Oprah and Dr. Sharon Malone on Everything You Need to Know About Menopause

thank you all for joining the opr. 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.

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. stop 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 inter. menopause your body will go through a. transitional period known as param.

menopause which can begin as early as. your mid-30s param menopause can last. anywhere from 4 to 10 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. menopause for over three three decades.

she is the chief medical adviser for. Alloy Women's Health and the New York. Times bestselling author a grown woman. [Music]. talk so happy to have you here Dr blon. thank you so much for having me Oprah. you know it's it's what we were saying. before that I I I feel like I've been. talking about it and talking about it. 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 menop 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 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. premenopausal phase and that really. starts at puberty and that encompasses. the your reproductive life your the peak. reproductive years which start somewhere. at 1213 and it goes to women uh when.

they're early 30s that's premenopause so. when we're talking about that that's the. concern then when you become per. menopausal 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 per. menopausal years where you start to have. 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 there sometimes. regularly and sometimes not a real. indication that you're in Parry yes. because sometimes for women that's the. 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 it's 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 4 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. per menopause 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. per menopause and women think of men is.

something that happens to old ladies. it's the average 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. premenopause. perimenopause menopause and. postmenopause and I don't really like. the term post menopause because it.

implies that at some point you're over. it done you're not 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 did 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 a 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 per menopause is that. there's a change in your. fertility because when you're a par. menopausal 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 because. you've already lost eggs you have it's. not because you've lost them it's. because they are less responsive oh. they're less functional they're less. functional and I'll give you an example. um I like to say for you're born with. all the eggs you're ever going to have. you don't get anym you don't make. anymore and then over time you ovulate. some but you're not losing them because. you've run out of them it should you. only ulate 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 legs. are my eggs going to last until I'm 45. or they going to 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 is going to.

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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. my alloy.com to start your consult with. a menopause trained expert today use. code Oprah to get $20 off your first. order 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 CU 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 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. years and years so again to Dr Malone's. Point hi Sharon um there just was no. conversations anywhere not um 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 I had been having night sweats. and Ticking those medical questions. those boxes um for night sweats for. several years before the doctor told me. that um so that meant I had disrupted. sleep uh which can lead to all kinds of. things anxiety. depression um I had I certainly had. brain fog um and I had um 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 um 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 I. mercifully because my doctor understood. it um and he gave me the full um. education you know as I understand it. still to this day doctors are. gatekeeping um that because of the bad. studies in 2002 um but I 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 now well. for I whenever I was 54 that's when I. went on HRT so I I I I believe them what. is HRT can you explain that Dr Malone. yes um hormone replacement therapy. typically it 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 uh 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 and I hear some women are. also now taking 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 curv we're finding out a lot. more about testosterone because women. make testosterone too and I think that. that's sort of the the misconception is. that well estrogen is a female hormone. and testosterone is a male hormone and. that is not true women make almost as. much testosterone in the course of our. reproductive lives as we make estrogen. um that's really responsible for that. sex drive that you get right around. midcycle 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 uh chapter 12 is titled Mino boss. and uh how to deal with agism 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 number one. they don't understand it and the culture. doesn't understand it I would say the. first step is communication and and then. education like owning your story and. sharing it with those around you we come. with experience at the workplace needs. us there um whatever industry we're.

talking about um 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 uh I find most of the. time people want to be um they're. curious and they want to act with. compassion so for me it certainly felt. like a big risk to tell my story um but. once I named it and owned it I I I feel.

nothing but Embrace actually from my. industry despite the fact that I was. told I should conceal my secret yeah I. I'm so happy to hear that's changing we. all know your husband is actor and. producer Billy crup in the book you. write about honest conversations you've. had with him I'm not going into details. today uh 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 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 um not. just in the workplace but your partner. your life partner um and obviously I had. to share this with Billy at a very very. early stage much more earlier early than. I was prepared for but I just was like a. 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 um. Stripes Beauty which is creating. hydration from scalp to vag and then led. me to having the confidence to write the. book um and then the book I did um I. wrote because it was the 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. vag what what has been the response it's. been amazing Oprah honestly. um I've been you know out on the streets. and and stopped by people who I think. they're going to ask me um 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 um making. it easier by sharing your story so and. also thanks for the vagge of Honor. because now the walls of my vagina are. um are not so um 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 and. more authentic and just say able to say. you know sorry I've just got to get the. lube um or. you know let's let's do it this way you.

know and I think um 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 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 in grown women talk not a disease and. the hormonal changes during param. menopause 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 we're. going to do and all of that and so me so. many women are doing experience ing 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 com women have been going. through menopause for as long as we've.

been alive yes 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 or 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 primin. and so women have been using hormones. for since. 1942 those who had access and the. awareness of it but it really changed. everything. in22 in 2002 okay I was taught about. menopause and what to do about it and. then from 20 02 on doctors who were.

trained didn't really get that. information because yeah I was talking. to doctors uh uh 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't 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 can you clear that up.

for us to understand what actually. happened you know it's a 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 had. who were symptomatic during menopause. typically the hot flashes in the mood. swings with an estrogen product it.

worked MH so when 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 cuz remember. estrogen and progestin go together go. together if you have a uterus yeah so we. knew that it treated the symptoms of. menopause that wasn't that wasn't new. news but what we found was that uh there. was a nurses study where they just. looked at a group of healthy nurses. young women 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. observation study so the Women's Health.

Initiative that was really uh 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 of. of NIH specifically for women so they. recruited women in that study that were. anywhere from 50 to 7 79 years.

old the majority of the women 90% of the. women were over AG 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 studied. design second part was that when they. were looking they said well let's have. some safety stops let's make sure that.

we women aren't having an increase in. breast cancer because of this estrogen. because that was a thought this is 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 in. cardiovascular disease but they saw a. slight increase 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. 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 there I remember I was doing the. Oprah show when this happened and it was. a big announcement and everybody's like. oh that's it exactly uh 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 is. that they generalize that data to. everybody well what about a 50-year-old. well what about if I start it when I'm. 45 whenever I'm menopausal because. that's when we clinically would start it. that's a very different outcome and that. was the that was the 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 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 disas it is more than all. cancers combined and all accidental. causes of death for women do we know for. sure that HRT that horomone 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 MH 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% wow yeah. wow wow we've got people joining us on. Zoom with questions Trisha and her.

husband stevenh are joining us from. Idina Minnesota what's going on with you. Trish uh I would say my um par. menopausal 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 um I. really thought I might have uterine. cancer I was really freaked out um went. to my doctor got checked out and she. said I think this might be the beginning. of per menopause and um suggested I try.

an IUD which I did um which was great uh. 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 um trying not to wake up my husband. you know putting a towel down um and 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 per menopause and I. remember saying to her well um okay is. there what should I do and at the time. she said well it's just this is just. kind of just kind of to gut through it. and I said well are there blood tests or. you know anything that could measure. this for me uh and she said no your. hormones really fluctuate a lot so we. can't really do those tests so left. feeling like oh my God I guess this is.

just my future it just all felt so. halfhazard to me and sort of nebulous. especially as someone who gets their. physical every year gets their mamogram. you know colonoscopies right on schedule. this um this issue to me felt like oh my. gosh it doesn't feel like there's a rule. book here and that's I think so how so. many women feel and I so happy to see. Stephen standing or sitting by your side. in support of I know I I I know you told. the producers Stephen 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 Sav or pus something would.

be figured it out yeah if it was a men's. problem we' 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 is I mean it's. really well and a lot of it's hidden. from us right so you know Trisha's. Trisha's a strong mother she's doing. things all the time she's super. energetic um and so a lot of it's hidden.

she's you know she kept her symptoms to. herself and 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 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 it's. hidden to to men for sure I mean you. know and. I 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 oh. okay you've been through menopause but. my question is now that I have an IUD. and I don't have a a period every month. how is someone like me supposed to kind. of know where they are in the process. espec 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 per menopausal period is the. part that is most confusing for women. yes because but I would say this as a. rule of thumb if you 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 um.

brain fog if you have any of those. things in in in no particular order and. you list the 34 symptoms in grown women. 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 me. a pusle 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 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 uh dosages for women. who are per menopausal than when they.

are after 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 you and that's. why we say hormone replacement some. people don't like that phase but I'm old. so I still say hormone repl 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 okay. well that's enough of that and just go. right on and I have no int of stopping. unless and until there's a reason a.

medical reason why I should stop hormone. therapy but and and I I have read too. that you 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 the. menopause and per menopause 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 in office. and the doctor will tell you no or I. don't believe in hormones which is not. an un heard that too I've heard believe. in them I don't believe in them and and. that is really why when I left my.

private practice that I you know joined. uh the women that I work with with at. alloy Women's Health all because what it. is is really giving wh 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. whether you live in New York City or. whether you live in New Mexico it. shouldn't matter or in di any da exactly.

da so are you on hormones I did start um. the the patch the the astrad patch um. and 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 the this this. hormone therapy yes um 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 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. about tell us what's going on with you I.

do um hi um Dr Malone thank you so much. for your book it is um 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 a conversational I feel like. I'm in the room talking to you so thank. you so much for that book yeah um I mean. this has been going on for a few years. obviously 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 you talk to right you had these. symptoms you go to the doctor you're not. really getting any answers and then um. it was actually my girlfriends that. mentioned to me hey I you know maybe. you're you're going through per. menopause and I was like I'm not old. enough to go through bar menopause and. and so that's kind of how it happened. but um you know for me it was dry skin. red skin um brittle hair uh headache. uh you know all of those things and the.

big thing for me was mood um your mood. it this can render you absolutely. powerless and um 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 uh because I will say. things that you know I'm like did I just. really say that. um and so it's it does it leaves you.

feeling powerless so why does menopause. uh impact your mood so much and um you. know what is it that that causes the. more anger prone part of the mood that's. that's a great question you know that's. you know 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 we is hearing and 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's I think it's. worrisome for women is that they feel. out of control yeah in that sit. 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 brain 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 is 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 par. menopausal woman I know has had that. feeling where you're talking and right. in the middle ises out of your head and. it's very distressing because women. think am I going crazy is it 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 well. that's why a lot of women are put on. anti-depressants exactly that is exactly. right when they really need hormones. exactly yes because you know if you have. never had depression in your life or. anxiety in your life or 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 know it I was just. I just reached a first of all I could no.

longer read I could no longer. concentrate on. reading uh and I felt like whatever just. I just I I just my my life went into. like a flatline 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 per. menopausal are also having other s. symptoms is 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 3 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 and. violence 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 yes 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 lawrencville Georgia.

hello Amina what's going on with you. hello hi hi nice to meet you nice to see. you uh I guess the main thing that I had. a big problem with was. work um and. actually going through the symptoms at. work but my mail manager not. understanding um like I actually get. written up at work for not being in. compliance uniform compliance because I. had my sweater off or unzipped and your.

sweater is off unzipped because you're. hot right you're. fleshing ye well yes like I mean it was. it was ridiculous and it would 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 it still didn't matter um. so my family says I'm in denial of of. being uh in minute pause 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. and a couple other things right but then. I just heard you say you sit work with a. fan on your phone girl you sitting at. work with a fan on your phone and taking. your sweater off cuz you can't be in the. uniform and you don't think you're going. through it because it lasts like five. minutes that other people 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 Mal 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 sweat someone has none. someone has a 100 a day someone has. two that 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° outside then you must say H. maybe this is Perry menopause but let me.

just say that you said you're in denial. because there is also this stigma and. shame asso 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 because I. actually I actually hate the word oh I'm. flashing oh I just it just makes me feel. so old well see and that's that's agism. 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. 100% 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 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. because 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 I. don't even know them and I see them and. they're like oh and they're Fanning and. they're and I will just go up to him 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 as also you were. mentioning black women I start after I.

started uh HRT I started to notice other. women in particular who had this like. they were three notches down from normal. there's just 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 like a. lack of feeling like you know I can can. take on anything in the world it it is a. 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 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 uh white.

women do their symptoms start sooner and. that transition if I told you that per. menopausal phase can last anywhere from. 4 to 10 years for black women it's on. the 10year 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 o 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. that has huge get your F in 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 you know 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 longm so. that's why I say if you have them treat. them and you don't get any bonus points. for having endured. you're not going to say oh well guess. what I you get no bonus points Amina for.

having endured it all right I get it now. I get it I mean everything you have 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 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 and. improve so my question is what can I do.

now in menopause to be. preventative okay 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 is 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 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 prevention or. whether we're talking about um 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 what I think um. there's a brilliant neuroscientist by. the name of Dr Lisa muscone 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 and it's a premature. menopause if you've had 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 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. um I had a hysterctomy 7 years ago.

because I had a history of adenomiosis. 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 remember I said. 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 there the issue about blood clots is. is 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 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 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. Men and and care of women in midlife. should be separate and.

apart from the all the other things that. obgy and have to do it's a lot to keep. up with you know you've got to do. surgery and you got to deliver babies. and you've got to you know 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 uh area of. inquiry we need more research we meet. more doctors who are knowled ible about. it because that's what they do we.

deserve as women in midlife 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 param. menopause 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 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 hi. Berry all the people Gail 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 for sure than I was at. 46 so I I look at people some 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 it gets better we. deserve a celebration we do we do thank. you Dr thank you for writing this really. profound book grown woman talk and thank.

you to all of my guests for joining us. today Naomi Watts from set trishan. Steven Kylie Amina and Esther Dr Moon's. book grown woman talk is available. anywhere you buy your books and it's. filled with just um 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 about. treatments for menopause in a news study. that showed that more than half of women.

age 30 to 35 are experiencing moderate. to severe symptoms of param menopause. we'll be talking with women in their. early 30s about their questions and. concerns so keep an eye out for that on. the opra podcast go well everybody thank. you you can subscribe to the Oprah. podcast on YouTube and follow us on. Spotify Apple podcast or wherever you. listen I'll see you next week thanks. everybody.