382. Men, Menopause, and the Relationships in Between

0:00Dr. Kelly Casperson: This podcast is sponsored by Explore Worldwide. One of the themes that keeps coming up in my conversations is that it's okay to want more. More joy, more connection, a better experience. And thanks to our sponsor, Explore Worldwide, you can get so much more when you travel. All of Explore's adventures are 100 % human-made. Their tour leaders have actually stayed at that family-run guest house that isn't even online. They've eaten at the neighborhood restaurant the locals love and know the trail you'd never find on your own. Your vacation should feel uniquely yours, not like it was generated from the same prompt everyone else entered.

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1:05Dr. Kelly Casperson: Welcome to You Are Not Broken, the podcast that challenges everything we've been taught about midlife, hormones, and sexuality. I'm Dr. Kelly Kasperson, board-certified urologist, author, and a leading voice in women's sexual and hormone health. Enjoy the show. Hey, everybody. Dr. Kasperson. When two podcasters try to lead, it's like, no, you lead. You do the handshake. Okay, you ready? Yeah, that's staying in. Okay, this is all staying in. Yeah. All right, you guys, my name is Traver Boehm. This is Dr. Kelly Kaspersen. We are coming together to talk about men and menopause because menopause is often a challenging conversation for everybody.

1:47A lot of men that I've talked to in the last couple of years don't know how to react when it happens in their relationship. and Dr. Kasperson here is the foremost expert author, podcaster, hair model in this subject. And so she has more to say than anybody I know. And so Kelly, Dr. Kasperson, would you like to introduce yourself to my audience who's listening to this?

2:10Dr. Kelly Casperson: Yeah. Thank you to everybody who's joining us. Wherever you've come from, welcome. You've found yourself here for one reason or another. So buckle up. I'm a urologist and I always say I give men testosterone and Viagra every day. And then about seven years into my career, I was like, hold on, who's taking care of the women? And then I was like, hold on, 90 % of men are heterosexual. You want to do something with that super dick we're giving you, right? So have you talked to your partner about it? And I thought it was going to be the minority that hadn't talked to their partner about it. Like when guys come in and they get testosterone and Viagra and I'm like, what's your plan?

2:47Dr. Kelly Casperson: What's your plan with this? And very few talked to their partner that they were even going to the doctor to discuss this. So it was like the insight of like, oh, I was just thinking everybody was like talking about why they were going to the doctor today. But no. So everybody needs to get involved. My question for you, because I was just, I was doing a live radio show earlier today and the men did not, they're like, yeah, we don't know anything, but they were backing away from the conversation. And one actually had insight on it. One was like, isn't it so weird that people think women's health things are off limits or taboo?

3:22Dr. Kelly Casperson: He's like, that's really weird. So he had insight into his own behavior of stepping away from this conversation. Sure. I think first and foremost, men are taught that women's sexual health issues are gross. Like they're gooey? Periods are gross. I don't want to know what's going on down there. There's a whole bunch of stuff that isn't for my pleasure. So that's the weird shit. Let me just do a week and a half off every month and pretend that it doesn't exist. But they pop the hood of a car and like stick their head under the car and look at the motor like all the time. Women's bodies are Ferraris.

3:58Dr. Kelly Casperson: By the way, we create life. It's pretty fascinating. It's pretty fascinating. Zero argument from me here. I just, I also, I think it's cultural that we say like, you know, when she has her period, it's time for you to step away or it's time for, it's not your issue. And I've only seen in the last couple of years that men would ask to have like a tracking app of their woman's cycle on their, on their phone, that this actually plays into the behavior. I think culturally we've just said like, it is something that needs to be completely removed from the male conversation, even from the female conversation a lot.

4:35I think I told you when I was an acupuncture intern, I would say to a lot of my female patients, do you know you're getting your period next week? And they'd be like, no. And I'm like, I'm a 30-year-old cage-fighting meathead, and I know when you're getting your period. How do you not know when you're getting your period?

4:51Dr. Kelly Casperson: Wait, how did you know they were getting their period? Because they told me six weeks ago when their cycle was and how many days it was. And so I have a chart in front of me. I was thinking there was some like ear meridian that vibrated a certain way. thing like we don't know about i wish i could just like lean in yeah i'm like was her aura extra purple like yeah no no it was in the chart right it was in the chart and not astrological chart just to be clear i mean it's interesting because so many people are like oh i'd never asked my boyfriend or my husband or my partner to go buy tampons or pads and i'm like but that's like a normal everybody's like this is a normal part of life you can't even like buy the product The checkout person knows they're not for you, bro.

5:34Yeah. I would frame this all truthfully around relational maturity. That a grown-ass adult wants to know where his partner cycle is. Buys any of the tampons, pads, anything that she needs because he's an adult. He understands that menopause is coming because he's an adult. Same thing, she will understand the changes in his body as he gets older because she's an adult. But I think emotionally, we have a lot of, again, if you're a 13-year-old boy hearing about periods and go, oh, that's gross, I'll give you a little bit of leeway. Now, if you don't evolve as a 38-year-old man, 50-year-old man, then this is to answer your question.

6:19I don't know if I ever told you this. I had ChatGPT, since we were talking about AI a second ago, assessed the emotional maturity of my Instagram following. And it put it somewhere around 12 or 14.

6:31Dr. Kelly Casperson: Please hold.

6:35Now, my Instagram following, I know factually, is 35 to 55. But it was basing it off comments that it could read. So anyway, culturally, when it comes to women's health, I'd say specifically, the two main genders, and men specifically, are vastly immature.

6:53Dr. Kelly Casperson: I saw this meme, and it was a man, I think, asking other men, like, and she needed$800 for her pads and her tampons. is that right and like the comments were so good as the comments were basically like yeah no my girlfriends are twice that much like your girlfriends that's cheap blah blah blah basically just like the comments were so gold on being like oh yeah keep she's a keeper like keep her because that is a great deal per month and like lord knows if you ever bought tampons they're not they're not eight hundred dollars a month right but like just like it just was on so many levels showing how they have no idea what these things even cost and blah, blah, blah.

7:33Dr. Kelly Casperson: And then people have been like, oh yeah, no, keep her. That's a good idea. We as the male culture or men, it is time for us to be involved and engage in women's sexual health beyond the word sex. That's where we're stumbling. Like I'm super interested in that. I'm super hung up on this like lack of curiosity. Like I am desperately curious. God, I just want to walk around in a male brain for a week. I just want to do it. I'm desperately curious about what is happening in that male brain. So to me, I'm like, God, really? Because the lack of curiosity can come across like not caring. Fully. I believe that.

8:12Yeah, I see that.

8:14Dr. Kelly Casperson: And I think, again, desperately, women want their partners to care. There's a lack of curiosity and there's a lack of inspiration for curiosity. So if your whole life you're told, like, don't worry about that. Don't be curious about that. Then I can see the trail that that would lead to a lack of curiosity. But I will also say there is a shift. I did a workshop two years ago in the Dominican, and it was half men, half women. And on one of the nights we said, guys, you're gonna go talk to the female facilitators. Women, you're gonna talk to us male facilitators. You can ask any questions that you want.

8:51And at the end of the night, The facilitators got back together and we said, what were the questions? And for the men, what we were asked was, why did my ex-boyfriend do X? That was all of the questions. And the women said, they grilled us on periods. Does penis size matter? Pleasure, turn on, menstrual, hormones. What happens at this phase of your period? And we were all like, this is awesome. There's been some shift. So it's entering into the collective, but I think it's entering very slowly. That's why I wanted to have this conversation.

9:25Dr. Kelly Casperson: I love it. So people are here. They're ready to learn. Let's take it away. Okay. I think I said on the stage with you in Chicago that I view this as an initiation for women. And thus I view being a partner to someone as having an initiation, menopause, as an initiation for themselves. I'm curious, before we dive into the biology and hormones and all the things, does that language resonate with you? Wonderfully well, to the point of like, I don't think I can name it any better. And it's profound changes. And to some people, they don't feel anything. You know, there's some people who are like, I don't remember.

10:04Dr. Kelly Casperson: Like, nothing happened. And some people will be like, my entire world is rocked. Everything I thought I knew, I don't know anymore. Right? And there is this, for many, not all. There's a spiritual journey that goes with this. I describe it, and it's again, perimenopause, menopause, and we can get into the definition because we got to all know what we're talking about. But like, there's a tunnel. And sometimes being in the tunnel sucks. And you know you're in a tunnel. You're like, I'm kind of in a shitty tunnel right now. I don't feel like myself. I hope I don't stay here forever. Like, I am in a tunnel.

10:37Dr. Kelly Casperson: And the women who get through to the other side of the tunnel, they're like, that sucked. Super glad I went through that tunnel though. wouldn't go back, love where I am. So thinking of it as a journey, an experience, a transformation, whatever it is of like, very similar, and we'll get again, getting into the biology, very similar to going through puberty, right? Like you will never be eight years old again, or pregnancy. You will never be somebody who didn't have a baby again, right? Like these, and to think of it like women, I mean, everybody goes through puberty, women go through pregnancy, not all women, but women go through pregnancy, of like, there are tunnels we've gone through before.

11:17Dr. Kelly Casperson: Because I think some things that hurt this menopause transition is people being like, why do people have to change? Why do you have to change? Why does this have to be something? Why do we have to make this a thing? Right? And you're like, well, puberty is a thing. Pregnancy is a thing. Right? Like, there's other things that like are irreversible. And many people experience, right? And so I think we get a little petulant and petty when we're like, why does this have to be a thing? It's like, we don't ask puberty why it's a thing. It's just a thing. So it's not a belief system. It's not Santa Claus.

11:49Dr. Kelly Casperson: It is a thing. But just because we didn't talk about this thing for generations or decades doesn't make it less real now that we're talking about it. And since we're speaking to men, men, you have been through initiations. Any of the fathers listening to this know, as Kelly just said, you can't go back and be the guy who didn't have a kid. You can't go back and be prepubescent. If you went through the military or you went through a divorce, you can't go back and be the same guy you were beforehand. That is what your partner is going through. And there's an opportunity, I believe, having been in partnership with people who have gone through initiations, to go through an initiation with them.

12:30But it is a separate initiation. It is one that is for you, where all that is true the day before or the week before or the month before will no longer be true. And as Dr. Kasperson just described, there is transformation, there is growth. And for a lot of men, because your biology isn't changing at the same rate as your partner's, this is a spiritual journey. And when you get to take it on like that, one, it gives you a lot more tools and relatability, but it also makes it that the other side of it can be exponentially more beautiful than the life you're living right now. and like the tunnel, it's going to feel like you're falling down a couple flights of stairs.

13:11So hang on. We want this conversation to be where you can come in as a resource over and over and over to understand what's happening. I'm sorry I cut you off.

13:20Dr. Kelly Casperson: Yeah, and some of this might resonate and some of it might not resonate and it might resonate later in life. And I think the other people are like, well, how long does this tunnel last? Right? They're like, can you tell me this will be done on Tuesday? We're like, no. that is part of the journey is everybody's got a different length tunnel with a different level of darkness in the tunnel, right? And so like it is, to say it needs to go a certain way or it's expected to go a certain way, like understand that's not, we're not all Toyotas, we didn't come out of the same factory, right? We've all got our own journey to lead.

13:55Dr. Kelly Casperson: So, you know, and I think some people, especially people who like things a little bit more engineering wise and ones and zeros of like, just tell me when this is done. Is it 52? Of like, maybe, but buckle up, know that it's real and know that you can be profoundly influential, whether that's good or bad, influential. Beautiful. The last thing I'll say about initiation before we dive into the biology is in order for it to be truly effective, which you actually want it to be, it has to be longer than you want it to be. You have to get to a point where you can't just white knuckle this and be like, cool, she said on the podcast, it's seven weeks.

14:33I can just take a breath or drink my way through this or zone out and it'll happen. It's going to take a lot longer than you want it to. But on some level, if you believe in transformation and spiritual growth, you actually want it to take longer than you hope it does. Okay. Can we dive into the body? Please. For guys listening, what is happening with her? Can we first define the terms, Kelly? What's the difference between perimenopause and menopause?

15:02Dr. Kelly Casperson: Dude, somebody was so funny. They're like, I just thought perimenopause was how the British people said the word menopause.

15:13Wait, that's not true? So good. How many times in your career do you just go, oh?

15:21Dr. Kelly Casperson: Life is a journey of fascinating experiences. That's such a polite answer. I was like, that's not how the British say the word menopause. But so peri means surrounding. So perimenopause means surrounding menopause. Menopause is a word made up centuries ago by a male physician who basically means the end of periods, the pause, the cessation of periods. Now, hundreds of years ago, all we could see were the gross observable things. There were no microscopes, there were no hormones, we couldn't look inside a human body, let alone with a microscope. So all we had was gross observations of the world, right?

16:06Dr. Kelly Casperson: And so women after a certain age would not have periods anymore. And so that's where this word came from is no more periods. The problem with the word menopause is it doesn't tell you why it's happening. and it certainly doesn't tell you that stuff before the no ending periods is consequential, right? So we really like put this big word on this event, which once you actually learn what's going on is kind of arbitrary and meaningless. But if you understand the historical context of all we had was like the big observable things, okay, that's why no periods is a word in healthcare. So you actually need a very small amount of hormones to have a period.

16:52Dr. Kelly Casperson: Ovaries make hormones, testicles make hormones, adrenal glands make hormones, and then what we call end tissues. So like brain makes a little bit of hormones, muscle makes a little bit of hormones, but your big hormone creators, brain, adrenal glands, testicles, ovaries. So ovaries are small almond-shaped organs. They're very similar to testicles, but they're smaller and they're on the inside. So the size of the ovary is dependent upon the size of the mammal. So elephants have very big ovaries, hummingbirds, squirrels, very small ovaries. And there's only so many follicles or packets in the ovary.

17:30Dr. Kelly Casperson: A packet is released every month. It creates hormones and there's an egg. After a certain amount of years, you're out of packets. Now, in America in 1900, average life expectancy was 47. And people will say, oh, it's because of infant mortality. No, it's because we didn't have antibiotics. The majority of people died of infections. We didn't have intensive care units, trauma bays, any cancer care, like clean water, right? We had nothing in the 1900s. And for centuries and millennia of human existence, life was short and hard, and there were no antibiotics and most people died of blunt trauma or infections.

18:11Dr. Kelly Casperson: Average age of menopause, 51. This podcast is sponsored by Jones Road. I like to take care of my skin, but I don't like the whole cover-up makeup routine. I like things fast and fresh. So when I found Jones Road Beauty's Miracle Balm, it genuinely fit the bill for my lifestyle and skin. You see, it doesn't mask your skin, it enhances it. No brushes, no complicated steps, just your fingers and go. And it's a total multitasker too. You can use it as a highlighter, a blush, even a lip tint. One product, several jobs. And the best part, it's actually good for your skin. No phthalates, sulfates, petrolatum, cyclic silicones, EDTA, or BPA.

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20:16Dr. Kelly Casperson: Now, when I need something, my first thought is, I wonder what Quince has. Find the fall pieces you'll reach for most at Quince. Download the Quince app for app-exclusive offers or go to quince.com. Get free shipping on your order and 365-day returns. Now available in Canada and the UK, too. And when Quince asks where you heard about them, let them know it was You Are Not Broken. It's the best way to support the show. So some women lived longer than their ovaries, but on average, people didn't live much longer than their ovaries. it's very important because people are like why are ovaries so shitty right like why do they crap out halfway through and you're like um halfway through is actually like exceptional right like 40 being halfway done 40 used to be the end my friend and now it's halfway that's exceptional trauma care medical care sanitation clean water all the things and i really want to reframe it because people get a little pouty when they're like, why does the ovary have to crap out?

21:22Dr. Kelly Casperson: And you're like, no, humans used to crap out at this age. Like the amount of packets were designed for the size of the human and humans, because of the size of the human usually made it about 40 to 50 years. So that's all important though, because we tend to dismiss this or we tend to say it's some sort of design flaw, but we don't do that with hearing aids and teeth and eyes and hips and heart valves and tumors. Like we don't go around being like, well, your tumor's natural. Like just suffering, I guess, is the plan now, right? Like we don't say that with anything else and you can see the immense bias towards the ovary being done.

22:01Dr. Kelly Casperson: Cause we're like, well, guess there's nothing to do. And you're like, we don't tell people when you lose a tooth, like there's, guess there's nothing to do, you know? So like, that's just a very important part of this education is number one, This is us outliving hormone production. Number two, hormones affect every single cell in the body. Hormones are teeny tiny little molecules that move around the body to communicate. And I always say hormones help healthy cells stay healthy. Hormones aren't very good at treating disease, but they're very good. They help mitochondria. They help nerve function.

22:36Dr. Kelly Casperson: They help muscle. They help bone. They help skin, collagen, blood flow, clitoral artery, blood flow, erections. This is all hormones. And so hormones are profoundly important. And what we've done now, because we've extended life expectancy to 80, 84, is we now outlive ovarian hormone production. So that's what's actually happening. But we call it menopause, which means no more periods. but the no more periods is happening because of profoundly low hormones and so we say well how low how low are we talking about some women you'll check their hormones and they will have zero there's zero and estrogen as a means of comparison when you're pregnant is in the three thousands when you're having a period is it anywhere from 300 to 500 this is american values and men have estradiol, estrogen of around 30 to 40.

23:33Dr. Kelly Casperson: So women, after menopause, your hormones are so low that you don't have a period anymore, but your estrogen is actually lower than that of a man. And then men are like, men have estrogen? Yes, actually estrogen is profoundly important for men's sex drive. So everybody has all the hormones just in different combinations and amounts, but hormones go profoundly low, lower than a man's estradiol after menopause. So that's the long everything. But it helps people understand like, why is this a big deal? And my big metaphor for men, and it's, you know, some men are like, oh, I get it now. And some men are like, oh, it's kind of disgusting.

24:10Dr. Kelly Casperson: But it's like, take your testicles, remove them slowly over time, and then just be like, you're fine, right? Are you fine? Your dad, your dad did fine. why can't you do fine? It's just natural to outlive your testicles. And how I say it is like, some men's testicles, you outlive your testicle production of testosterone, we give you testosterone. There's actually over a dozen different formulations of testosterone on the market for men who outlive their testicular function. So I think truly, if this life expectancy thing keeps going on, if we're looking at 100, 110, 120, if we keep living longer and longer, many, many more men will be outliving their testicle function as well.

24:52Dr. Kelly Casperson: So I just like to normalize it because it only happens to women. I'm like, yes, it happens less frequently to men. But we have over a dozen FDA-approved products that insurance pays for men who outlive their testicle function. Let's normalize it. And if you think it's just happening just to women, guys listening, ask how many of your friends are on TRT. And I'm talking about guys. I remember, I mean, it was big in the jujitsu community. That's a whole nother conversation when it was like 25 year olds on TRT. But at 50, I know a bunch of people who are on it. And very few of them are like, oh man, this is it, I'm done, I'm worthless.

25:32No, no, I just went to the doctor. I get a shot in my ass twice a week and everything's back to being awesome. So is it a shame element? If we talk real quick about, is it dismissal? Is it dismissive? Like, what can we say to men here that is in the collective that we don't want them to plug into about the psycho-emotional aspect of what their partner is going through. Does that make sense?

25:55Dr. Kelly Casperson: Yeah, that it's real. I mean, I think if we could truly see ovaries and watch them get smaller, we would have a better grasp on this. Like, we can look at testicles. If your testicle was smaller, you would notice. It is something that you can't see hormones, you can't see ovaries. So there is a layer of like, is it real? but it's that it's very real, very validating and very common. Because I think so many people are like, I'm the only one going through this. My partner is the only one going through this X, Y, and Z. No, no, no. Universal situation. It's just, it's, we're getting to the point and I completely blame Gen X for this.

26:33Dr. Kelly Casperson: And Gen X is like, dudes, this is happening. You know, like Gen X has just had this energy of the shared, like, wow, why is there no support for this thing? 50 % of the humans go through this. It's insane. Short plug for the M Factor 2.0 documentary and the M Factor 1.0 documentary. These are PBS documentaries. The menopause one came out about two years ago, the 2.0. It's the sequel, prequel, because it's about perimenopause. It's released in March, 2026 on PBS. So they actually have men's groups in the second documentary. And so they have a scene of like five guys sitting around and talking about menopause.

27:14Dr. Kelly Casperson: And they were, what is expressed in the film is their relief to know it wasn't them. And the way they talk about it is like, they're like, it wasn't, turns out it wasn't me. I wasn't the problem. And it actually wasn't her either. It was this health thing that she was going through and she needed support. And it was like, what could have broken them? The knowledge and the advocacy and the support of the community and each other, they were like, no, no, we're good now. But for a while, I thought this was all my fault. We thought it was all her fault. Like blah, blah, blah. Instead of being like, oh, this was like a tunnel we were going through.

27:50Gotcha. I love the tunnel analogy. Is there any point we have to add to the person listening to this who still is like, nah, yeah, she's a doctor talking about like, is this really real? Is there like anything else we need to do to belabor that point that this is actually not made up, psychosomatic, just a means of control or manipulation that like it is literally like you wouldn't say to your 12-year-old, I think you're faking your voice dropping. And yeah.

28:24Dr. Kelly Casperson: And like, you know, for a lot of pregnancy, you can't see that the person's pregnant. That doesn't make them not pregnant, right? Like it's like, we don't take a person who's diabetic and be like, yeah, I'm not sure about that.

28:40Dr. Kelly Casperson: I can't see your diabetes. So like, it's not real. You know, and so it's almost like somebody's inability to think it's real is almost a sign of being dismissive. You know, because we don't do that. Like, I don't see your depression, Traver. Like, you sure it's real? Like, you gotta take your word for it on some things and, you know, read the books and blah, blah, blah, blah, blah. And I always encourage, like, you don't have to take my word for it. There's tons of books about this. and not to confuse that with the lack of support in the medical community because doctors didn't get trained on this for about 20 years because of the women's health initiative in 2002 and so don't confuse like a doctor's inability to help with it not being real gotcha that's a great point to to say can you give me again just street level i'm a guy my wife is going through changes what is the difference between peri and menopausal i know you gave the definition, but how would I know which one is happening or the difference between the two?

29:41Dr. Kelly Casperson: I mean, the truth is it doesn't really matter. Okay. No periods after a year is a symptom of low hormones. So like saying like the symptom is means it's a thing or not a thing. It's irrelevant really. You know, the treatment is hormones. You can start those in perimenopause. So there isn't, truthfully, it doesn't matter. And a third of women will not have periods that end. uterine ablations, hysterectomies, IUDs, birth control, right? So again, it's a crappy definition because it doesn't even apply to all women. And the definition is a symptom of what's going on. And I mean, an actual better word for it would be secondary female hypogonadism.

30:27Dr. Kelly Casperson: That's very medical of me. But basically being like, she had hormones and now she doesn't. like that's actually what's happening okay i don't know if that that phrase is gonna catch on right right right so that's why we dumb it down and we call it menopause can you talk about some of the symptoms that are super common that are often perhaps misinterpreted by male partners because a lack of a period or a woman not having a period i don't think is a lot of conversation or like, hey, you and I need to sit down. I don't think you've had your period for three months. Something's going on here. Yeah, totally.

31:09Dr. Kelly Casperson: So one of the most common symptoms, which is profoundly important, but quite subjective, so that's why it irritates people, not feeling like myself or NFLM, not feeling like myself. Now that's a frustrating thing because like, how do I know Traver doesn't feel like Traver today, right? I have to take his word for it. I can't x-ray you. There's no lab value. So you have to take people's word for it. And women tend to be dismissed frequently of like, is what you're feeling real? But not feeling like myself is 60 to 80 % of women in perimenopause. Why is that? Because hormones profoundly affect the brain and the mitochondria and dopamine and serotonin And all the things that make Kelly feel like Kelly, all of a sudden is not firing and wiring correctly.

32:02Dr. Kelly Casperson: And so it's a very, again, vague, it's hard to put your thumb on. But women know, I mean, men know, like everybody every once in a while has like, I just not feel like myself today. And the best thing about getting treatment for perimenopause and menopause, which is just replacing the hormones that are going, that you're outliving, right? Is people coming back and being like, I feel like myself again. That's the job I have. My job is making women feel like themselves again and men who have low testosterone. That's the best thing ever, right? But it's like, I can't measure it, but they know when they're back.

32:35Dr. Kelly Casperson: You know, Susie feels like Susie again. Great, nailed it, awesome. This podcast is sponsored by Addy. Let's stop pretending low libido isn't a big deal. If it's bothering you, it's worth paying attention to. Meet Addy. Addy is a non-hormonal FDA approved option for women under 65 with bothersome low libido. Although the exact way Adi works is unknown, it's believed to work on brain chemistry, is taken once daily at bedtime, and it works over time. Adi, flabanserin, is a prescription medication for women under 65 with hypoactive low sexual desire disorder that is distressing to them, known as HSDD.

33:12Dr. Kelly Casperson: Adi is for low desire that happens in all situations and is not caused by a medical condition, relationship issues, or medicines. Addy is not for men or to enhance sexual performance. Addy can cause severe low blood pressure and fainting. Your risk is higher if you drink alcohol close to your dose. Don't take Addy if you have liver problems, take certain medicines, or are allergic to any of its ingredients. Before taking Addy, tell your doctor about all the medicines you take if you have had any mental health conditions, are pregnant, planning pregnancy, or breastfeeding. Side effects may include dizziness, nausea, tiredness, trouble sleeping, and dry mouth.

33:45Dr. Kelly Casperson: Learn more at ADDYI.com, including important warnings. Visit ADDY.com and complete an online telehealth visit today. With commercial insurance coverage, ADDY is as little as$20 a month. Eligible patients only. Restrictions apply. Visit ADDY.com, ADDYI.com. And just so guys listening to this, is it that exact languaging? So if you're in a little bit of detective work as a male partner, do women say, I just don't feel like myself? Yes. They'll say that very specifically saying, I just don't feel like myself. Something's off. Okay. So that's a flag for a partner then to get curious. I want to go into a little bit perhaps later in the conversation of what are some of the approaches you've seen that have been successful versus what are approaches that are not successful.

34:36but I'm also curious, are there other symptoms that you would say are in the top three? So not feeling like myself, what are the next two?

34:44Dr. Kelly Casperson: Sleep issues, huge, like 60 % of people, perimenopause, menopause. They sleep too much. They don't sleep. They wake up multiple times. Exhausted during the day, can't sleep at night. Awful. You need hormones to sleep, turns out. Overgeneralized, this is always the not everybody category, but low estrogen, low progesterone, low testosterone can really mess with people's sleep. So sleep's a huge one. So exhausted during the day, can't sleep at night. And then the third one you were saying was anxiety. Yeah. And how does that present? Like, what does a woman say to her partner that - They just know they're just like, I am anxious all of a sudden.

35:21Dr. Kelly Casperson: Like, ugh. Like, just kind of this like edgy thing or like reactive or like nervous. Or we used to be like, dude, I was chill. I had never had anxiety before. And then it's just this like feeling of like, enginess. And it's quite unpleasant for anybody who's had it. And I think it's dismissed a lot because, you know, everybody's got anxiety in America. Have you seen the world? Right? But it's really like this feeling of like, this is not how I used to be though. Or it can be things get worse. Like my ADHD gets worse. Or like, you know, things where you were like, I had all this under control, but I just can't now.

35:59Dr. Kelly Casperson: Like the wheels are coming off. I can't keep it together anymore. So those are other signs. Okay. Is it fair to ask an age range here when this, like if my 22-year-old partner says like, I just don't feel like myself, I'm probably going to ask different questions than if a 45-year-old partner. I know that's probably a long range. It's a huge range. It's a huge range. So average age of menopause in America is 51. So that means average. That means 50 % of people have menopause before 51. and then 50 % of people have menopause after 51, right? So if you're like, it happens when you're 51. No, no, no, that's what average means.

36:38Dr. Kelly Casperson: And then perimenopause can be up to 10 years before. So let's say, you know, if you went through menopause at 45, mid-30s is when perimenopause can start happening. Now, going back to the 22-year-old, I met a woman on my book tour. She went into menopause at 19. That is significant premature ovarian insufficiency. that's very rare, but it happens. And I think what happens a lot, you know, this is my joke, is women are two ages when they go to the doctor, too young for something or too old for something. So you better go to the doctor on the right day, damn it. Just at 51. Yeah, specifically in February when you're 51, the February of 51.

37:21Dr. Kelly Casperson: So there's a lot of dismissal of you're too old for that, you're too young for that, blah, blah, blah, blah, blah. When the truth is it's a, we're talking decades here, mid thirties to six, like some women have periods until they're like 58, you know, 60. So it's hard to get pregnant, but they still have periods. Beautiful. I want to shift this now to a bit of, again, if we're coming back to, I want men listening to this and men having sort of an action step or an understanding of what's happening. How are men getting this wrong? How are they interpreting these signs or in your, experience, taking what is a biological set of evidence and internalizing it as a relational set of evidence or even a personal set of evidence of there's something wrong with me or there's something wrong with her that isn't biological.

38:12How are you seeing this conversation mishandled commonly?

38:17Dr. Kelly Casperson: I don't care. Just deal with it. That it's a behavioral issue, like that it's in your head instead of in your ovaries, right? Like that there's a right way to deal with this, that you just need to like white knuckle it. Some people will make jokes and be funny about it. It's not funny. I don't make fun of you about your diabetes and your depression. Like let's not, it's not funny. But I get coping mechanisms. I get it. Not caring. And the other thing I would just add, just to wrap up the cornucopia of issues I've seen people do with it, is like the whole, men will be like, I don't want to change.

38:51Dr. Kelly Casperson: you're changing, I don't want to change. You solve that, Traver, you'll be an effing billionaire. Because women are like, I am. You can't go through the portal and not be a parent anymore. You can't go through the portal and not be in puberty. And so many men are like, I don't want to change. I need something to be just like, I liked the way it was. And she's changing. And men just want her to be like them and not change. And it's like, she's changing though. And so like that is really hard. I mean, if you have any advice for that, please tell them because I think everybody's very frustrated with that duality.

39:29I think the nature of relationship is evolution, period. If you do not want to be in an evolutionary process where you're a transformational process, then opt out of relationship. This is what I would tell men. If you are opting into relationship, marriage, partnership, boyfriend, girlfriend, then you are opting into an evolutionary and transformational thing. Just like I would not get on a train that is moving from east to west and then be pissed that it's moving from east to west. I would stay on the station and not get in it. So every single guy listening to this, if you are in relationship, you are in an evolutionary process.

40:10Now you can choose to join the evolutionary process and go through what will probably be hard, which is by nature change, but you will also come out on the other side having a radically different understanding of yourself, of intimacy, of biology, and I would say of the world. Because you've actually been in a container and a partner to one of the most fascinating experiences there is on earth, which is someone going through an initiation. It is a wild thing to partner with. Anybody who's been with someone who's gotten pregnant and then had a kid. Like you've been a part of, you know how many men I know, Kelly, that are like, I see my wife radically differently because I watched her give birth.

40:57And they were literally just like, I cannot believe the magic. I saw God coming through her. Why were you with her before? She was hot. Like, that's great. I'm super glad that that.

41:10Dr. Kelly Casperson: Super glad you had that experience. Yeah, yeah, yeah. Now she's gone. See, now that's the process that we're trying to get you to go through here. I think guys need to, we have to let go of control, first of all. We have to be willing to evolve. This is, we can go into a whole nother side conversation of what is happening in the world and what is happening with relationship is the call from life and the call from the feminine is men need to evolve in consciousness. And we are stuck. We're rigid. We're grasping and holding on. The other thing I would add to that is like men seeing men as the default and society sees men as the default, right?

41:53Dr. Kelly Casperson: Like women also will see men as the default and that women are somehow like other instead of equal but different, right? So it's like, it's just like, dude, stop thinking your experience is the default, right? 50 % of the world isn't you. So stop thinking you are the default. Because there's a world of opportunity to learn when you're like, oh, oh, you mean it's like a whole different world over there? Yeah, it's a whole different world over here. Stop trying to make us you. We're not you. I love that. I can feel as a guy how there has been a leap that I've had to take to go, oh, there's a whole nother thing happening with this person in partnership.

42:41How she relates to the world, how she relates to her body, how she relates to sex, how she relates to food, how she relates to life is completely differently,

42:49Dr. Kelly Casperson: completely different than how I do. Now, I don't want to live that way and I don't think I would do well living that way. Yet, having just gotten to experience it through female partners, it has opened up an entire other part of being human to me. An absolutely magical, wonderful part of being human. And I hope that's why every single guy listening to this believes they're here on earth, is to feel and experience the breath of life. Not just your one little lane where everything's cool and you don't have to step out of your comfort zone. Yeah, like everything's fine. Why can't you be?

43:31can we just name the podcast everything's fine why can't you be if i can if i can circle this back super quick i think of three male archetypes kind of the most common male archetypes that are perhaps let's say unconscious you have your 1950s marlboro man your sensitive new age kind of nice guy. And then now in 2026, a man who's just completely collapsed. And so I'd love if you would share a little bit, and I'll give you kind of the setup for each one of how they react and what they can possibly do that's a little bit different. So your 1950s Marlboro is most of our fathers or grandfathers, which is very individualistic, very stoic, very unemotional.

44:14and, I will just say this, ashamed of and afraid of any part of themselves that feels feminine because then it appears weak. So I would view this archetype as the guy that says to his female partner, like, you just got to fucking get over this. Like, you got to buck up and get through this and stop making it influence my life at all negatively. It's someone who's very disconnected, shut off and shut down. So in your experience, have you worked with partners of that man, of that archetype? And if so, what has helped soften them or bridge that? What languaging can we give them about what's actually happening?

44:59Dr. Kelly Casperson: I don't think it always goes well. It doesn't go well. You know this. That's why we're recording this. You know this too. Yeah. I mean, there's a lot of what we call stonewalling behavior. it can often look like the woman being like he just does not listen he just it's like i say words they don't go in his head like he does not listen or stonewalling of like i don't want to talk about it i don't want to talk about it i see this with sex a lot too i don't want to talk about it the woman's like i want to change we need to talk about this i want it to be different blah blah he's like i don't want to talk about it and then they come to me and they're like what should we do and i'm like therapy and they're like but couldn't testosterone help and i'm like no therapy.

45:40Dr. Kelly Casperson: Like when you get to the point where it's like you can't get through to somebody, I don't know a better answer than therapy. And then realizing like, do you want to be in a relationship with somebody that you can't get through to? That's what's on your plate. And I think that's a hard pill to swallow because we want easy, quick answers and we want everybody to come to the happy conclusion at the end of the tunnel. But it doesn't always work out. I think some people are just too fixed, like in their way. Yeah. Have you in all with this archetype? I grew up with this. Like this was a lot of my system.

46:14And when I had female partners who would almost invite me into the process, say, hey, you know, it'd be wonderful. I would love to have you on board as a teammate. I need your support. I need your strength. I need your logic. I need the things that that guy is almost using as the stonewall, but I need it applied in a way that works relationally. Have you found that at all to be helpful?

46:40Dr. Kelly Casperson: I think the team dynamic is brilliant and works very well. Because I think most people, they understand like, dude, teams are more powerful than the individuals, right? Because it's like, I've got some skill sets, you've got some skill sets, probably could come up with more solutions to the problem if there was more people who had their sleeves rolled up. So I think the we is so much better than I or you. Because at the end of the day, we're a team. I might not like X, you might not like Y, but we're a team. How do we get through? I think it's a power move. Beautiful. So for you guys listening who identify with that archetype, your teammate is suffering.

47:18And this is about her right now. So your teammate is suffering. You've got a hurt goalie. Oh, Kelly, this is your billion dollar answer. There we go. Gentlemen, you've got a hurt goalie. Have you seen what happens when a goalie gets hit in a hockey game? The whole team is like, you do not touch the goalie. I've seen more fights on social media because someone nicked a goalie. Gentlemen, your goalie is hurt. Okay, let's transition to the other side. I see also a lot of the sensitive new age kind of nice guys. And what I've heard from them is beautiful. This is all my problem now. I'm going to micromanage.

47:57I'm going to make sure it's constant. How are you? What can we do? And there's this smothering that seems like it happens, which is the reverse or the opposite of their side. Have you seen that? And what have you seen to be helpful with that?

48:10Dr. Kelly Casperson: Yeah, I mean, it can get into a little codependency, right? Of like, you're reinforcing the brokenness instead of like the journey part of it. And the resilience that is inherent within her. Like we all need support, but we don't all need somebody else to handle it for us all the time. Sometimes, yes. All the time, probably not, right? And then there you get into this role of like being dependent and being codependent and X, Y, and Z. And I think it always comes from a very helpful, like it comes from a very helpful, loving place. Like, thank God they're showing up. It's fantastic. But it kind of becomes an identity.

48:47Dr. Kelly Casperson: And the whole point is to try to move through the tunnel instead of being like, I guess, fixed or like this has to be how it is all the time where like somebody's codependent on another person for existence. So yeah, I think it comes from a good place though. And I think you kind of get into it like, oops, here we are. Something I see with that community a lot too is I'm okay if you're okay. So the checking in with the person who's going through the challenge isn't really authentic. Like the anxious attachment. Are you okay? Are you okay? hey, are you sweating? Are you this? Are you this? What can we do?

49:21And as opposed to saying, I'm great, I'm okay. Now, what can I overflow into your cup? How can I be here to support you as opposed to tell me 700 times that you're okay so that I know I'm okay? So I think the lesson for that community too is go take care of your own shit. Be strong, be supportive, be there and allow her to go through the initiation and the process that she's going through without you making it about you.

49:49Dr. Kelly Casperson: Yeah, I mean, I think that's good adult boundary work. You know, like at the end of the day, we're individuals working as a team, but we still need to be individuals and have our own space and stuff. And what I was holding was the fixer. Dudes love fixing shit. Give me the YouTube video on how to fix this one, right? And let me tell you the harder things I've fixed in the past. Let me give you my fixing resume. I'm going to name this for my podcast is How to Fix Your Menopausal Woman with Dr. Kelly Caspersen. It'll be great. AKA the broken goalie.

50:24Dr. Kelly Casperson: We'll get all the lessons. But so there's like the fixer dudes, which we do. We love the fixer dudes. But like perimenopause is a rough fucking road. No joke. But it is like a natural experience that we need to go. It doesn't actually need to be completely fixed. Now, if you're suffering and you need hormones, go get help. Yes, I fix things. Like we like to fix things. It's not like you're broken and have to be fixed though. Like a certain way. And the power of just presence and being there and listening and being like, I don't know what this is like at all, but like, I got your back. We're a team.

51:01Dr. Kelly Casperson: That person didn't just try to fix anything. But that person was there and present and saw them, right? But like, you can do all that and you still don't have to fix it. It's okay if you don't fix it. And I think a lot of guys are like, it'll be better if I can fix it though. And it's like, not always. Yeah. What's the swap out for them? Because I know when someone says don't do, it's really helpful to do. Ask. Do you need me to fix something right now? Do you need me to fix something or just listen? Because now you know what your assignment is and guys are like, great, I got an assignment. Got it.

51:37Dr. Kelly Casperson: Very good. And the woman's not trying to handle something that she didn't want in the first place. Is this a listening conversation or is this a fixing conversation? Ooh. Thousand times I popped that question. And it's so good because as a dude, I'm like, cool, you just need me to listen? Amazing. You can do that. I can do that. Look at these. Look at these. I just blink by a pretty little eye. See that? Yeah, that's what I do. Everything gets fixed anyway. It's amazing. Kelly, do you find the... So the third archetype I work with a lot is the collapsed guy. Do you find in your practice or have you experienced where women are showing up and saying, this just blew my guy out of the water.

52:21He just hit the bottom. He just zeroed out. He's done. He's collapsed. He's down in the basement, smoking pot, playing video games because he can't deal with the fact that I'm not taking care of everything. Is that an active archetype in menopause?

52:36Dr. Kelly Casperson: I don't want to say it's not. I haven't seen much of it. To me, I'm like, dude, check that guy's testosterone. Oh, gosh. I'm sending everybody listening to this. Go get your T-levels checked. I'm just saying 10 to 20 % of men have low testosterone. Like a screening test is, some people are advocating for it. No, I don't know. I mean, tell us more about that guy. What's the woman saying? What's the guy saying? Oftentimes what I have found is that's a relationship where the man is being mothered. and now that the mothering human is going high, I have to take the 100 units a day of love and care I was giving you and I need them for me because I'm kind of feeling like I'm drowning or I don't feel like myself and that man's abandonment issues, mother issues, mother wound, all that shit fires and he just becomes a toddler who is going to lie down in the supermarket and have a tantrum and say, I give up, I can't deal with you, there's nothing I say that works, yada, yada, yada.

53:35Bummer. Yeah. And so I would say to that man, you got to one, grow the fuck up and then get real curious about why when things aren't all about you, you disappear. Let's see also heterosexual relationship,

53:52Dr. Kelly Casperson: woman who mothers male partner. You don't have sexual desire for things you mother. So if you are being mothered by somebody, don't wonder why she doesn't want to sleep with you. Is that too blunt or is that perfectly blunt? No, no, no. I remember doing an Instagram post a couple years ago that was like, your girlfriend, your therapist, your mother, one of these three wants to have sex with you, even if they're the same person, if it's the same person. So I'm with you. That's a brilliant paper. This is a very old podcast episode that I did. It's the low desire challenges for women partnered with men.

54:29Dr. Kelly Casperson: And one of them is mothering. is like, we're not wired to want to sleep with the things we mother. Different project. People need to know that. Can we transition from that into libido and sex and what's happening? So for men experiencing, can you just talk about the biology? Like, is there a drop in libido? Is there an increase in libido? Tell us more. That's me just jumping into rapid fire. Yeah.

55:27Dr. Kelly Casperson: goes down. Pleasurable touch or interest in that goes down. Responsiveness, like blood flow, arousal, orgasm changes. It can become painful. The amount of years that go by before a woman will see a doctor about pain with sex. I mean, to me, I'm like, we got to get in front of this problem. But we always say, I have two problems. I have low desire and I have pain with sex. And I was like taking problems away from people. So I'm like, you have one problem. You have pain with sex, you don't desire hitting your thumb with a hammer. If it hurts, you aren't going to want it. So I always like to tell you, we got to deal with the pain with sex.

56:06Dr. Kelly Casperson: So vaginal estrogen, vaginal DHEA, lube, all good things. This is everybody. As we age, our vascular system ages, the pumps, our pumps get a little bit slower. So male erectile dysfunction, ejaculation problems, libido problems with women, orgasm problems, arousal problems, libido problems. And there's help available. Yes, we absolutely need more sexual health trained physicians. For the amount of people who want to have sex or are having sex, doctors are horrifically undertrained in this. But help is available. I see wins every single day. But again, just because we can't see hormones doesn't mean they aren't playing a profound role in our life.

56:48Dr. Kelly Casperson: And one of those roles is sexual health. How do you see this conversation working well? How do you see, I have an idea in my head of what men do that make it just more problematic or add an emotional shame, hurt layer to it. So even if the biology becomes righted, there's still anger, resentment, objectification that's happened, et cetera. How do you see this conversation first going well from the man's perspective. And I want to say first just to honor, if suddenly there's a drop in libido in any relationship, that's going to be startling. And that will probably also open up a lot of older wounds around self-esteem, about desirability, etc.

57:36So I want to honor the man's experience here too and not say, well, you're just supposed to have a huge drop in your woman's libido and go, huh, that's nothing. Let me just get on with my day. So how do you see this conversation going well?

57:51Dr. Kelly Casperson: We aren't taught how to talk about sex when it's going well. We're not taught. We're not taught. Okay. Like, that was so great. Why was that great for you? What did you like about that? When we do that again, should we do it differently? You want to do that exact same thing again? Like just talking about like it being good, we're uncomfortable with. And then when shit hits the proverbial fan, we don't know how to talk about it when it's good. So we're like, oh God. Then we really don't talk about it. Team again, we, relationship, our, our sex life. I've noticed we get away from the you, you, you blame, right?

58:25Dr. Kelly Casperson: Takes two people to have sex. So in a heterosexual relationship, loving, paired, together, know each other, best case, aka best case scenario, the woman orgasms 60 % of the time. So she's having less fun at the party if we're using orgasm as a proxy for party. And where I'm going with this is if it was not all that good to begin with, and now you have pain, or now you have sleep issues, or now you have anxiety, or now you have I don't feel like myself, aka now you have perimenopause and menopause. It's one thing when it was fabulous and the woman's like, that was fabulous, I need this back. But she's like, it was not that great to begin with.

59:04Dr. Kelly Casperson: I can take it or leave, right? So a question I often ask in my office is, was it good to begin with? Because I can't make you desire moldy chicken, right? And so I think that's not talked about because everybody assumes everybody's sex life was great. But then you have this heterosexual orgasm gap where you're like, studies show it's not, it wasn't, it's not that great for her a lot of the time, right? And so now you're upset that she just doesn't want something that she didn't like that much in the first place. And that doesn't, this is a whole other podcast episode, but that doesn't mean women don't like sex.

59:36Dr. Kelly Casperson: They just didn't like the sex they were having. that's a big topic what sex means to me is xyz therefore when we don't have it i make it mean xyz you don't love me are you look you know are you interested in somebody else like are we on the rocks am i unlovable did i do something to piss you off because i think sex means love but if you don't communicate what sex means to you it might be and i'm directly talking to the male in this scenario. Sex might be assumed that it's just a physical need that is not really a problem and you don't really need to get it from me anyways. Instead of like, sex means you love me.

1:00:20Dr. Kelly Casperson: So when we don't have sex, I'm feeling profoundly unloved, unlovable. Right? And so that all comes back to communicating. Like, are we communicating what sex means? Because when the sex isn't there, then somebody's like, well, wasn't that good to begin with? And then the other person's like, I'm unlovable, right? You're like, we need to talk about this. Yeah. When you said you ask, how was it in your office? You said, I'll ask my office, how was it? Are you just speaking to the female partner? Are you often speaking to a couple? Usually the female partner. Just the female partner. So guys, listening to this, you have an opportunity right now to ask yourself, what does sex mean to you beyond the physical, beyond the friction, beyond the act itself?

1:01:05If there was a drop, and get vulnerable here, get really honest with yourself. I get to have a lot of men who come in and say, it means I'm not desirable anymore. I'm not desired by my partner. And there's a wound around that that's not quite societally acceptable. That as men, we're not supposed to be the desired ones. We're supposed to be the ones that desire the woman and go out and get her. That's how we've set up the mating game here in the West. So I would invite you men listening to this, ask what's underneath sex and then go one step even deeper. What does it mean to you at your core? And are you willing to then share with that with your female partner and perhaps say, this is what I really need.

1:01:51I've had this conversation, Kelly, a lot with men who say, I get it. She's going through something and we're not having a lot of sex. But what I did was say, would you remind me in the morning that you still think I'm really hot? And you're also going through this thing. And they're like, I'm good. I'm good when that happens. Like I get a little pat on the butt, you know, walking in the shower. Like you're super fucking hot. And like, thanks. And then the dude's off to the races, you know, for the day.

1:02:19Dr. Kelly Casperson: Totally. And isn't that cool? You're like, oh, I thought putting a penis in a vagina meant putting a penis in a vagina. Like, no, no, no. It actually means like that I'm lovable and I'm safe. And like, it's like all this other interesting stuff that you're like, oh, well, if we cuddle or we hold hands or we go out on a date or we go watch comedy together or we go dance. So many people make everything stop because this one thing stopped. Instead of like, I can get X, Y, and Z in four different ways. I hope men listening to this got that. It's incumbent upon you, men listening, to say to your partner, this is what it means to me, and then present some options of, this is what would feel really good, and replacement of that.

1:03:03Like you said, can we watch a movie and cuddle? Can we hold hands? Can we do X, Y, and Z? And if you're going to tell me that the only thing you can do is have sex to scratch that itch or make you feel that way, I'm going to ask you to get more creative.

1:03:18Dr. Kelly Casperson: I was talking to somebody very recently about this. I'm like, there's an aisle in the grocery store that you can't go down right now because either it hurts in that aisle or for whatever reason, you don't get to go down that aisle right now. It doesn't mean you throw out the entire grocery store. There are like 12 different aisles. The fact that you're not aware that there's 12 different aisles doesn't mean there isn't 12 different aisles. So don't throw out the grocery store. And maybe it's a horrible analogy. I don't know, but it came to mine the other day. It's like, there's just one aisle you can't go down tonight.

1:03:48Dr. Kelly Casperson: That's fine. You've got 12 other aisles. Use them. Go explore them. And talk about it. I think we can come back to over and over, communicate, communicate, communicate, communicate, communicate, and speak about what's happening for you. And speak as if you're sharing. I just want you to know my experience and then listen to their experience. There's a lot of globalizing with men. This means that. There's a lot of doomsdaying or catastrophizing. That's it. She's going through this thing. We're never having sex again and not vocalizing what's actually happening in the moment. Do you think about the midlife divorces, which is a very fascinating topic because a lot of people don't want to admit that perimenopause and menopause is the third person in this room contributing to the divorce.

1:04:36Dr. Kelly Casperson: And you're like, by the time you talk to the divorce lawyers, by the time they're in the divorce lawyer office, like, you're not getting a divorce just because a penis didn't go in a vagina. But there's lots of people who have amazing relationships who explore all 12 vials of the grocery store. And the penis can't go in the vagina anymore. And they didn't get it. So it's like, it's everything, but it's not everything. It's a big complex topic. But nobody goes up to the judge. It's like, judge, we would like to split these assets because a penis didn't go in a vagina. Right? Like, it's always so much more than that.

1:05:10So much more. It's so much more. So you guys, this is an exploration. This is a time. We say it's an initiation. An initiation has guides. An initiation has insights that you didn't have before. An initiation has opportunities to look at the world differently. How else can you create pleasure? How else can you experience pleasure? How else can you create closeness? How else can you experience closeness? Same with intimacy, the big scary I word. How do you as a man, how can you learn to receive from the other aisles in ways that feels almost as good because that aisle is closed at the moment.

1:05:47Dr. Kelly Casperson: And it doesn't mean the aisle is going to be closed forever. This podcast is sponsored by Joy and Blokes. One thing I've always believed, if I'm helping one person with their sexual health, I always have to think about who's on the other side of that relationship because intimacy doesn't happen in isolation. And I've said this for years, if I'm prescribing a blue pill for a man, what about his partner? Are they dealing with pain during sex, low libido, hormonal changes? Are they both healthy enough to enjoy their relationship they're trying to build together? I see it with women and their health all the time too.

1:06:18Dr. Kelly Casperson: She starts optimizing her hormones, more energy, better sleep, the brain fog lifts, libido comes back, and the next thing I hear is, now my husband needs help too. That's one of the reasons I like Joy and Blokes. They care for both women and men, connecting patients with licensed clinicians for personalized hormone optimization when it's clinically appropriate. And they publish peer-reviewed research on outcomes, real improvements in energy, mood, mental clarity, sexual function, and quality of life. Whether you're navigating perimenopause, menopause, low testosterone, or simply wondering why you don't feel like yourself anymore, the first step is understanding what's going on with your body.

1:06:58Dr. Kelly Casperson: If you started feeling better

1:07:03Dr. Kelly Casperson: It's worth asking whether your partner could benefit from doing the same. If you've been wondering whether your hormones could be contributing to the way you feel, visit joyandblokes.com slash notbroken and use code notbroken for 65 % off labs and 20 % off treatment. That's J-O-I and B-L-O-K-E-S dot com backslash notbroken. Code notbroken. It will if you like bang on the aisle the whole time and start yelling at it. aisle and you get pissed at the aisle and resentful of the aisle. And like, you just keep trying to ram your cart down the aisle. Like, it's not good. We just need like an image of a guy like shouting down in a open for me.

1:07:47Yeah. Don't do that. Don't do that. Kelly, can we switch to real quick? What are some of the hormonal changes that are often happening in men around the same age? So I viewed this as I've seen a lot of couples where one person decides to get in shape, the other person decides to get in shape. One person decides to change their diet, the other person decides to change their diet, and they're both better for it. So if this is happening to you on a grander scale, or happening to women on a grander scale, a larger scale, what are the opportunities there for men around their health and hormones at this age as well?

1:08:20Or this stage, rather?

1:08:21Dr. Kelly Casperson: Sleep, exercise, muscles, lean body mass, stop alcohol stop drugs I think it's just so incredibly optimistic that we call this midlife you know but it really is like this is the initiation for everybody of like either my parents are passed or you're watching your parents age properly what do I mean that successfully whatever that might mean for you or poorly and everything we do in midlife and call midlife whatever you want, 35, 55, whatever you want to call midlife, right? It's optimistic we call this mid, knowing what we know now about the 1900s and dying of infection by 47. So what we do now is what gets us to be that person when they're 82 functioning like they want to function.

1:09:08Dr. Kelly Casperson: And I think this like, well, she needs to clean everything up and exercise because it's like, bro, you do too. Lean body mass is incredibly important. Metabolic health, incredibly important. Like your penis depends upon your metabolic health. Your penis depends upon your cardiovascular health. Can we hold one second, one second, because we're talking about penises and so this is super important. For someone who doesn't know what metabolic health means, what does that mean? Don't eat too much sugar. Don't get diabetes. Like most diabetes is preventable. Are you talking about weight gain? Are you talking about hormones?

1:09:39Dr. Kelly Casperson: Too many carbohydrates. So there can be skinny people with like diabetes and metabolic issues. And basically what they mean by metabolic health is too much sugar in your bloodstream. Like too much sugar is toxic. Can create weight gain, but can also create liver issues, cardiovascular issues, brain health, long-term, erectile dysfunction. The rate of erectile dysfunction with diabetes skyrockets and is stubborn to treat. So that's what we, when they say metabolic health, they usually mean blood glucose, insulin resistance, sometimes obesity, but you could be skinny and metabolically unhealthy.

1:10:12So you're saying metabolic hits the penis, cardiovascular hits the penis.

1:10:16Dr. Kelly Casperson: Alcohol hits the penis, stress hits the penis, not sleeping hits the penis. Like the penis is just a canary in the coal mine. People should be stoked. If you've got solid erections at 50, like good on you, right? Like people should be more, why are you people more proud of that? Like good on you. As soon as we end the podcast, I'm going to go tell all my neighbors. Erection's good, bro. Yeah, they're good. Okay, awesome. Happy for you. It's a good week. She can go high five people down the street. Guess who's 50? Guess who'd I just heard on a podcast? Pump still pumping? Great. Fantastic. Yeah, I mean, I think we should talk about female erections more too.

1:10:51Dr. Kelly Casperson: That was like, erections feel fantastic. And we don't even talk about women having erections. They feel fantastic. Women, lady bummers, fantastic things. Like we're all built the same. And you know, how joyously we talk about like, hey, healthy penises. But it's like clitorises are the exact same thing. Like same thing matters to clitorises, right? Like metabolic health, you got to exercise, heart health, you know, sleeping, stress, all that. It's like, it's no different for women just because it's researched way less. Can we give this to me? I would love to give this to men as there's a real call to action here.

1:11:26There's a real opportunity that you get to look in the mirror and say, am I the way I want to be? Am I sleeping the way I want to be sleeping? Is my erection the way I want it? Is my emotional state? Am I mature enough to be with this person?

1:11:39Dr. Kelly Casperson: Do you desire you? And what are the areas you would want to clean up right now or you can clean up? Would you want to sleep with you? How many mirrors do you have in your... That was personal. Is this like a Blink-182 song? It's like, I just have this song in my head for this whole podcast. I'm like, well, I guess this is growing up. That's a Blink-182 song. I guess this is growing up. I view this as such an opportunity for maturation for men. Oh, it's so badass. It's so wild. Who doesn't want to be mature and wise and have gone through life's journey knowing you were awake for it and you did your best and you showed up and you didn't die when you had hard conversations?

1:12:26Dr. Kelly Casperson: That's the whole thing about the conversation thing. It's like, guess what? You won't die. I promise you. Nobody's like, they died because they discussed something difficult. You're going to feel like you're going to die. But there's like this sense of elation afterwards like, oh, didn't die. It didn't die. Beautiful. I would love to close. Is there anything else you would like to share with men or ask of men or ask men before we give them a solid CTA here? Seemingly random, but not so random. Shout out for lube with sex and vibrators. Do not be afraid of them. It does not mean she's not aroused or turned on.

1:13:03Dr. Kelly Casperson: It does not mean she doesn't love you. We love technology in our life. I have three vibrators for my effing mouth at this point because it works better than my hand in a tree branch. Let's not be afraid of vibrators. Pleasure is everybody's job. And the more pleasure she has, and the more she feels safe. Oh God, we need to do an entire podcast about safety and sex. But like the more she feels safe and pleasurable, the more she'll show up to the party. So I see a lot of like, I'm worried about what my partner's gonna think about the vibrator and blah, blah. And I'm like, dude, the more you orgasm, winner, winner, chicken dinner.

1:13:44Dr. Kelly Casperson: Love her orgasm, support her orgasm, prioritize her orgasm. If you want her to show up to the party, make sure it's a freaking good party. And the party doesn't always need to be putting something hard into a dark hole. I'll even add, the deeper she'll go at the party, and if you want to take someone on a ride and have them experience things that are otherworldly or out of consciousness or other consciousness that's going to be a couple orgasms deep and you getting to be a part of it right you getting to be there for that guys and not be responsible for it but guide and facilitate that is a really fucking cool feeling and it goes a lot deeper the next morning and the next day and the impact on that person's life beyond like, yeah, cool.

1:14:29Then we got off a bunch of times. It literally will change someone to their core. Kelly, what is one conversation? If you have some men listening to this, their partners are in menopause, in perimenopause, what is one conversation you would ask them to have this week after listening to this podcast?

1:14:48Dr. Kelly Casperson: Tell me something you don't know about me or like, tell me something that you don't think I know about you. Just like have some fun, especially in like long-term committed monogamous relationships. You're like, I know, I know them. You don't. Like get curious about stuff like that. That's cool. You know, like keep the brains actually like brains love monotony and routine and stability. And then brains also hate that. Right. And so it's like, keep it. If what you want is a long-term committed monogamous relationship, keep it entertaining. Yeah. I love it. Thank you. Can we talk very quickly? I know you're a doctor.

1:15:24How is it helpful to have the male partner involved in conversations with the doctor? And maybe what are some ways that it's not helpful to have him involved?

1:15:34Dr. Kelly Casperson: I just had a patient, so female patient. She was having an issue for like two years. She saw multiple doctors and finally like, you know, traveled out of state to go to this other doctor to try to help. And her husband came with and he advocated for her in a way and actually like helped because he was like, hey, could we just X, Y, and Z? If you want to believe it or not, it doesn't make it not real. There's gender bias in medicine. There is power in a man saying something. Like welcome to 2026 if you're not awake, here we are. So there is some power in that for the guy to be like, hey, can we blah, blah, blah, right?

1:16:10Dr. Kelly Casperson: Like men just get questioned less when they're in the doctor's office. When they say like, it's this bad, people are like, oh, it's that bad. And when women are like, it's this bad, we're like, is it? But is it? So I think showing up sometimes as an advocate can be profoundly helpful. And then, so I would say yes, absolutely. Especially if you're like, God, are we getting anywhere with this? But not in an angry way, but in like an advocacy way. Could we just check X, Y, and Z? We always want to keep team, team, team, team with doctors. But sometimes I think a woman doesn't feel comfortable telling the whole story.

1:16:45Right?

1:16:46Dr. Kelly Casperson: because the relationship might not be fully open to communicating in X, Y, and Z. So it's like, if they're there all the time, I can kind of tell there's a part of the story I might not know. Okay. I think that's a really important thing to say. So I wouldn't make it be like, you need to be there all the time. Like, no. But if you have a gut feeling of like, I think I just might need to show up today or show my support. I have patients and then like, you know, we hang out. I know them for like a year or two and then they bring in their partner and I'm like, what fun is this? Like, this was fantastic.

1:17:15Dr. Kelly Casperson: Like, you're Michael? Like, awesome. You know, because I have that sort of relationship with people. I'm like, oh, I'm so excited to get to meet the person. So, yeah, I don't know. I guess it's a, you know, it depends. Okay. I'll share for guys listening. I remember going to the emergency room with my ex-wife, and she was having a miscarriage. All of the staff was male and wanted to inject something. You probably know what this is. Maybe it was an ectopic. They thought it was ectopic. and so they were going to give her something that was going to flush out her system. It was really, really toxic to where they couldn't even have a woman do the injection itself.

1:17:56Long story short, she was like, I don't think I want this. And the male doctor and the male attending came back in and were like, if you don't do this and you have a problem, the insurance company will not cover it. So we recommend you do it. And I remember saying, she needs five minutes to sit with this before she does anything. So I need you guys to step outside. And just that was enough for her to go, I don't want this. I really don't want this. When they come back in here, can we tell them we're not doing it? And I think if I had I not been there, this, the bullying, you know, this is three o 'clock in the morning.

1:18:32She's going through a bunch of shit. So I will validate that me just standing up and saying, gentlemen, you're an MD and you're not, but everybody get the fuck out. she's going to go sit with her gut for five minutes was really, really profound. I'm grateful that we didn't take it.

1:18:48Dr. Kelly Casperson: Yeah. I love that. Thank you for sharing that. Anything else you would leave the male audience about this entire journey? Like this is the work of your life. So you're deep, deep, deep, deep in the trenches. I work with men, but not around this particular issue. If we gave you the billboard or whatever the magic, you know, end of podcast saying you could only leave one message or... Take care of your goalie. Watch out for that aisle. Be kind. That's what it would be. You know, we're all just all humans trying to human. And if you can find the spiritual journey in this, man, you're winning. Like you are winning on that.

1:19:29Dr. Kelly Casperson: And if that sounds like completely woo, welcome to the beginning of the tunnel, right? So that's what I would say. Be kind. And if you get to find the spiritual, somebody's like, we're dead for so much longer than we're alive.

1:19:48I love that.

1:19:50Dr. Kelly Casperson: Right? And you're just like, oh, this is precious. Communication, and this is coming from a surgeon, so I've had a lot of learning. It takes a long time. And it's not clean. There's a lot of blah, but it's better than not communicating. And I'll say to you guys, that's so much of what's said in the masculine culture is we're here to protect. We're here to provide. Here's your opportunity to actually show up for your partner with so much presence. That is all that's the root of what's required of you. I'll echo what Dr. Casperson said of, this is a real opportunity to have kindness. This is a real opportunity to literally tap into a part of yourself that may not have been alive before in the relationship.

1:20:37And that is just unwavering support and presence because it is her time of going through the transition. But if you stay present with it, you naturally will go on a very similar ride. And I hope you all find the spiritual part of it because I think that is the greatest part of this midlife journey.

1:20:55Dr. Kelly Casperson: I love it. Just to share an example, my husband's like, Kelly, I want to grow old with you. I want to grow old with you. And you're just like, bring it on. Let's just get gray together. Let's try to keep as many muscles as we can, but let's get gray. Let's do it. You know, I'll leave the guys with this. My buddy Jeremy operates on Instagram as long as this love bombs says like, treat people like you want them to stick around. Oh. I think it's a very helpful way of putting it. So here's the opportunity. For my audience, Kelly, for people who don't know you, where can they find you? Where can they find more of you?

1:21:36Where can they get your books and listen to your podcast?

1:21:39Dr. Kelly Casperson: Yeah, thank you. So my books are The Menopause Moment and You Are Not Broken. The You Are Not Broken is the first one. It's more about female sexuality. It's fantastic. It's a light weekend read. And not being ironic, it truly is. podcast at YouAreNotBroken. And I love hanging out on Instagram at KellyCaspersonMD. Beautiful. And you all can find me at manuncivilized.com or at Traverboem on Instagram, T-R-A-V-E-R-B-O-E-H-M. And you can also hear my great conversation with Dr. Casperson on the Uncivilized podcast. Thank you all for listening. Thank you all for joining. Kelly, it's always a pleasure.

1:22:14Dr. Kelly Casperson: So fun. If you found this episode funny, helpful, insightful, please take a moment to follow, rate, and share the You Are Not Broken podcast with someone who might need this conversation too. That support is how this information reaches more people. And thank you. For courses, books, and my monthly membership, and the Casperson Clinic information, visit kellycaspersonmd.com. This podcast and all content from Dr. Kelly Kasperson is intended for educational and informational purposes only, and this is not a substitute for individual medical, coaching, or psychological advice, diagnosis, or treatment.

1:22:53Dr. Kelly Casperson: Always seek the guidance of your qualified healthcare professional with any questions you may have regarding your health. Never disregard or delay medical advice because of something you've heard on this or other podcasts. Thanks for being here, and remember, you are not broken.