You Are Not Broken

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You Are Not Broken I am Kelly Casperson, MD
My mission is simple: to share proven tools that empower you to create a better life.

And, it’s to make you feel a little less alone, to encourage you every step of the way, and laugh a lot as we learn and grow together.

10/20/2026

Reminder: hormone care is not one size fits all. That’s why men have so many options. When women have as many options as men we will have equality. Rachel S. Rubin MD

Mark Cuban Mark Cuban Cost Plus Drug Co you are a better deal than Medicare!!!Results: The total estimated savings when ...
10/20/2026

Mark Cuban Mark Cuban Cost Plus Drug Co you are a better deal than Medicare!!!

Results: The total estimated savings when using Cost Plus Drugs compared to Medicare was $462,375,491.53 and $618,833,850.34 for 30- and 90-count pricing, respectively. The price of a 42.5-gram tube of vaginal estrogen cream was $22.48 on Cost Plus Drugs, compared to $293.66 through Medicare Part D.

Xu R, Escott M, El Haraki AS. The Mark Cuban Cost Plus Drug Company Effect on Urogynecologic Drugs. Urogynecology (Phila). 2025 Oct 1;31(10):994-997. doi: 10.1097/SPV.0000000000001653. PMID: 39868809.

Another fine day at work. Women are half the population. 51% to be pedantic. We live in all 50 states in the USA. And at...
10/19/2026

Another fine day at work.
Women are half the population. 51% to be pedantic. We live in all 50 states in the USA. And at the end of the day we need healthcare, livelihoods, and funding for science, medicines and systems that support our health.
I am so proud that I get to share womens’s stories and push for change, seats at the table and progress to level the gender disparity in medicine and science. Bring on the future. For everyone.
Thanks to Mother Nature for a beautiful fall day in our nation’s capital.

How science starts: Someone notices something.A woman starts testosterone. A few months in, she says, “Weird thing. My a...
10/19/2026

How science starts: Someone notices something.

A woman starts testosterone. A few months in, she says, “Weird thing. My asthma is better. I’m barely using my inhaler.”

A clinician pays attention.

That observation becomes a question.
Could testosterone affect the airways?

The question sends researchers looking for a mechanism.
And here’s the fun part: before puberty, asthma is more common in boys. After puberty, it flips, and it’s more common in women. Lab and animal studies suggest androgens calm some of the immune cells that drive allergic airway inflammation.

So is testosterone an asthma treatment?

Not yet.

The strongest signals come from population data and mechanism studies, plus a handful of small androgen trials. Direct clinical trials of testosterone for asthma? They don’t exist. The one large real-world cohort showed effects that were modest, delayed, and complicated.

Which is exactly the point. That gap is where the next trial lives.

Observation → question → mechanism → trial.

Now, notice where it starts.

It doesn’t start in a lab. It starts with a person describing her own body. And for decades, when that person was a woman, the first step got skipped. “It’s a coincidence.” “It’s in your head.” “Your labs are normal.”

Dismiss the observation and you never get the question. No question, no mechanism. No mechanism, no trial. No trial? Then “there’s no evidence,” and the dismissal looks justified. Convenient.

So hear me clearly:

Your voice matters.

Your firsthand experience matters.

You are not an anecdote. You are data that hasn’t been collected yet.

Keep talking. Keep writing it down. Keep telling your doctor.

That’s how science starts.

10/18/2026

Hang onto your patches. New guidelines. Menopause therapy is highly recommended. American College of Obstetricians & Gynecologists American College of Physicians

Researchers looked at over 300 million lab tests from more than a million women in the US and Israel. lining women up by...
10/18/2026

Researchers looked at over 300 million lab tests from more than a million women in the US and Israel. lining women up by their final period instead of by birthday.

What they found:

📉 A step-like jump at the final menstrual period in 52 of 90 lab tests. Not just hormones. Bone, liver, kidney, cholesterol, blood chemistry.

👨 Men? No jump. Their labs drift slowly with age. Men age on a ramp. Women hit a cliff.

⏰ Hormone changes started 12–15 years BEFORE the last period. That’s earlier than we’ve been taught. Perimenopause can start in your mid-30s.

🦴 Osteoporosis and heart attack risk climbed faster after menopause. Depression scores and sleep problems spiked in the first year, then eased.

💊 Women on hormone therapy had much smaller jumps. The bigger the jump in a test, the more hormone therapy softened it. Their numbers looked like a smoother continuation of pre-menopause.

Is this proof hormone therapy prevents disease? No. It’s observational, with real limits like healthy-user bias. We need randomized trials.

But it’s one more piece of evidence that menopause is a whole-body event, not a hot-flash problem. Not a “no periods” problem.

So why are we still waiting until women are in crisis to talk about it?

You are not broken. You are not imagining it. Talk to your doctor.

Reminder: none of this is individual medical advice. Please discuss your own plan with your clinician.

— Dr. C

📚 Pridham G, Hayut Y, Lavi-Shoseyov N, Neeman M, Hovav N, Toledano Y, Alon U. Population-scale reconstruction of menopause dynamics reveals a physiological cliff at the final menstrual period. *Nature Medicine*. 2026;32:3823–3831. doi:10.1038/s41591-026-04614-0

Testosterone is not a “male hormone.”It’s a human hormone. And women make it too, in fact, more testosterone than estrog...
10/18/2026

Testosterone is not a “male hormone.”

It’s a human hormone. And women make it too, in fact, more testosterone than estrogen across our lifetime.

So why does it do so much? Because just like estrogen, there are androgen receptors in every cell. It acts everywhere.

Sexual function

Bone density

Muscle mass

Mood

Cognition

Pain modulation

Metabolic health

Autoimmune conditions

Cardiovascular health

Bladder control

Sleep

That’s not a “libido hormone.” That’s a whole-body hormone.

So why is it so hard to get? Why is there still no FDA-approved option for women in the US? Why do so many of us hear “your levels are normal” and get sent home?

Today’s Substack walks through how women make testosterone, what it does, where the research is strong, where the gaps are, and the controversies around using it.

You deserve to know this. Then talk to your doctor.

New post is live. Link in bio.

10/18/2026

If you can even find a patch.
I predict we will be moving to cheaper options since this “non shortage” patch shortage isn’t abating.
Oral is safer than most medications. For many people it is a great option. Speak with your clinician. This is not individual medical advice.

10/17/2026

Go Gen X!
Join Dr. Casperson and Jennifer Weiss-Wolf on the “you are not broken” podcast episode 392.

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