The Oprah Podcast - Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause
Episode Date: April 1, 2025BUY THE BOOK! “Grown Woman Talk” by Dr. Sharon Malone, published by Crown Publishing, is now available wherever books are sold. The paperback version will be available on April 8, 2025. https://ww...w.penguinrandomhouse.com/books/722319/grown-woman-talk-by-sharon-malone-md/ Dr. Sharon Malone, menopause expert, Chief Medical Advisor Alloy Women's Health, and author of the New York Times bestseller, "Grown Woman Talk," joins “The Oprah Podcast” to explain everything you need to know about this natural stage of life that impacts 1 billion women worldwide. Actress Naomi Watts, who writes about her menopausal journey in "Dare I Say It," will also join the conversation to share how she has learned to navigate her marriage, career and motherhood while also dealing with perimenopause. Dr. Malone will give you a greater understanding of the science behind menopause including what it is, why it happens, when it starts and how long it lasts. She will also discuss why women experience such a wide range of symptoms, why hormone fluctuations happen and why hormone replacement therapy can help. Dr. Malone answers questions from women in the throes of menopause including how to deal with workplace bias, how to manage drenching night sweats, what causes those unpredictable mood swings and what we can do to prevent dementia and Alzheimer’s as we age. Alloy Women's Health is a direct to consumer digital healthcare company revolutionizing the way women age by offering education, expertise, and safe, science-backed solutions for perimenopause & menopause symptoms, skincare, sexual health, gut health and more. Treatment plans are customized and everything is delivered with free shipping. Alloy customers receive unlimited follow-up care with their menopause-trained physician through the duration of their active prescription and access to community through member support groups and more all from the convenience of their home. Alloy offers a fast, easy, and 100% digital solution to help women find guidance and treatments wherever they are. Being with Alloy is like having a menopause doctor in one's pocket. https://www.myalloy.com/ Follow Oprah Winfrey on Social: https://www.instagram.com/oprah/ https://www.facebook.com/oprahwinfrey/ Listen to the full podcast: https://open.spotify.com/show/0tEVrfNp92a7lbjDe6GMLI https://podcasts.apple.com/us/podcast/the-oprah-podcast/id1782960381 Learn more about your ad choices. Visit megaphone.fm/adchoices
Transcript
Discussion (0)
Thank you all for joining the Oprah Podcast and for watching us on YouTube.
I appreciate you taking the time to spend it here with me.
And I am just so appreciative of the conversations we're having about things that impact all
of our lives.
And I'm guessing you all have been hearing a lot about menopause these days.
But the more I talk about it, the more I realize we need a Menopause 101 because there's still
so much, there's
so much confusion still out there and we need reliable information and we need facts.
Menopause is not a disease or a disorder, but a natural part of aging that all women
born with ovaries will eventually experience.
Menopause occurs when a woman has gone 12 months without a period, which means her ovaries
have stopped producing hormones and her body is no longer capable of reproduction.
For most women, menopause occurs between the ages of 45 and 55, but before you enter menopause,
your body will go through a transitional period known as paramenopause, which can begin as
early as your mid-30s. Paraminopause can last anywhere from four to ten years and may include symptoms like
hot flashes, fatigue, mood swings, dry skin, dry everything, and low libido.
To help us understand more about the menopausal journey, I invited Dr. Sharon Malone to the podcast.
Dr. Malone has been a pioneer and nationally renowned expert in menopausal journey, I invited Dr. Sharon Malone to the podcast. Dr. Malone has been a pioneer
and nationally renowned expert in menopause
for over three decades. She is the chief medical advisor
for Alloy Women's Health and the New York Times
bestselling author, A Grown Woman Talk.
So happy to have you here, Dr. Malone.
Thank you so much for having me, Oprah.
You know, it's what we were saying before, that I feel like I've been talking about it,
and talking about it, and talking about it, and you say you talk about it, it's every day,
and then there's still all these people who have never heard about menopause and what it means for
all of our lives. Right. You know, even for the women who are out there who are currently going through menopause,
they haven't heard this conversation.
I know.
And there's another 6,000 women every day going into menopause.
And so the backfill is constant because there are people that just haven't had this conversation,
not with their doctors, not with their mothers, and not even with their friends.
So I'm hoping those of you who are seeing this,
if you're watching for yourself,
that you pass it on to somebody who you also know needs it.
Let's start by you explaining the four stages
of women's reproductive and post-reproductive lives.
Can you walk us through what they are?
Yes, the first-
You do that very well in grown talk,
but I want you to share it with people
who haven't read the book yet. I would love to. The first stage that we're
all familiar with is your pre-menopausal phase, and that really starts at puberty, and that
encompasses your reproductive life, your peak reproductive years, which start somewhere at 12,
13, and it goes to women when they're early 30s. That's premenopause.
So when we're talking about that, that's the concern.
Then when you become perimenopausal, that is that amorphous phase between being your
peak reproductive years and the end of your reproductive years.
And the end of reproduction really starts at menopause. So there's this great space in between the perimenopausal years where you start to have
some of the symptoms of menopause, but you're still having your periods, sometimes regularly,
sometimes not.
But all of the things that we normally associate-
Isn't the sometimes regularly and sometimes not a real indication that you're in peri?
Yes, because sometimes for women, that's the changes.
So you're not in menopause until it has stopped.
You are not in menopause officially until you have had your last period.
And how do you know when you've had your last period?
Well, you know you're in menopause when you've gone 12 full months and you've not had another
period.
Then it's official, you are menopausal.
But what's confusing for women is that in-between state, because it can start as early as your
mid-30s and it can go on until you've had your last period.
And that can go on from anywhere from four to 10 years for women.
And that's where I think a lot of the confusion comes in. Because if you're having
your period and having hot flashes, well then, and you go to your doctor or you're having
sleeplessness or mood disturbances and you go to your doctor and the first question they
ask you is, well, when was your last period? And if it was last month, they immediately
get off the conversation of perimenopause or menopause.
So all of the symptoms that we typically associate with menopause that people are familiar with,
like hot flashes, mood swings, sleeplessness, painful sex, can start in perimenopause.
And women think of menopause as something that happens to old ladies.
The average age is 51.
But a 35-year-old having these symptoms is very much in that menopausal transition, that
in-between state.
That could go on for another 10, 15 years.
It can go on for another 10 years.
And I think what is also confusing is that when women say, all right, so we've got pre-menopause,
perimenopause, menopause, and postmenopause.
And I don't really like the term postmenopause
because it implies that at some point you're over it.
You're done.
You're not over it.
You're never over it.
You're never over it.
And people think that because your hot flashes stopped
or you didn't have hot flashes
that you didn't have menopause.
And I'm saying, yes, you yes you did yes you did yes because
Menopause is what I've learned it is it is losing the eggs
So you no longer have eggs you have automatically gone into menopause exactly
That's right
But there are other ways that women can go through menopause other than just the natural process that happens.
But the natural process is losing your eggs, which means you are no longer able to produce
a child.
Absolutely no longer fertile.
And sometimes it's not just the complete loss of eggs, it's the loss of function of your
eggs.
Because the other thing that happens that people don't talk enough about during perimenopause
is that there's a change
in your fertility.
Because when you're perimenopausal, when you're 40, you still have eggs, you're still having
your period, but your fertility is not what it was at 20.
It's not what it was at 25.
So that's-
Because you've already lost eggs.
It's not because you've lost them, it's because they are less responsive.
Oh, they're less functional.
And there's less functional.
And I'll give you an example.
I like to say for,
you're born with all the eggs you're ever gonna have.
You don't get any more, you don't make any more.
And then over time, you ovulate some,
but you're not losing them because you've run out of them.
It should, you only ovulate about 500 times
in your lifetime,
but you had a million when you were born,
those eggs become less functional.
And every woman has a different expiration date
stamped on your eggs.
So you don't know, are my eggs gonna last until I'm 45,
or are they going to expire when I'm 35?
And that's why we start to see the fertility changes is that, and for each individual,
when you reach the end of that road, it's going to be different from person to person.
I thank you for taking the time out of your busy day to listen to this episode about our
health and well-being.
We'll have more of my conversation about menopause with the author of Grown Woman Talk, Dr. Sharon
Malone, after these messages. FDA approved solutions to your menopause and perimenopause symptoms prescribed by menopause trained doctors.
With unlimited ongoing care with your own personal doctor, you can message them anytime
from anywhere for no extra cost.
Menopause is inevitable, but suffering doesn't have to be.
Alloy has everything you need to age happily and healthily.
Feel like yourself again.
Go to myalloy.com to start your consult with a menopause-trained
expert today. Use code OPRAH to get $20 off your first order.
Welcome back to more of my conversation with Dr. Sharon Malone about the latest science
on menopause. I want to bring in actress and activist Naomi Watts to this conversation.
She too has a new book, Dare I Say It? Everything I Wish I'd Known About Menopause.
It's a New York Times bestseller.
Naomi, I hear you're on set.
Thank you for joining us.
Thank you for having me, Oprah.
Yes, what was the inspiration for you to write it?
Because you were going through it or had been through it?
Yeah, I was told at 36 when I was trying to start a family
that I was going to be going into early menopause and that I was told at 36 when I was trying to start a family that I was going to be going
into early menopause and that I was close to it and probably wouldn't be able to have
children naturally.
So it sent panic through me.
I had heard from my mother long ago.
I remembered that she had said I went into menopause at 45, but I didn't know she had
a multitude of symptoms that carried through the years and years. So again, to Dr. Malone's point, hi Sharon, there just was no
conversations anywhere, no preparation with your doctor, no real details from
your mother, and certainly friends weren't talking about it. And which symptoms were the most frustrating for you?
Well, I had been having night sweats and ticking those medical questions, those boxes for night
sweats for several years before the doctor told me that.
So that meant I had disrupted sleep,
which can lead to all kinds of things, anxiety, depression.
I certainly had brain fog and I had migraines.
And then the worst one that was kind of intolerable
was dry skin because I was on camera all the time.
And it wasn't just dry, but it was itchy and aggravated
and red and sensitive all the time.
And being under hot lights and makeup,
everything aggravated it.
So, and I didn't know that was connected to menopause at all.
I went to multiple dermatologists who gave me ointments,
which worked for a day or two,
but then the same thing would just keep cycling.
Was HRT hormone replacement therapy recommended to you?
Yes, it was, and very early on,
and mercifully, because my doctor understood it,
and he gave me the full education.
You know, as I understand it, still to this day,
doctors are gatekeeping that
because of the bad studies in 2002. But my doctor was ahead of the curve. And this I've
been on HRT successfully and safely for over 10 years.
I know we're going to talk about HRTs with Dr. Malone because there is so much confusion,
misconception about HRTs.
I've been on them for, I think, Matt, well, whenever I was 54 is when I went on HRTs.
So I believe them.
What is HRT?
Can you explain that, Dr. Malone?
Yes.
Hormone replacement therapy, typically it is comprised of estrogen, which is the secret
sauce in hormone replacement therapy, and a progestin, which is the second hormone that
you take when you have an intact uterus.
Now, for women who've had hysterectomies and don't need to have the progestin, you can
just take estrogen alone.
But most of what we associate with the symptomatic relief
really comes from the estrogen component of it.
And I hear some women are also now taking
a little bit of testosterone also.
Yes, they are.
Yeah.
And, you know, but all of the studies that have been done
really basically are with estrogen and progestin.
We are sort of behind the curve.
We're finding out a lot more about testosterone
because women make testosterone too. And I think that that's sort of behind the curve. We're finding out a lot more about testosterone because women make testosterone too.
And I think that that's sort of the misconception is that, well, estrogen is a female hormone
and testosterone is the male hormone.
And that is not true.
Women make almost as much testosterone in the course of our reproductive lives as we
make estrogen.
That's really responsible for that sex drive that you get right around mid-cycle.
So we're coming back around to understanding that maybe there should be more to hormone
replacement therapy than just estrogen and progestin, but we need a lot more studies
about that.
Okay.
We're going to talk more about that.
But in your book, I think this is really an interesting aspect, Naomi, because in your
book, chapter 12 is titled Minnow Boss and how to deal with ageism in the workplace.
What advice would you give menopausal women who I think in many cases start to feel invisible at work and also feel a level of embarrassment and shame
about going through this change because there is no understood that number one
they don't understand it and the culture doesn't understand it. I would say the
first step is communication and then education like owning your story and
sharing it with those around you. We come with experience.
The workplace needs us there, whatever industry we're talking about. So it's
important to own your story and say what it is that you're going through so people
know how to behave and help. I find most of the time people want to be, they're curious and they want to act with
compassion.
So for me, it certainly felt like a big risk to tell my story.
But once I named it and owned it, I feel nothing but embrace actually from my industry, despite
the fact that I was told I should conceal my secret.
Yeah I'm so happy to hear that's changing. We all know your husband is actor and
producer Billy Crudup. In the book you write about honest conversations you've
had with him. I'm not going into details today but what's your advice for women
who have not talked to the men in their lives about this? I mean, yeah, it was one of your earlier conversations with him
Yes, I I think that is the real sign of intimacy to be able to share your truth
No matter how vulnerable it makes you feel and as I said before even not just in the workplace
But your partner your life partner
And obviously I had to
share this with Billy at a very, very early stage, much more earlier than I was prepared
for, but I just was like, what am I going to do?
Like am I going to hide?
No.
And it was met with compassion and curiosity and, you know, he wanted to help and that sort of opened up me in ways that
led me to start a company, Stripes Beauty, which is creating hydration from scalp to
vag and then led me to having the confidence to write the book.
And then the book I did, I wrote because it was the manual, the guide,
that I wished I'd had when I was flailing around,
trying to navigate bits of information
from wherever I'd go.
So tell us a bit about this wellness brand you created,
Stripes Beauty, from scalp to badge.
What has been the response?
It's been amazing, Oprah.
Honestly, I've been, you know, out on the streets and
stopped by people who I think they're going to ask me for a selfie because they've seen
me in King Kong or the ring or something. And they in fact are coming at me with tears
in their eyes and joy saying thank you for giving me the dialogue, the permission to
speak with my partner, my family, and making it easier by sharing your story. And also,
thanks for the badge of honor because now the walls of my vagina are not so dry and sensitive.
And can you tell me what has been the most delightful surprise for you about sex post age 50?
And how does your company stripes play into that?
Well, I think we're more experienced at everything and we know what we want and what we like and don't like. And I think at this age, you
just are more, you know, leaning into that truth and more authentic and just able to
say, you know, sorry, I've just got to get the lube or, you know, let's do it this way,
you know? And I think there's something very sexy about a woman who knows what she wants.
And we still have desire.
We just need to get a little bit more organized.
Well dare I say thank you for joining us again.
Okay, Naomi, I know you have to get back to work.
Thank you for joining us.
This is one of the many reasons I love Zoom.
Thank you for taking the time out of your workday schedule to be with us.
Thank you. taking the time out of your workday schedule to be with us. Thank you.
All right.
Well, I just want to make sure that everyone understands that this is a natural cycle of
life.
Yes.
You say this in grown women talk, not a disease and the hormonal changes during perimenopause
are as significant as those in puberty and in pregnancy.
So imagine going into puberty and not knowing anything about what's going to happen to your
body, which a lot of us women did.
Nobody had said anything about what a period is and what the hormones were going to do
and all of that.
And so many women are experiencing the same going into menopause because their doctors
don't even know.
There's a lack of an awareness and information from doctors from what I've learned from you and other doctors.
It's not even taught in medical school.
You know, it used to be.
And let me say because, you know, I'm in the old group of people and, you know, the study
that really changed everything in 2002, the Women's Health Initiative really did an about
face on the conversation about menopause because let me just say,
women have been going through menopause
for as long as we've been alive.
The only thing that's changed historically
is that more of us are living long enough
to get to this phase of life.
But women have complained about menopause forever,
but it was thought to be, you know,
women just being hysterical with the symptoms
or you're losing your mind.
Women would go to sanitariums at that point where because of the mental illness and the
mental, the distress that it caused women.
But we have known how to treat the symptoms of menopause since 1942.
That was when the first estrogen product was introduced.
That was Primorin.
And so women have been using hormones for since 1942, those who had access and the awareness
of it.
But it really changed everything in 2002.
I was taught about menopause and what to do about it and then from 2002
on doctors who were trained didn't really get that information because...
Yes. I was talking to Dr. Haver who was saying she had an hour of training about it, a discussion
about it and was in another session that lasted six hours. So you come out of medical school
with seven hours of training. So since 2002, doctors have been trained about it.
And obviously so many doctors even, I think,
are still confused about
the Women's Health Initiative study done in 2002,
which said, can you clear that up for us
to understand what actually happened?
This is one of the reasons.
The reason why this is so important is because this 2002 study is the reason why so many
people are afraid of hormone replacement therapy.
Exactly.
In a nutshell, you know, as I told you, 1942, we've been treating women who were symptomatic
during menopause, typically
the hot flashes and the mood swings, with an estrogen product.
It worked.
As we sort of got more women who were taking hormones, we found that there were some tweaks
that need to be made along the way and added the progestin component to it.
Because remember, estrogen and progestin go together.
Have to go together if you have a uterus. Yeah.
So we knew that it treated the symptoms of menopause.
That wasn't new news.
But what we found was that there was a nurse's study where they just looked at a group of
healthy nurses, young women, and watched them through menopause.
And what they found is that the women who took estrogen therapy or HRT had half the
risk of heart disease than women who didn't, the nurses who didn't take hormones.
So imagine now the thought was, okay, we're not only relieving the symptoms, but we are
actually decreasing the risk of cardiovascular disease by 50%.
Well that would be a blockbuster, right?
But you couldn't prove it
because it was just an observational study.
So the Women's Health Initiative
that was really initiated in 1991,
the purpose of it was to sort of solidify that finding.
Does hormone therapy really reduce the risk
of cardiovascular disease by 50%?
That was the central question.
So we do a study, largest study ever in the history of NIH specifically for women.
So they recruited women in that study that were anywhere from 50 to 79 years old.
The majority of the women, 90 percent of the women were over age 55.
So it's not surprising that when they looked at the women, they said, well, there's really
no difference here.
We don't see any improvement in the cardiovascular.
It was like the same whether you took it or not because they were starting it on women
who were too old.
So that was problem number one with the study design.
The second part was that when they were looking, they said, well, let's have some safety stops.
Let's make sure that women aren't having an increase in breast cancer because of this estrogen,
because that was a thought.
This is the point that got everybody, made everybody nuts.
So when they got to about five years in the study and they looked into the data to see how is this coming.
There was this dramatic press conference that they held because not only did they not see
the expected decrease in cardiovascular disease, but they saw a slight increased risk in breast
cancer.
From these 60 to 79 year old women.
From these women who were on average 63 years old, more than 10 years after menopause.
So when you hold a press conference and it's dramatic and they stop the study, hold the
presses and they say, not only does hormone therapy not improve your cardiac profile,
it increases the risk of breast cancer. And when they said that, I mean, women who were taking hormones happily...
Abandoned them.
Overnight.
Well, I would understand why.
Because I remember I was doing the Oprah show when this happened and it was a big announcement
and everybody is like, oh, that's it.
Exactly.
Hormone replacement therapy is dangerous, it causes cancer.
And now what we're hearing, what I hear you saying, and I've heard other doctors say,
this was a flawed study.
It was a, it was a very much misinterpreted study.
Because if you had said, I don't disagree, okay, your data is your data.
If you start women on hormone therapy later in life,
you're not going to prevent their heart disease.
I think that's probably true.
The problem is that they generalize that data to everybody.
Well, what about a 50 year old?
Well, what about if I started when I'm 45,
whenever I'm menopausal,
because that's when we clearly would start it.
That's a very different outcome. And that was the misinterpretation
of taking very limited findings and applying it to everyone.
So...
But it became the narrative.
It became the... It's what people believe.
It's the reason why my best friend still won't do an HRT
because she's like...
She wrote about her in the book.
Still won't do an HRT because she's like, she wrote about her in the book, still won't do an HRT because she's like,
I don't know, I think it causes cancer.
It has been, when you say the words breast cancer to women,
I think that is their number one fear, is breast cancer.
Despite the fact that the number one cause of death
in women is cardiovascular disease.
It is more than all cancers combined that the number one cause of deaths in women is cardiovascular disease.
It is more than all cancers combined and all accidental causes of death for women.
And do we know for sure that HRT, that hormone replacement therapy, helps now cardiovascular
issues with women?
There is everything.
When you take that same data, the largest study ever done, and you exclude the women who are older and only
apply it to the women who are under 60.
Yes.
And within 10 years of menopause, guess what they find?
The same findings that we had from the observational study that the cumulative data says that if
you start hormone therapy within 10 years of your last period or before age 60,
you decrease the risk of cardiovascular disease by anywhere from 30 to 50 percent.
Wow.
Yeah. Wow.
Wow. We've got people joining us on Zoom with questions.
Trisha and her husband, Steven, are joining us from Edina, Minnesota.
What's going on with you, Trish?
I would say my perimenopausal symptoms started about two years ago.
I was 47.
I didn't know that that's what was happening,
but I had a 90-day period that was so heavy.
I really thought I might have uterine cancer.
I was really freaked out.
Went to my doctor, got checked out, and she said I think this might be the beginning of perimenopause and
suggested I try an IUD, which I did, which was great for a while.
But then I started experiencing the most intense night sweats.
I mean really just waking up feeling like I had 104 fever,
whole body shakes, soaked through to the mattress pad, trying not to wake up my
husband, you know, putting a towel down and then you know consequently having
tons of daytime fog the next day and just feeling really really bad about
that. So I went to my doctor who is great and who I love and she just kind of said
to me
Yeah, well, that's perimenopause and I remember saying to her well
Okay, is there what should I do? And at the time she said well, it's just this is just kind of
It's kind of to get through it and I said we're either blood tests or you know
Anything that could measure this for me and she said no your hormones really fluctuate a lot
So we can't really do those tests. So I left feeling like oh my god I guess this
is just my future. It just all felt so haphazard to me and sort of nebulous
especially as someone who gets their physical every year gets their
mammogram you know colonoscopies right on schedule. This issue to me felt
like oh my gosh it doesn't feel like there's a rulebook
here. Yeah, that's I think how so many women feel and I'm so happy to see Steven standing or sitting
by your side in support of, I know you told the producers, Steven, that if men went through menopause
things would be much different. How do you think?
I mean, it's ridiculous when you get into it because, you know, I don't know anything about it. My mom didn't talk to me about it. When Trisha started describing her symptoms to me,
I know that if there was symptoms anywhere from really annoying to, you know, debilitating,
over a course of, you know, there's tens of millions of women in the United States alone
who are going through this,
there would be a pill. There would be some kind of salve or poultice. Something would be available.
They would have figured it out.
Yeah, if it was a men's problem, we'd have this solved already.
So it was really hard to, you know, again, just support Trisha as she went through it just to figure it out.
What did you think was happening? What did you think was happening?
Since Trish didn't know what was happening, and I know, I don't know many men who've been raised with any idea of what it out. What did you think was happening? What did you think was happening? Since Trish didn't know what was happening and I know, I don't know many men who've been
raised with any idea of what it is.
Yeah, I mean, it really, well, and a lot of it's hidden from us, right?
So you know, Trish is, Trish is a strong mother.
She's doing things all the time.
She's super energetic.
And so a lot of it's hidden.
She's, you know, she kept her symptoms to herself when we started to talk about it.
The thing that kind of triggered for me is she goes through periods of I would call it weariness
She's not tired. She's weary like we get to the end of the day
And that's it. So she has to shut it down right? She just has to shut it down is what I heard you say
It's it's over
Um, and so that's really the thing that struck me the most about it
But as trisha and she's really open with me about it, which has been great, just to understand her and see if I can
support her some way. But it's really, it's hidden to men for sure.
I mean, you know, and I assume I'm like...
So what is your question for Dr. Malone, Trish?
My question is, I understand that the absence of a period for 12 months or longer is sort of the definition of, okay, you've been through menopause. But my
question is, now that I have an IUD and I don't have a period every month, how is
someone like me supposed to kind of know where they are in the process,
especially because it's not like there are these blood tests that can sort of
say, okay, here's your marker and here's where you are in this whole thing?
That is an excellent question because, as I said, that perimenopausal period is the part
that is most confusing for women.
Yes.
Because, but I would say this as a rule of thumb, if you are between the ages of 35 and
45 and you are having any one or any combination of those 34 symptoms that we associate with menopause, hot flashes, mood swings, sleeplessness, painful sex,
irregular, heavy periods, brain fog.
If you have any of those things in no particular order.
And you list the 34 symptoms in grown woman talk, yes.
Then you are perimenopausal.
Now the question then becomes,
well, I'm still having my period,
and this is the part that really makes my head explode
because there are still doctors out there who are saying, well, you're not menopausal yet because it hasn't been 12 months since your last period.
Right. That's ridiculous.
You should be treated when you are symptomatic and no one can tell you when your symptoms are intolerable,
And no one can tell you when your symptoms are intolerable, but you know. And that's the point at which you should engage and ask someone to please fix this for me.
And to be honest with you, we do know what the answer is.
It's not like we're waiting to figure out for someone to discover something.
It's hormone therapy in some form or fashion.
And we may use different types and different dosages
for women who are perimenopausal
than when they've had their 12 months of no period.
The doses may change, the types may change,
but the concept is still the same.
You treat a hormonal issue with hormones.
And that's why we say hormone replacement.
Some people don't like that phase, but I'm old,
so I still say hormone replacement.
You've been on hormones for 15 years.
I've been on hormones for 15 years.
And I knew exactly what was happening and I was like,
well, okay, well, that's enough of that.
And just go right on.
And I have no intention of stopping unless and until
there's a reason, a medical reason why I should stop
hormone therapy.
But-
And I have read too that the moment the symptoms start, that's when you start, you
need to start getting help, therapy, assistance with it the moment you get the first symptom.
Right.
When you are bothered, when you are either, you find out that it's either affecting the
quality of your life, the quality of your work, the quality of your relationships.
When you reach that level,
then that is the time that you should seek care. But here's the reality is, as we said, I say it
over and over again, there are not enough doctors who are out there who know how to treat menopause
and perimenopause. So what's a woman to do when you have read everything that you need to read,
and you are clear, and you know exactly what's happening to you and it's not uncommon for you to go to a doctor's office
and the doctor will tell you, no, or I don't believe in hormones, which is not uncommon.
I've heard that too.
I've heard that too.
I don't believe in them.
I don't believe in them.
And that is really why when I left my private practice that I, you know, joined the women that I work with at
Alloy Women's Health.
Alloy.
Because what it is, is really giving women access who don't have access to doctors who
know what they're doing.
Or it's too expensive to go to those doctors because you, you know, everyone should have
access in my mind to the same quality care care whether you live in New York City or whether
you live in New Mexico. It shouldn't matter. Or in Dyma. Any Dyma. Exactly. So are you on hormones?
I did start the patch, the estradiol patch. I had to kind of go up a few notches but it really has
is definitely helped with night sweats.
I've seen a big change there.
And, you know, and here's the other thing is that for people who are just sort of getting
into this hormone therapy game, a lot of them don't have the experience of knowing what
to do.
So they give you the answer based on, okay, well, this is what it's supposed to do, but every person's different. Yes
Thank you, Trisha. Thank you, Stephen. Thank you both for joining us. Thank you. I hope it gets better. I hope it gets better
Getting there. Thank you. You're getting there. Thank you
My hope is that this conversation with dr
Sharon Malone will help you become more informed about your own body and menopause
Which is a natural part
of aging that 1 billion women all over the world are experiencing right now. Stay with
us. We'll be back in a moment.
This episode of the Oprah podcast is brought to you in part by BetterHelp. How many times
a day do you compare yourself to others or wish your life looked like someone else's?
We all do it sometimes because it's easy to envy friends' lives on social media when
you only see the good parts.
But you know what they say?
Comparison is the thief of joy and in reality, nobody has it all together.
Online therapy can help you focus on what you want instead of what others have.
Like that career goal you've set your sights on or that relationship you want to grow or that daily habit you want to get into.
Because your best life is always better than the idea of someone else's.
BetterHelp makes therapy more accessible and less overwhelming.
With affordable online sessions that you can do anytime, anywhere.
That's why over 5 million people have used it for mental health support.
So stop comparing and start living with BetterHelp.
Visit BetterHelp.com slash Oprah Podcast today to get 10% off your first month. I welcome you back to the Oprah podcast.
We're talking with guests who are in the throes of menopause and have questions for our renowned
health expert, Dr. Sharon Malone.
Kylie is a mom zooming in from Tampa, Florida. Kylie, you say you feel like an alien in your body,
and I hear that from a lot of women
when we're talking on this subject, an alien in your body.
Tell us what's going on with you.
I do.
Hi, Dr. Malone, thank you so much for your book.
It is not just a guide, but it is a travel guide.
It is a, you know, we're on a journey here through life,
and it is just an incredible book.
So thank you.
You were ready for some grown woman talk, right?
Yes, grown woman talk.
It is conversational.
I feel like I'm in the room talking to you.
So thank you so much for that book.
Yeah, you're right about that.
This has been going on for a few years, obviously.
And that's why I call it a journey, because it took a while to figure
out and you hear that from every woman that you talk to, right? You have these symptoms,
you go to the doctor, you're not really getting any answers. And then it was actually my girlfriends
that mentioned to me, hey, you know, maybe you're going through perimenopause. And I
was like, I'm not old enough to go through perimenopause. And so that's kind of how it happened. But you know for me it was dry
skin, red skin, brittle hair, headaches, you know all of those things. And the big thing for me was
mood. Your mood, this can render you absolutely powerless. And the reason why is because it doesn't just affect you,
but it affects the people around you.
And so it's the one symptom that actually affects others.
And so, you know, I'm constantly asking my family
for grace all the time, because I will say things that,
you know, I'm like, did I just really say that?
And so it does, it leaves you feeling powerless.
So why does menopause impact your mood so much and what is it that causes the more anger
prone part of the mood?
That's a great question.
When we talk mood, mood encompasses a lot of things.
It's anxiety, Sometimes it's depression.
Sometimes it's just mental fatigue or brain fog.
And sometimes it is weariness.
Sometimes it is irrepressible rage.
You can see and hear yourself and say, now I know that that should not be my response.
It is inappropriate for the situation at hand,
but you really, what I think is worrisome for women
is that they feel out of control in that situation.
But here's the connection.
We think of estrogen and our reproductive hormones
as just having to do with reproduction.
It's only about our breasts and ovulating
and being pregnant.
But the reality is our reproductive hormones affect most major organ systems in our
body and what's the one that needs estrogen the most? Our brains. So the
areas of our brains that really are responsible for mood, for sleep
regulation, for temperature regulation, all of those areas are
responsive to estrogen or lack thereof. And when you're in perimenopause, it's
not so much that on any one given day you have too little estrogen, some days
you have too much, some days you have too little. So it is the wild fluctuations
that is really scrambling your brain about how to react to situations.
And every woman, every perimenopausal woman I know has had that feeling where you're talking
and right in the middle is just out of your head.
And it's very distressing because women think, am I going crazy?
Is Alzheimer's on the horizon for me?
And it's just your brain trying to adjust.
It's used to regular hormones in a cyclical fashion.
A lot of women are put on antidepressants.
Exactly, that is exactly right.
When they really need hormones.
Exactly, because if you have never had depression
in your life or anxiety in your life,
and now all of a sudden you have it,
that should be the first, second and third thoughts
about what could be causing this.
I was depressed and didn't even know it.
I was just, I would just reached,
first of all, I could no longer read.
I could no longer concentrate on reading.
And I felt like, whatever.
Just, I just, my life went into like a flat line
I just felt like okay. So what whatever and
I now realize that that was a form of depression. Yes
Absolutely, and when you add to that the fact that most women who are perimenopausal are also having other symptoms
It's not just in isolation because you're having hot flashes,
you're having night sweats, your sleep is disturbed. All of those things affect your mood as well
because I can tell you if you haven't slept in three months, you're not going to be in a good
mood the next day. Nor are you going to have any sort of tolerance for that or you know the fatigue
factor comes in. So it's all interrelated and it is something
that we don't really pay enough attention to
and women a lot of times will suffer in silence about this
because you're afraid to say something.
And if your expectation is that this is just what part
of being a woman is about, that you're just supposed
to suffer and then as I get older, yes, I'm tired,
yes, I'm fatigued.
If you accept that as normal, then you won't seek care.
And that to me is probably the most heartbreaking thing,
that women suffer silently.
Well, thank you so much.
Thank you for joining us and sharing your story.
Thank you, Kylie.
Thank you so much.
Thank you.
Amina is a mom of two joining us from Lawrenceville, Georgia.
Hello, Amina. What's going on with you? Hello. Hi. Hi, nice to meet you. Amina is a mom of two joining us from Lawrenceville, Georgia. Hello, Amina.
What's going on with you?
Hello.
Hi.
Hi. Nice to meet you.
Nice to see you.
I guess the main thing that I had a big problem with was work and actually going through the
symptoms at work, but my male manager not understanding.
Like I actually get written up at work for not being in compliance, uniform compliance,
because I have my sweater off or unzipped.
And your sweater's off because you're hot, right? You're flushing.
Well, yes. Like, I I mean it was it was ridiculous and it kind of got me because I'm
like, um, hello I'm 54. I had to remind this person like how old I am and it still didn't matter.
So my family says I'm in denial of being in menopause because my symptoms have been all over the place or up and down or not
have like I don't wake up wet or so. So you think because you don't have that you're not going
through it? I don't well I don't have that and a couple other things right but then I just heard
you say. You should work with a fan on your phone. Girl you sit there work with a fan on your phone
and taking your sweater off because you can't be in the uniform
and you don't think you're going through it?
Because it lasts like five minutes.
The other people are like, oh my God, this is so much.
Okay, let, let, okay.
We need some grown woman talk with you right now.
All right, Dr. Malone, have at it.
I know, I need to read that book.
Have at it, have at it.
Every woman is going to experience these symptoms
maybe differently.
Someone has drenching night sweats, someone has none.
Someone has a hundred a day, someone has two.
But once you start to realize that this is a problem,
I'm hot and no one else is in the room that's hot,
or it's 50 degrees outside, then you must say,
maybe this is perimenopause.
But let me just say that you said you're in denial because there is also the stigma and
shame associated with it.
You know, like you're afraid.
The reason why your family is telling you and you don't want to admit it is because
you think there's, you are attached to the stigma around it, that it means something.
It's true.
Yes.
I actually, I actually hate the word, oh, I'm flashing.
It just makes me feel so old.
Well, see, and that's ageism and then that's just shame around women's bodily functions.
But let me say something because I think it's really important when it comes to women in
the workplace.
First off, menopause is not a disability.
You know, we don't need special dispensations for menopause.
What you do need is access to treatment
when you are having these symptoms
and you are bothered by them.
Now, can the workplace be more sensitive
and be more aware of the fact that if you are a woman
and you are within a certain amount of, you know,
certain age range, a hundred percent of your workforce, if they stay there from 45 to 55,
will go through this of your female population. I mean, that is just taking into account. Think
about the things that have changed in the past 20, 25 years. Women, you have breastfeeding rooms now
where you can come in, you could, 50 years ago,
you couldn't even be pregnant in the workplace.
It is just acknowledging the fact that women,
our bodily functions, our physiology is different.
It doesn't mean that it's worse.
It's a natural phase of growing and maturing.
It doesn't make you inferior.
It doesn't make, because you are having hot flashes,
it does not mean that you're old.
Cause remember I told you,
some women will have symptoms as early as 35.
It's just a matter of not allowing yourself to suffer.
And once you realize that, again,
this is affecting the quality of your work,
then this is the time in which you should really engage
and get treatment for these things.
And don't be embarrassed about it.
As a matter of fact, don't be embarrassed.
Once you feel better, you should tell your friends.
I do that all the time.
When I see people, I don't even know them.
And I see them and they're like, ooh,
and they're fanning and they're,
and I will just go up to them and say,
girl, you know, we have something for that
right you don't have to do this for 10 years I don't know I don't know why we think that suffering
is what we should be doing. When it's also you were mentioning black women I started after I
started HRT I started to notice other women in particular who had this, like, they were three notches down from normal.
There's this, like, this dullness that comes over a lot of women who are going through
this and don't even recognize that that's what it is.
There's a lifelessness, a lack of vitality, a lack of feeling like, you know, I can take
on anything in the world.
It is a, it's a dullness.
Right. And you don't feel like yourself. And you don world. It is a, it's a dullness. Right.
And you don't feel like yourself.
And you don't feel like yourself.
You don't feel like yourself.
Or you've been that way so long that that now becomes yourself.
Exactly.
Yes.
You know, but one of the things that we found out too, from the study of women across the
nation, just observing women as they go through this process, is that they did break it down
by ethnic groups.
And they looked at white women, black women and Asian women and what they found is that black women go through menopause on average
about a year, almost a year earlier than white women do.
Their symptoms start sooner and that transition, as I told you, that perimenopausal phase can
last anywhere from four to 10 years.
For black women, it's on the 10-year end of that spectrum.
So can you imagine for 10 years before you've had your last menstrual period, hot flashes,
mood swings, all of these things that you talked about, and then you get to menopause
and you're like, oh, had my last period.
Well, no one told your body that, okay, well, we're done with that now.
Then you can still have hot flashes and all those things for another decade after that.
And let me tell you, that has huge...
Get your fan or get your hormones, okay?
But let me say, hot flashes, the thing that I want to say, hot flashes are not benign.
It's not just annoying and they're not funny.
They actually are harbingers sometimes of long-term health implications of menopause,
such as increased risk for cardiovascular disease, such as increased risk for weight gain, for
hypertension, for all of these long-term things that we talk about.
A hot flash is sometimes the first signal to saying,
hey, maybe you're at risk for these things, which again, will affect not just the quality
of your life in the short term, but in the long term. So that's why I say if you have them,
treat them. And you don't get any bonus points for having endured them. You're not going to say,
oh, well, guess what? You get no bonus points, Amina, for having endured it.
All right?
I get it now.
I get it.
I mean, everything you have to talk about.
Tell your family, tell your family they were right.
Yeah. Yeah.
Thank you so much, Amina.
Thank you.
Thank you for having me.
Thank you. Thank you.
Thank you for listening.
I'm glad you joined me here on the Oprah Podcast.
We'll be back.
There are some common questions for menopause expert and Alloy Chief Medical Advisor, Dr. Sharon
Malone, after this.
This episode of the Oprah Podcast is sponsored in part by Alloy Women's Health. Are you confused
about menopause and perimenopause? Alloy has all the answers and experts you need to feel
like yourself again. With Alloy, you get safe, effective FDA-approved solutions
to your menopause and perimenopause symptoms
prescribed by menopause-trained doctors.
With unlimited ongoing care with your own personal doctor,
you can message them anytime from anywhere for no extra cost.
Menopause is inevitable, but suffering doesn't have to be.
Alloy has everything you need to age happily and healthily.
Feel like yourself again.
Go to myalloy.com to start your consult
with a menopause trained expert today.
Use code OPRAH to get $20 off your first order.
Hi and welcome back.
So glad to be with you here.
I'm with New York Times bestselling author,
Dr. Sharon Malone, talking with people who have questions
about their menopause symptoms.
Esther is a mom of two, zooming in from one of my favorite places. Maui, hello, welcome.
Thank you. Thank you both for your continued discussion on this topic. I have learned so
much about menopause just listening to all this information. My mom is in her late stages of Alzheimer's,
so I can't talk to her about her experience with menopause. I can't help but feel like when I walk
into a room and forget why I walked in or a word doesn't roll off the tip of my tongue that this is the start of dementia or will this
brain fog improve?
So my question is, what can I do now in menopause to be preventative?
I think that is very important when we talk about Alzheimer's, what we know and what we
think we know.
And what we do know is that women are twice as likely
to be diagnosed with Alzheimer's in their lifetime
than men are.
And the women who are more likely are women
who have a female relative with Alzheimer's.
It's not to mean that you will,
because it's a very much a multifactorial process.
What we also know is that the same things
that we tell you to do that decrease
your risk of cardiovascular disease, decrease your risk of Alzheimer's. So regular exercise,
good night's sleep, cutting back on alcohol, don't smoke, and for goodness sake, watch
your diet, weight is important. All of these things, just lifestyle, whether we're talking
about heart disease prevention or Alzheimer's lifestyle, whether we're talking about heart disease prevention
or Alzheimer's prevention or whether we're talking about just the rules that you need
to observe for healthy living and aging.
So all of that.
But what we do know, and I'll tell you what we know and what I think, there's a brilliant
neuroscientist by the name of Dr. Lisa Mosconei who has written a book called The Menopause Brain.
And what we know is that for women who have an early menopause, and early means you have
had your last period before age 45, or it's a premature menopause if you've had your last
period before 40, those women who do not get hormone replacement because they are so young are at
increased risk for cardiovascular disease and Alzheimer's. Now do we know
for a fact that estrogen therapy is a prevent it is a preventative measure for
Alzheimer's? Maybe. That's where we need a lot more data on that. We certainly know
it helps you with brain fog. We it certainly does. But you can't take HRTs because of...
I had a hysterectomy seven years ago
because I had a history of adenomyosis and endometriosis.
So the doctor has been a little wary of giving me HRT
because of the estrogen.
No, ma'am.
No, ma'am.
That is not a contraindication to HRT.
It is not.
And as a matter of fact,
not only is it not a contraindication to HRT,
to estrogen therapy, I should say,
because you've had a hysterectomy,
remember I said- You don't need progestin.
You don't need the progestin.
All you need is the estrogen.
So yes, you can have estrogen.
The only reasons, the only contraindications
that we have for HRT, or if you personally have breast cancer or an estrogen-dependent
cancer such as endometrial cancer, if you have undiagnosed vaginal bleeding, if you
currently have a heart attack, you, not a family history of a heart attack or stroke,
or you have active liver disease, and the issue about blood clots is debatable,
but we'll leave that aside for now.
But that's it.
Those are the only contraindications.
So you might go back to your doctor and say, well,
Or go to another doctor.
Yeah.
I honestly don't think that doctors
are trying to do a bad job.
I really don't because I worked for-
I don't think that they're trying to do a bad job.
I think that they just don't know. They don't know, and they don't even know what they don't know. And they don't because I worked for it. I don't think that they're trying to do a bad job. I think that they just don't know.
They don't know and they don't even know
what they don't know.
And they don't know what they don't know.
And that's the problem is that you've got to keep current.
And that's why I really would advocate
that menopausal care and menopause
and care of women in midlife should be separate
and apart from all the other things
that OB-GYNs have to do.
It's a lot to keep up with.
You've got to do surgery and you've got to deliver babies and you've got to give birth
control.
But this phase of our life that we will spend anywhere from 30 to 40% of the rest of our
lives in this menopausal phase deserves its own area of inquiry.
Absolutely.
We need more research, we need more doctors who are knowledgeable about it because that's
what they do.
We deserve, as women in midlife-
I was just going to say, we deserve better.
We deserve better and we deserve to have the attention paid to the issues that have historically
not been paid attention to.
Esther, thank you.
Thank you for zooming in from Maui.
Have a beautiful day out there.
Beautiful day.
Dr. Malone, I know you believe that paraminopause
should actually be thought of as a time for celebration.
Tell us why.
Because, you know, it is a celebration of a time of life
where I think we should all look forward to.
And I do say this in my book Oprah I
Said when people have a different vision of what that time of life is like
People think of it as you know, oh, I'm getting old or dread but I
Mean this sincerely. I mean for people like Michelle Obama Naomi Watts
You Halle Berry all the peopleail, who are out here showing
young women what this phase of life looks like.
It should be something that we look forward to because I don't know about you, but I am
happier now at 66 than I was at 46.
So I look at people sometimes like, oh, don't feel sorry for me.
I know.
When all the women are complaining about turning 40 and 45, I just go, oh, honey, if you only
knew, it gets better.
Right.
It gets better.
We deserve a celebration.
We do.
We do.
Thank you, Dr. Malone.
Thank you for writing this really profound book, Grown Women Talk.
And thank you to all of my guests for joining us today.
Naomi Watts from SET, Trishon Steven, Grown Woman Talk, and thank you to all of my guests for joining us today. Naomi Watts from SAD, Trish and Stephen,
Kylie, Amina, and Esther.
Dr. Malone's book, Grown Woman Talk,
is available anywhere you buy your books,
and it's filled with just, I would say,
essential information and more insights
on what it means to grow and age beautifully. Dr. Malone and I are talking again in a few weeks
about treatments for menopause and a new study
that showed that more than half of women age 30 to 35
are experiencing moderate to severe symptoms
of paramenopause.
We'll be talking with women in their early 30s
about their questions and concerns.
So keep an eye out for that on the Oprah Podcast.
Go well, everybody. Thank you. out for that on the Oprah Podcast. Go well, everybody.
Thank you.
You can subscribe to the Oprah Podcast on YouTube and follow us on Spotify, Apple Podcasts,
or wherever you listen.
I'll see you next week.
Thanks, everybody.