long-term relationship, but by the brain, that's six to 12 months. That's where the infatuation, like that love infatuation crazy phase is supposed to be like cocaine on the dopamine brain. Like it's not, I mean, it is not sustainable. Like, and for people to think that that's how it always is. And I'm always curious about, you know, the people who like fall out of love, air quotes is like, are they just, they lost their dopamine high and they're always like chasing it? Most likely. I think so too. Right? Yeah. Instead of like, no, this is the kind of your brain's like, yep, I know what underwear is wearing today. I already know that.

Well, all my underwear is the same, so she knows every day. Anyway. But yeah, I know the, I know the routine. I know what the routine is right now. So therefore, no, that's a really interesting though. The routine is I get handsy when we get into bed. Yes. That is your routine.

And then my routine is that sometimes I'm not. But then what I'm learning is that isn't always a me problem. I don't, yeah. No, and I know you don't think it is. Don't feel attacked. No, I know. You know it's not.

I know, I'm aware. That's not an issue at the moment. We understand each other pretty well. But I love that you brought up the meaning how much it means to you and definitely provide provided some clarity on Kristen needing to be connected to want to have sex and me wanting to have sex to feel reconnected. Yeah that's a definitely the disparity there and Talking about what something else you bring up Kelly in your book that really

Snagged me that I told Luke about immediately was when you talk about the desire thing, which we talked about in the very beginning, right? But the spontaneity versus the responsive. It was one of the first things that hit me really hard. And I thought it was super fascinating. It's like going back to that spontaneity is like the Hollywood, the desire, the this, that, whatever. But the response, this kind of, if you don't mind if I quote this,

but responsive desire on the other hand, is when you're not having sexy thoughts crop up, but once you get around to touching, kissing, and being naked, you're like, oh, I forgot how awesome this is. Which is kind of what Luke and I were saying in the beginning about our personal relationship. And I really wanna, I feel like I have a lot of friends

that feel that way. And I really wanna like I have a lot of friends that feel that way. And I really want to push that onto a lot of women. It's like very okay to think about desire that way. Yeah. Again, it's the sex ed we didn't get, right? Yeah. It's like, both types of desire are totally normal. And you tend to get a little more responsive desire the longer you're in that

relationship because the brain's like, okay, well, now you have to work and pay the bills. And by the way, the garbage needs to go out on Thursdays, right? Like life kind of creeps back in because you're not in this like drunk high spontaneous, this person's new and sparkly, right? And so just telling people that responsive desire is a thing. And then I think encouraging people to be like, if you have a responsive desire, knowing what you need to do to transition to sexy time. Because so many people just think like, you know, I come home from work, I made dinner, I cleaned up the living room and your partner's like, you don't have sex now? And you're like, no, right? You're not in any sort of sexual context. But if you're like, hey, I want to prioritize

with this with you, I think sex might be good if I can get there. What do I need? Do I need yoga? Do I need a bath? Do I need time by myself with a personal massager and some lube that you come in in 10 minutes? Right? It's like learning how to transition instead of like, you were just sitting at your desk job all day and you're going to go run a marathon. You're like, no, I'm not. I like that. Like learning how to transition instead of like, you were just sitting at your desk job all day and you're going to go run a marathon. You're like, no, I'm not. I like that. Like learning how to transition. Like, it's just sex ed to help people. Right. Learning how to transition though. I think it's such a, like a bullet point, I think for our listeners that I want you guys to pay attention to because it's something I'm taking note

is that it's very okay that you might need to learn to transition because everything you just said like hit really hard with me. Right and that transition might even be just letting or just letting your guard down. Yeah, letting your guard down or like being willing to have some passionate kissing for 15-20 seconds might be enough instead of just being like pulling away after a kiss. Just give in for a second. Like feel this when we're kissing. Yeah. And especially if we consider our partner's sexual advances to be just another thing on

your to-do list. Right? Like I see so many people who are like, I need to do this to make him happy. So basically to control his mood. This is in a heterosexual relationship. But like kind of otherwise he'll be grumpy. I need him to be happy. He's going to get mo- So we're having sex with him to control his behavior, which number one, he's an adult. He needs to freaking figure out that behavior

problem. I know couples like that. I'll just say that. Yeah. Anyway, continue. Yeah, no, it's a thing. And you're like, oh my God, we're adults and this is how we're acting. It's horrific. But if sex is another thing on your to-do list, you will never desire that. It's like sex needs to be about you, about the relationship, about sharing something, about connecting, whatever it is. But if it's a to-do list, you're like, and then you're like, I don't desire it. And you're like, you think? Yeah. That's a chore., wonder why? Well, that's why. So it does go back down to communication as well.

Education and communication, like truly, right? Totally. I mean, that's we always, everything comes back to communication in successful relationships. Essentially, I feel like it's always the common theme. If you're not communicating, you grow further apart. You're miscommunicating. All these things comes back to communication. Yeah.

And then the assumptions come in and the assumptions are like always worst case scenario. 100%. Yeah, let's talk about assumptions. Oh, because at one, I just literally, as I was about to speak, but I looked down and within your, um, the fake truths that we think are facts, right? Masterbation is bad. Well, but not for men. I still to this day, living in Los Angeles, have girlfriends who are like,

Oh, I don't do that. Oh, no, I don't do that. I say, I save that for him. Or like, Oh, if, well, if he wanted to watch porn, like that's fine, but like, no, I don't do that. What? Like, how do you even know what you want then? Or how do you know what would make you happy within your relationship? What? Yeah. Well, it's amazing how much power we give away

without realizing it, right? Yeah. Of like, you mean you're putting your pleasure in the hands of somebody else who doesn't even own the body parts. Like, he doesn't even have the hardware. Right. Right. Like, and Lord knows if you didn't get a sex education, they didn't either. And so, I mean, it's like you have to communicate about what works for you and what feels good for you. But I mean, like, Luke is right. Once you start talking about this, and so many people are like, okay, let's have one conversation.

It's like, no. No. Like, definitely not. And I'll say as a woman, like, I still, I mean, I've seen all the porn and I was told all the things to do that guys want and they want the blow jobs and they want this and that. But that's also just what I've heard. I still need to ask him at times or thank God he's so communicative with me to say like,

do this, do that. And I didn't know that's what he wanted in that moment. So I'll say for my hands-on experience pun intended That the best way to learn is to be communicative in the act Especially with like oral or with non P and PI V sex is to be like or even with PI V like I keep doing that That feels good. Yeah, don't stop that or Hold on. Use your hand do blah blah blah do these things Yeah, totally anyway being able to communicate in the act as well as before or after with boundaries desires

Etc is just key to having a good sex life I agree so I also want to talk about something because this was something that really made me interested in having this conversation with you, Kelly specifically, was that at the end of the day, you are a urologist, you are a sex educator, but sometimes medication is needed. It is necessary, it is helpful. I don't know if I should say necessary, I'm not a doctor, but helpful. And I will say specifically, and you guys, this is not an ad for this medication called Addi, but it is something that I'm learning about, that I'm excited to become a brand partner

for, that I'm actually going to be taking personally because it is something Luke and I have discussed. I could be their brand partner without taking it. I feel like that's a little bit weird, and I will be very self-admittedly. I've noticed a low libido. Not all the time. I still love Luke very much. We have a great sex life, but I don't know if it was our pregnancy loss. I don't know if it was my body confidence. There's a lot of things about myself that I have nothing to do with Luke that I've noticed a low libido.

So you actually write about in your book, you say the Little Ping Pill and Addy or a Flo Banseron is something I had never heard of because we all know what Viagra is and we all know there's a shit ton of ED medications and a bunch of male medications out there. I mean, there's literally things you can buy at a gas station that you probably, I'll just say you shouldn't.

But there are things- You probably shouldn't. You definitely shouldn't. There are things at a gas station that say like, I'll just say you shouldn't. But there are things that I say like men, this is for you. And nothing ever for women, ever. And what I read in your book that I actually did not know was that Addy was first thought to be or I don't know if it was prescribed or thought to be in trials as an antidepressant and I didn't know that. And it was realized that it did not make people less depressed, but it did heighten their libido. So do you want to talk about that Addy with me?

Because I am fascinated and I'm very excited to give it a try because I'm like, let's try anything. Why not? Totally. I get people, because people are like, medication for desire, blah, blah. And it's like, okay, well, if you know or understand, which I think a lot of people do,

that there are medications you can take that negatively affect your sex life. Most commonly would be the SSRI antidepressants, right? Which I'm not one. Notoriously. What's that? Sorry, I was like, which I'm on. I'm on an SSRI.

I have been for years, I've been vocal about it on our podcast that I've been on Luxupro and I have heard that that can deplete my libido. So yeah. And I think it's a natural way to get, because people are very comfortable and they understand antidepressants, right? And I think most people understand their sexual side effects to antidepressants. So it's like, if it follows that there are medications that negatively affects your sex life, doesn't it also make sense that there are medications that

positively affect your sex life? And people are like, oh, yeah, it's the same side of the coin, right? So that's what phlebancerin is. It's centrally acting non-hormonal. So what it means is it works in the brain by increasing dopamine. And dopamine is the neurotransmitter that is released in anticipation of something lovely, right? You get a hit when you get it, but you also get a hit in anticipating it. So like, if I'm thinking about men's chip ice cream, that's just a dopamine hit for me, right? So you get a hit by anticipating a reward, that's what dopamine is. That's how they think the drug works is it's increasing the dopamine. You're more interested in something that's rewarding. Again, is any medication going to make you love mushy ice cream? Melted

ice cream? No. You have to have sex worth desiring, but it really can help a lot of people who need a little boost in the neurotransmitter department. Incredibly safe medication. You take it once a day at night. Side effect is sleepiness. And I love to say this, it's actually like good sleep. Like you sleep better. Sleepiness. Not, I'm groggy the next day sleepiness. Not like a bed and a drill. It's the best side effect you could possibly that's amazing. Yeah. Especially if it's, paired with an orgasm. I mean, like, you're gonna have the best sleep of your life. One million percent. Totally. I mean, it's funny because the FDA made

them do like a driving safety test because like, what the side effect is sleepiness and they can't have a bunch of horny women fall asleep at the wheel. You study this, right? And so they did and the women who were on Addy actually drove better than the women, like the placebo arm and the theory being you drove better because you were better rested. Oh, yeah, I believe that. So a side effect, a good sleepy. Yeah. And I do love that you said that it is a non-hormonal drug because I think that is something that's

so important that women need to understand because I've learned so much more about my hormones and my body when we started trying to get pregnant more than I ever knew in the last 40 years of my life. Strangely enough, lack of sex education and body education once again. Just so you guys all know, again, this is not an ad for Addy, but it is something I'm going to be doing and something I'm going to be talking about more. And the fact that Kelly is beyond familiar with this makes me very happy. So I feel excited to have this conversation with you. And it is a place.

It doesn't replace communication. No, it does not. It looks point. It, but like, you know, the, the side effects are minimal. It helps probably about 60% of people who try it so it doesn't help everybody But not to poo poo it just to give people like this is not a mirror. It's not gonna fix your relationship, right? This isn't a marriage. It's very it's very specific like You got to have all the other pieces in place and then it can be for people that it works well for

They're very happy on this medication. Awesome, and it's, I'll just say from a male anatomical point of view, I think medically, it's a lot easier to increase blood flow to a region than it is to increase sexual desire in a woman where that's not the point, right? Does that make sense, Dr. Casperston? Yeah. So I, for men, there is something that, yeah, it's gonna work. You're gonna get hard You know, it's a little bit of a simpler solution if you ask me. So this is seems awesome. That's something's available It's awesome because the first time we heard about it I don't remember how it was came up and I go, oh, so that's like female Viagra and Kristen was like no That can't be and someone else was like no that can't be and then it was like I feel like a month later

It came back and it was like kind of yeah, that is what the point is. It's like a woman's desire enhancer. Yeah. Yeah. Yeah. I mean, you're not wrong. Like Viagra is a blood flow drug, right? Right. And so it's like Viagra gives you blood flow to the penis. Usually men who have an erect penis have, they're like, oh, desire for sex. It's kind of tight in. But flow banserin doesn't improve your blood flow to your genitals, but it does improve. And again, the sex ed of desires different than arousal, which is different than orgasm, which is different than ejaculation. They're all different pieces, different than erections of the sex ed we never got. But by and, like people, the

mainstream media will call it the female Viagra just because nobody really knows all those details, but it is technically a little bit different than a blood flow medication. Absolutely. I just think that's the easiest way to translate it to the general public. Yes. And to understand what it is. I think that's why they call it the little pink pill because Viagra is a little blue pill. Exactly. Yep. Yep, totally. Makes sense to me. In my business marketing brain,

100%. That's the easiest way to let everyone know what it is. Yes. Yeah. But I just thought it was important to touch on because you guys, as our listeners will be hearing me talk about it moving forward because I'm going to be drawing it and I am working with the brand partner. And actually one of the questions that we got from Instagram was as a urologist, can you prescribe Addy? Or how is Addy slash little people? Yeah, like where do you have to go? Yeah. Yeah, yeah.

Any, any, your primary care doctor can, your gynecologist can, urologists who are familiar with it can. I think you can actually go on the adi website to, if you've tried and failed, because I would say this, as a physician, I would say most physicians are not well-trained in sex med. Right. And what is that drug? A lot of people don't even know that this drug has been available for a couple of years. But insurance covers it. You usually have to do a prior off, but you can even, I always tell people you can even try it like cash for a couple of months to see if it works. Because I have had

a little bit of struggle with insurance, but by and large, if you fight enough and yell enough, they'll cover it. But it's not hugely cost prohibitive. But if it's going to get better and better, the longer it's been out is my hope. Yeah, I think so too. Or if I answer that question, yes, urologists can prescribe it. Okay, perfect. And then you don't have to be a special, anything special. Okay. And then I have another question. They didn't ask for anonymous, but I'm going to go anonymous. But this is about perimenopause. So it says perimenopause here, is it normal to have an increase in UTI and urine frequency at night? Yes, that's a hormone change. If we didn't get

good sex ed, we did not get good what happens to our hormones in midlife, ed at all. So estrogen goes down, it starts going down in perimenopause. So it's not like you have a fine normal estrogen and then boom, you don't have any estrogen, right? So it's kind of this roller coaster to off. And so the bladder is very sensitive to estrogen as is the vagina, the vulva, the clitoris, all of our structures down there. So when the estrogen starts to drop, you start seeing more inflammatory, irritative things. What can that look like? More urinary tract infections, more burning when IP, dryness, pain with sex, notoriously on the vulva that's six o'clock gets really ouchy for women

with entrance to penetration. I just feel like my urethra is burning all the time. All of those things are a low estrogen state. You can still be having your periods, and this can be happening to you. Vaginal estrogen, it's a prescription in this country, but it is a miracle cream. It's just like skincare. I'm like, this is just skincare for down there. It fixes 80% of it. I'm going to ask a question that I don't even care if it sounds dumb.

Um, definitely think something I've Googled before, but I will say like, I think every girl that I'm, every woman I'm friends with believes that once you have sex, P I pen, like penetrative sex, penis and vagina sex, you need to pee right after or you're going to get a UTI. So I will say TMI guys, but that's why you're here. Like half the time I can't right away. If I orgasm, I'm like, no, I like, I literally am not capable, but then I really, really need to.

And is that true or false? I feel like I should know this and I don't know the answer. Are you more likely to get a UTI if you don't urinate after post-sex? I don't think we have good enough studies to say that is a universal truth for everybody. So I would say if you have a vagina and you had PIV sex, you don't need to go pee right after sex. I swear it's something that is like drilled in our brains that like if you don't go immediately. It came from somewhere, right?

For sure. But if you are prone to UTIs or you're prone to UTIs after sex, there's probably something to just flushing out whatever is in the bladder so it doesn't sit there and multiply. So on the other side of the coin, as a urologist, how is it for men? Should men urinate to get whatever's left over out of the urethra post-ejaculation?

No, men have very long urethras. Yes. Right. So. Some longer than others. So, they're much, yeah, some of the urethras are longer than others, right? Some men, we say they suffer from long urethra syndrome when you will feel like joking about it.

But so, point being, men have a much lower rate of a urinary tract infection because really a urinary tract infection commonly is bugs from the back get messed around and then they get to the bugs or they get to the place in the front that's not supposed to have those bugs, right? And if you have a very short urethra like a female does, it's just easier for the bugs to get into the water treatment plant. So a healthy vagina is part of a healthy vagina is part of the UTI prevention plan. And that the health of the vagina suffers in perimenopause and menopause because of our drop in estrogen. And that's why you see these urinary tract infections become more and more of a problem

in a woman's 40s, 50s, 60s and beyond. Okay. So possibly another dumb question because I was I have one after you. Okay, great. We're full of dumb questions. These are no, they're not. If you were asking this question, thousands of people have these questions are not done. But just meaning I feel like I've done so much research and I've asked like my own doctors and I'm still going, have I asked these questions before because I have questions now. So we were pregnant for a short period of time. We had a loss. Is it because you keep talking about the hormones affecting the bladder? I know we're talking about sex guys, but I'm also talking about just health in general. And I never really considered

what was causing me to have to urinate like 40 trillion times a day or night because I wasn't so far along that there was something pushing on my bladder. Do you know what I mean? So was that because of hormone as well? Yeah, I mean, it could be. Okay. I would say it's probably different for different people. Yeah. But yeah, you're correct that a lot of people will notice more urgency, frequency in the beginning, even though they don't yet have a bowling ball squishing the bladder, which then it of course also causes more urgency, frequency. Right. I just wasn't even truly, because I'm not perimenopausal yet, obviously, but I was not aware that estrogen or hormones in general had anything to do with my bladder, which

is like so wild. Maybe I just... Yeah, that's the education. Yeah. When do we learn that? Do we not learn that until we are already at that state? Like, I would love to know that now. So when I'm at that point, thank you for that education. I mean, I think about this a lot because I'm like, we've labeled estrogen and testosterone, the air quotes, sex hormones. And I think what happened when we labeled them as the sex hormones is that they became not important for

the rest of our body. And they're incredibly important for like bone strength, muscle health, cognitive function, cardiac health, right? But we labeled them sex hormones and like nobody wants to talk about sex. And so they kind of become erased from being useful anywhere else in the body. But they're super important. Like you said in the beginning, it all comes down to communication and like education about it. And it's like, if we don't get that education, we're kind of left to grasp at trying to have it make sense.

You know? Truly. I mean, I'm not joking when I say this specific podcast episode, this interview with you, felt like the most full circle moment because we started our podcast November of 2022. And it was the very first thing we started talking about was we weren't even technically truly dating at the time. We were She was just in denial. We were dating. Fine. But anyway. But it was really just You guys weren't communicating over whether or not you were dating. We were we were just communicating about sex and relationships all day long from a long distance. And it's what really made me gravitate toward Luke.

And I'm like, you just have to be the podcast host on this. Like I need a man to be the quote unquote, you know, speaker of all men that wants to ask the hard questions, admit the things that they don't know. And for us to have these conversations. So it just feels very full circle to talk about these things. Well, Kelly, thank you so much for being on today. And I'm mind blown. And I truly, truly guys, I urge you all to buy this book for yourselves, for your friends, buy it for like, I don't know,

like a bachelorette party, perhaps like, whatever. Oh, yeah, we do book clubs. Yep. People do book clubs. And they also share it with their partner. Like so many men read the book because the other partner is like, dude, read this book. Yes. And then they're like, it's a good book. I learned a lot. I'm saying, dude, read this book. Like I.

Dude, read this book. It's funny. It's interesting. It's not boring. I know it's a weird thing to say, but to the men out there. It's not a super long read. And I would just say. Yes, not super long read. Kristen has been so excited about this.

And she opened it. Like we just got the book yesterday. Since she opened it, she has been so excited. She goes, can you believe this? She has so many pages, dog-eared, and all kinds of notes in it. She was like, oh my gosh, can you listen to this? And she'll call me over when I'm doing something else. Like, come on, just let me read this to you.

And she just felt like it really. A lot of pen marks up in here, for sure. I love it. I mean, to tell your listeners in all fairness, they might not be able to find the book right now because it's getting a second publication, September 2024. Congratulations. So, I know we're gonna go international. So, it's so exciting. Congratulations. It's huge. It's hard to... Thank you. I know. It's pretty fun. So, so exciting, congratulations. It's huge. It's hard to, thank you. I know, it's pretty fun.

So if you can't find it right now, I'm sorry, but it's for good reason. It's getting a shiny coat of paint for a relaunch September 2024. Amazing. So is it available in audiobooks, like on Audible or any? If you can find like a third party. Third party, okay.

It's available, but it's been taken down from most platforms. Okay. Interesting. So I got really lucky and thank you for sending it to me. Yeah, no, you got, well you got a hand delivered copy. I did and it's signed. Thank you.

Like my, my little heart melted into a million pieces. Yeah. Okay. Well, you guys, for the time being, please follow Kelly on IG. It's Kelly Casperson, C-A-S-P-E-R-S-O-N-M-D. So Kelly, or Dr. Casperson, I'm not sure how you'd like me to address you. You can call me Kelly. Kelly, okay.

I have a question for you and you can just say no. There's a question we close our podcast with. I'm not sure if you've heard our podcast before, but if you like to. I did not give her that. You didn't get the heads up before. Yeah, but if you want to do it for fun. Do you want to do this? Try me.

Do you want to sing it? Oh my god. I think we have to. Okay, three, two, one. I would do anything for love, but I won't do. What would you not do for love? Luke wouldn't be a vegan. This is all about boundaries. It's just whatever. A lot of people just jumping up anal.

I'm like, well that's weird. Luke wouldn't be a vegan. But Dan say he won't have a chicken cordon blue. He would not have a chicken cordon blue. He won't eat chicken cordon blue. I'll say mine first. I will not move no matter what to Antarctica. No one lives in Antarctica. Well, what if we could one day? I don't, I wouldn't move in with the in-laws. Oh, that's a good one. Yes. Yeah, I like that. We haven't heard that before either. That's a boundary. That's a boundary. That's a healthy boundary. That's great. Luke, what's yours? It's very healthy. Let's see. I've said a lot. Luke, what's yours? It's very healthy.

Let's see. I've said a lot. We've done this a lot of times. Got to come up with another one. You pushed it first. I know. I know. Let's see.

I also wouldn't move to Mars, which I know we also can't live there. But one day, maybe, but I still wouldn't do it. Yeah, I wouldn't go to Mars. No, I will not take that list. I will hide if I get enlisted, or not enlisted, wouldn't go to Mars. I will not take that list. I will hide if I get enlisted or not enlisted drafted to go to Mars. I would hide. Is that yours? You can't see mine. They don't want us. We're too old for Mars. We are too old. That's true. I mean,

um, let's see. What's a bound, what's a hard boundary for you, babe? I would not give up fishing. Okay, that's fair. Is something you know I'm passionate about. I've never said that before, but it's true. I thought you were gonna say pegging, but you went fishing. I would not give up pegging. No, you wouldn't do that. Conversation for another day.

We'll have to communicate about that first. What is a whole nother episode? Oh my gosh, thank you so, so much again. Everyone please check out on Instagram. And in September, 2024, we're gonna remind you to get your damn book, because too bad for you for the moment. I know.

But that just tells you how well the book did, that it's getting a second coat of paint. No, it's wild. We had to help all the people. And books live forever. It's the best thing about writing a book. And congratulations on being an author, because it's just the best.

I'm so excited to have spoken to you. It's cool. Thank you. Thanks for having me. Great. It's good to hear. Thank you. Thanks for having me. Great. Thanks, Kelly. Bye. Thank you.

Bye-bye. Make sure to follow us on social media. You can follow me on all platforms at christen.doty and follow Luke on Instagram at luke.double-underscore.broadcast. Be sure to click the subscribe button so you can stay up to date with new episodes every single Wednesday. Thanks for listening. See you next week. Come hang out with us as we chat about hilarious, odd, and sometimes disgusting stories from the internet. You like Scooby-Doo?

You trying to quit Taco Bell? You ever done ventriloquy with your vagina? Or have you ever came so hard you pushed your partner through a window? Then this show is definitely for you. Listen, we're obviously judging you for admitting that, but why not come be judgy with us? Listen to the Judges on the iHeart app, on Apple Podcasts, or wherever you get your podcasts.