256. The Unfettered Urologist - Dr. Boone

A woman was feeling bad that she was avoiding sex because it was taking her partner too long to orgasm via her vagina.  I set the record straight and offer some tips and tricks.  Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/G98XnL --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

9 Feb 202210min

On social media A woman asked – my vagina is so dry that sex is painful, how can I fix this? Wikipedia: Gaslighting is a colloquialism, loosely defined as making someone question their own reality. The answer provided on social media to this question: - Regular sexual activity, self stimulation and pelvic floor exercise can help keep your vagina health. - IS THIS ACTUALLY TRUE? - This doctor said “I tell women to avoid sugar and use probiotics to make sure their entire ecosystem is “humming along” – NO evidence that oral probiotics affect vaginal microbiome – then she plugs her diet and her probiotic products - She then goes on to say – two additional ways to counteract vaginal dryness is to strengthen the pelvic floor by doing kegel exdrcises and using a “holistic formulation” that helps maintain optimal levels of natural moisture, and “supports a healthy vulva and vagina”. – this is her product – which states it “prevents leaks” and costs 70 dollars. Also claims to “reignight desire” – WTF I searched in J sex med - does intercourse delay or treat vaginal atrophy? – can’t find a damn thing I found on an internet site - “Regular sexual activity, with or without a partner, can help maintain healthy vaginal tissues through increased blood flow and avoid or lessen the effects of vaginal atrophy.” - No citations, so again I went to J Sex med – can’t find a thing On menopause.org - Regular vaginal sexual activity is important for vaginal health after menopause because it stimulates blood flow, helps keep your vaginal muscles toned, and maintains your vagina’s length and stretchiness. - No citations, and furthermore, the vaginal muscles are smooth muscles controlled by the autonomic nervous system – you can’t tone them with sexual activity - I will buy that stretching the vagina frequently probably allows it to be stretched frequently without pain – but is there evidence and why sex, why not just dilation? Current treatment options for postmenopausal vaginal atrophy Iuliia Naumova1 and Camil Castelo-Branco2 Int J Womens Health. 2018; 10: 387–395. It is important not to forget about the positive effect of sexual intercourse on the improvement of vaginal health – no citations (JAMA 1983;249:2195-2198) Vaginal Atrophy in the Postmenopausal WomanThe Importance of Sexual Activity and Hormones - But this study was not randomized – perhaps the less atrophy allowed the women to be sexually active and not vice versa? How do we know the sexual activity caused less atrophy? We don’t have any studies. Another paper on vaginal atrophy gave this recommendation - Regular sexual activity should be encouraged to maintain vaginal health. (II-2B) - Usefulness/efficacy is less well established by evidence/opinion Why is level 2-2B evidence cited as scientific fact? Pro-tip – Billionaire Marc Cuban just started an online pharmacy for low cost generic drugs https://costplusdrugs.com/ - vaginal estrogen tabs for < 10 bucks, cream for 54 dollars. What other myths do you want me to bust? Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/C7gjrk --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

6 Feb 202219min

Jan live topics - from hormones to bladder cancer to male questions - I answer them all! If I didn't get to yours join me for February's live Q&A by getting on my email list at www.kellycaspersonmd.com If I think I need hormone cream.....should I get tested for imbalance?? Is generic estradiol cream as good as Estrace? I’m seeing mixed reviews. The pharmacy gave me generic Doctor, what will happen, if we don’t take testosterone supplements after bilateral orchiectomy?? A woman writes in about worry about sex after hysterectomy Tightening cream – oh you get all my thoughts on this one. Is it too late for my to start hormones if it has been 10 years after menopause? Screening for STIs in men  🙏 How do you get a doctor to give you vaginal estrogen? Bladder cancer info Pain with penetration after orgasm – help! Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/IcBZb9 --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

30 Jan 202224min

Anorgasmia = persistent inability to achieve orgasm. 10-15% of women have never had an orgasm and there are so many reasons why. I talk about the top 5 things I say on repeat 1) vaginal estrogen is for almost everyone 2) systemic versus vaginal estrogen 3) Responsive desire is normal  4) Expand your view of heterosexual sex 5) and of course YANB! Check out ondrwear.com and use YANB to save 25% Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/WJA2M7 --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

23 Jan 202219min

National LS day is Jan 17th so I thought we would bring back Dr. Jill Krapf to help educate us on this silent condition that affects our sexuality so profoundly.  What is Lichen Sclerosus. Can it be prevented? How it affects sexuality Classic signs and standard treatments What about lasers for LS? Why is it important to be on maintenance therapy How can partners be supportive? Dr. Krapf's important research. https://www.instagram.com/jillkrapfmd/ https://www.lichensclerosus.org/ Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/VUemhu --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

16 Jan 202239min

This is an IG live I did with Dr. Prabakar, OBGYN, who is known as The Fibroid Doc on IG! We talk all about female pelvic bleeding and issues! What are fibroids? How do you get fibroids? What are symptoms of fibroids? What is adenomyosis and endometriosis The perimenopause transition and how it affects bleeding We discuss ablation and lifestyle changes to help with quality of life www.instagram.com/thefibroiddoc https://www.youtube.com/channel/UCyPUtuVimf7GpprOiuXVWaw Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/652eyN --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

12 Jan 202227min

Check me out being interviewed for the amazing "Hit Play Not Pause" podcast with Selene Yeager!   Your brain is your largest–and arguably your most important–sex organ. It’s also the most overlooked, especially during the menopausal transition when we spend a whole lot of time talking about our vaginas (which are important, too, of course!). I am her guest and we talk about all of it in a show that drives home the mind-vagina connection during menopause and midlife. Follow her at www.instagram.com/fitchick3 www.instagram.com/feistymenopause Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/45W2PS --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

9 Jan 202253min

I reflect on my podcast and me and how we both grew in 2021 - like I got bangs, and quit drinking! I list my top 4 episodes -  I discuss 2022 plans for me and the podcast Thanks for your support heading into year 3! Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/uLGR8d --- Send in a voice message: https://podcasters.spotify.com/pod/show/kj-casperson/message Learn more about your ad choices. Visit podcastchoices.com/adchoices

2 Jan 202221min