unPAUSED with Dr. Mary Claire Haver The Testosterone Conversation with Dr. Kelly Casperson: Beyond Libido
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Apr 23, 2026 Dr. Kelly Casperson, a urologist and author focused on women’s sexual health and menopause care, explains why testosterone in women is misunderstood. She walks through where it is made, where it acts in the body, and its roles beyond libido. The conversation covers dosing challenges, research gaps, genital therapies, and practical steps clinicians use to assess and try testosterone safely.
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Regulatory Gap Leaves Women Without Options
- There are zero FDA‑approved testosterone products for women in the U.S. despite many male products, partly due to post‑WHI regulatory caution and teratogenicity concerns.
- This regulatory double standard limits validation and insurance coverage.
Testosterone Restored A Doctor's Motivation
- A physician who had emergency surgical menopause regained motivation and completed a long-planned deck after starting testosterone.
- Kelly Casperson uses this story to illustrate testosterone's effects on drive and goal-directed energy.
Testosterone May Lower Breast Cancer Risk
- Observational pellet data suggests women on testosterone had ~30% lower breast cancer rates compared with SEER population.
- Although critics demand RCTs, the signal and biologic plausibility (testosterone may be breast protective) merit more research.
