Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy

Hello everybody. So glad to have you. join me on this the Oprah podcast. It is. my hope that these conversations are. somehow enhancing your life. It's great. to spend time with you here and I. especially like hearing from listeners. who zoom in and talking with the. audience was one of my favorite things. during the years of the Oprah show. So. it's um been fun vibing with you all. here on the Oprah podcast. Welcome back. Dr. Sharon Malone. Uh her New York Times best-selling book. is called Grown Woman Talk. More than 47.

million women enter menopause each year. and yet I am still so surprised to learn. this. Only 6% of those women are getting. the help they need. That's 6% and now. new studies are showing that women as. young as their early 30s are starting to. have symptoms of [music] perimenopause. Dr. Sharon Malone is here for it. She. has the answers for all your questions. You don't know when your ovaries are. going to expire. Every person has a.

different end date [music] on that. As a certified menopause practitioner. and OBGYN, Dr. Malone has been. empowering women to take charge of their. health for more than [music] three. decades. Dr. Malone is the chief medical. advisor for Alloy Women's Health and the. New York Times best-selling [music]. author of Grown Women Talk. Every woman should have it. Grown Woman. Talk, your guide to getting and staying. healthy. And this is what we all want.

and this is a manual for living your. life as you're going through. perimenopause and menopause and it's a. manual not just for you but anybody you. love or care about who's going through. it. And that is every woman who lives to. be uh old enough to go through it. And. we are continuing our conversation. around menopause. We'll be talking about. specific treatments and sex after. menopause a little later but first we. saw this somewhat alarming new study. that showed that more than half of women. ages listen up 30 to 35.

are suffering from moderate to severe. symptoms of perimenopause. and they're suffering in silence. And. one of the things that Dr. Malone says. in Grown Woman Talk for sure is that you. don't need to suffer and you suddenly. certainly don't need to suffer in. silence. And I'm sure there are a lot of. reasons behind that and we're going to. dig into it. Dr. Malone, can you talk. about these studies? What is your take. on that?

You know, I'm not really sure what to. make of the fact that women are starting. to experience symptoms earlier, but I. think that stress is certainly a factor. I think that how we live, you know, the. the environment that we're in, you know, who knows maybe it is some of the. the endocrine disrupting chemicals that. women are exposed to that are causing. this. So it is a very interesting. area that we that needs to be explored. further. because we are aging ourselves faster.

than I think that we should be given. this day and time. Well, one of the reasons why you should listen. to Dr. Sherry Malone and read her book. Grown Woman Talk is because Michelle. Obama, one of the women we all admire so. much in the world listens to Dr. Malone. and she actually has a quote on the. cover. The first person I turn to for a. whole host of issues, especially my. health. And isn't it wonderful to see. the light of Michelle Obama and Michelle.

Obama being the age that she is I'm sure. now having gone through menopause and. still being the vibrant force in the. world that she is. I think having women. like Michelle Obama, having women like. Halle Berry, having women like yourself. is is evidence for all of you who are. 30, 35, 40, 45 getting ready to go. through it that there is not only life. after, but life actually gets better. That's exactly right. You know, I was. thinking, Oprah, when I got to the end. of my career after practicing for 30.

years, and when I decided it was time to. stop doing that, I had no idea what the. next chapter was going to be. But I knew I was done with that, and. I created a whole new life for myself. after 60. I mean, I wrote my book when I. was 62 years old. Um I have, you know, a. new career really taking the message of. menopause and women's health outside of. just the office when you're just talking. to people one-on-one. There are only so.

many people you can get to. That's right. But to be able to take that message and. to amplify it and to get out. Doesn't it feel like your life kind of. blew up? Oh, absolutely. And that's what I want. to tell young women. Don't think that. you need to know everything that's going. to happen to you and to your life when. you're 30 years old. You have many. chapters, and I want them to be. encouraged by looking at people like you. and Gail and Michelle and all these. wonderful women who are out there. recreating.

a life that they want to live, and it. we're doing it on our terms. Absolutely. We wanted to hear from women. in their early and mid-30s who are. finding out that they have these. concerns. And so, Chandler, hello, lives. in Santa Monica and was in an audience. that I did the ABC special on menopause. with her mom. Chandler, what's your. question? Hi, welcome. Thank you. Um you know, I think I walked. away after that show feeling like a lot. of the symptoms that everybody was.

describing were really similar symptoms. to when you hear about like right before. you're about to get your period or while. you're on your period or just being. a 30-year-old woman in your car having a. bad day. And I was sitting in the. audience and I was thinking, wait, like. I have rage, I scream in my car, am I. going through menopause? So, I think Dr. Malone, my question is how do you know. the difference between those menopausal. menopausal symptoms, especially if. you're still getting your period, versus.

just like being a woman having a bad. day? I think this is something that should. reassure you. Because only about 1% of women will. actually go through menopause before age. 40. So, that's very uncommon. So, it has to. be some other circumstances. Sometimes. though, we're seeing a lot of young. women who are diagnosed with cancer. We're seeing a lot more breast cancers. in young women in their 20s and 30s. even. And so, sometimes it's a result of. chemotherapy. But, I think that you.

should take some comfort from the fact. that it's unlikely. And if you are. having problems with either with your. menstrual cycle or with mood or rage, sometimes you have to take a step back. and go, well, sometimes you're mad and you have. a reason to be mad, you know? You have. to look at what was your day. But, what. happens in when you're perimenopausal, the symptoms are more persistent and. pervasive when there's no reason why you. should be having those symptoms. You.

see, you know what I mean? Let's talk about what the symptoms are. You talk about 34 symptoms in Grown. Woman Talk. Mood swings, hot flashes, depression, anxiety, uh vaginal dryness, changes in libido, frequent urinary tract infections. There's a lot of overlap between things. that young women can experience and. things that perimenopausal women. experience. But, I think so you could. take a look at it and say, how much of. this is due to the situation?

And how much am I sitting here and I'm. depressed or I'm having these issues. when there's no apparent reason? It should at least raise a flag for you. But, for younger women, you really. before you jump to just this might be. perimenopausal, I think you should look. at things like there other things such. as what's called PMDD, which is premenstrual dysfunction, which. is basically PMS. And that's not So, young women can have. all those symptoms, but they only happen.

it does mean your hormones are. fluctuating. But that is the natural fall in your. hormones that happens with a normal. menstrual cycle that happens. But if you. say, "Is this consistently happening the. week before my period?". Yes or no, then that's probably more. likely to be PMDD. There are other. situations what's called polycystic. ovarian syndrome, which is PCOS, where. women can start to have again irregular. periods that, you know, that you can. have periods twice a year and you think,

"Oh my god, am I going through. menopause?" Well, these are things that. can be easily ruled out. You know, so as younger women, yes, can. you have some of those symptoms? There. is an overlap, but I think one of the. things that young women tend to show up. with sometimes. um and that is infertility. We That's the That's the thing about uh. uh perimenopause and this menopausal. transition. And again, as I said, you. don't know when your ovaries are going. to expire. Every person has a different.

end date on that. And sometimes it's the. the delay in getting pregnant that is. the first sign that things are going. that we things are changing. is off. Yeah. Yes. Not wrong, but off. Yes. Off. Off. Thank you so much. Did. that help? It. Yes. Okay, thank you so much. Thank you so. much. Fallon is 35, and I hear you. actually had an aha moment during that. ABC special, Fallon. Hello. Hi. Yes, I did. Um. Uh you may have even caught me crying.

somewhere in the audience. Yes. Uh my my aha moment was that I finally. found some understanding and a new sense. of sympathy for my mother and what she. went through. you know through menopause cuz we didn't. really talk about it. We just saw her. getting hot and the air conditioner is. always at 68 and we don't understand why. or she's. you know having moments that she's. angry. I'm like well we didn't do. anything or you know and just I could. see the changes but we didn't understand. what that was and so yeah, there was.

moments that I was in the audience and. coming to tears cuz I wanted to hug her. To say I get it now. I get it now. And. she's talking about a special that I did. recently with ABC. It was called the. Menopause Revolution and you can now. find it on Hulu. So I'm glad you had. that aha moment. Do you have a question? Yeah, so my question is being a. 35-year-old woman, I have been. experiencing a lot of the premenopausal. symptoms, but I've also been diagnosed. with endometriosis at the age of 21. And.

I wanted to know having endometriosis, will that affect the symptoms that I. have in my premenopausal. development? Am I at higher risk for. certain things because of my. endometriosis and maybe is that. something that's bringing you know the. premenopausal on sooner? Before you answer that, can you tell our. audience what endometriosis is? Yes. Endometriosis is a can be a very. debilitating condition for women where. normally the endometrial tissue or the.

tissue that lines your uterus, that is. what gets stimulated every month and. then you slough it if you don't get. pregnant. You know, that's what your. period really comes from the stimulation. and actually elimination of that tissue. Well, that works fine if that tissue is. in lining of your uterus. It has a way. out. But if that tissue is on your. ovaries or it's on your bowel or it's in. other places that has no exit, then that. can be very painful because the same. process it gets you know it gets.

stimulated every month with your cycle, but it has nowhere to go. I got it. So it actually can be on your bladder, your bowel, and it causes pain. It can. cause infertility if it's on your. ovaries. It causes scarring. And women. who have endometriosis. often have suffered for years before. they get an adequate diagnosis about. what's going on because pain is a hard. thing to you can't see it all the time. And you know, they'll go get a scan or a. sonogram and they go, "Well, looks.

normal." And you have no idea, but they. say, "I'm in pain. I'm in pain." The. average woman with endometriosis has. gone to the ER five to seven times for. relief of their pain. And this gets back. to not believing women. And there's also. this trope. that we have been taught is that. endometriosis is a disease of thin white. women. So again, when you are complaining of. the I have pain, I have pain with sex, I.

have pain when I'm having a bowel. movement, or urinary issues, they're not thinking about that because. their image of who they think has. endometriosis may not be you. And that's. why there's often a delay in diagnosis. with endometriosis. Yeah. So that's 3 years. Yeah, took 3 years. And that's that is typical to be quite. honest with you. All right, so I interrupted so you could. explain what it was to the audience. Now. what's the answer to her question? But endometriosis in and of itself, we don't know that that is going to.

alter the course of. of menopause for you. It might not. necessarily, it may not come earlier. It's going to come when it comes. But. what happens for a lot of women with. endometriosis, they end up going through. menopause prematurely because once your. symptoms have gotten to be so severe. and you've tried medication for it. Sometimes we try birth control pills. Actually, one of the medications that we. use to sort of keep endometriosis at bay. is actually a medication that puts you. in menopause.

Which is? Lupron. It's a It's a Lupron. It's a. shot and now there's a newer pill that. you can do, but basically what it does. it shuts your ovaries down. So, that. cycling and all that stuff is going in. your body, it just goes away. Well, it's. great. It helps with your endometriosis, but it gives you menopausal symptoms. So, that's where menopause and the. endometriosis connection comes in. And. also So, for young women who have. endometriosis, once the symptoms get to. be so bad and you've tried all those.

medical management things and you may. even try surgery to go in and remove. some of the endometrial tissue, but if. it comes back, often the definitive. treatment for endometriosis is. a hysterectomy. And it's a hysterectomy with removal of. the ovaries. Which means now you're going into. menopause. menopause forever. So, that's sort of. the endometriosis, you know, menopause. connection. Either some of the. medications that you're on will throw. you in menopause temporarily.

and or if that's not working, then. you're having a surgical menopause. And. this can happen again for young women. They may be in their 30s and 40s and. that's devastating from a lot of. different standpoints. And and just symptom relief. But. the one thing I want you to understand. is because once you get to menopause, if. that is the route that ultimately you're. on and it ends up with the hysterectomy, you can be treated with menopausal.

hormone therapy. That is That does not. mean that oh, I'm 35 years old. I've had. a hysterectomy and my ovaries are out, so I just must endure. No, you can be. treated with menopausal hormone therapy. Did that answer your question? It does. Thank you so much. Thank you so [clears throat] much. And that information helps so much. Thank you. Thank you, Fallon. 35-year-old Sasha. says she found the special uh inspiring. also and educational. I'm so glad to. hear that, Sasha. What's your question?

No, um well, I found it inspiring and um. very informative. I love that everyone. was so vulnerable and sharing so much. Um I'm 35. I. would like to have kids, but that. probably wouldn't be for a couple years. And that would put me into my late. late 30s. And um I'm a black woman, so. you know, fibroids are more common among. black women. And I'm wondering the. relationship between. um.

to like later childbirth and fibroids. and how that might affect menopause and. kind of what that would look like. There is this study of women across the. nation where they looked at women, different ethnic groups, and they found. that black women tend to go through. menopause earlier, their symptoms are more severe, and they. last longer. So, obviously, if you're. going to go through menopause earlier, that means that perimenopause starts. earlier cuz you know, back that up 10.

years. If you're going to be menopausal. at 45, then you're a perimenopausal at. 35. Yes. One of the things that I always tell uh. young women, particularly when they're. concerned about what does this mean in. terms of childbearing and will I be able. to have a baby or not, first thing is know your family history. because I think you should talk to your. mother because at 35, if you talk to. your you say, "Mom, when did you go. through menopause?" If she remembers and. she shares that information. If she. tells you you were menopausal she was.

menopausal at 42, well, then that has some bearing for you. because at 35, you are more likely to be. perimenopausal and to maybe have some. fertility cha- challenges. more than someone whose mother had. menopause at 55. Do you see what I mean? So, yes, it has a direct uh implication. on when your symptoms start. Um but what. to do about it? And let me say,

we have more options now than we have. ever had. Because this is a situation if. you say, "I'm not really I'm not ready. to have a baby right now at 35. I may. not have even identified a partner at. 35." Then this is where. Harvest those eggs. Harvest those eggs. freezing might be something that you. would do because it at least preserves. that possibility for you that if you. just wait, then time will make that. decision for you rather than you making. that decision. Okay.

That's helpful, right? Mhm. Yeah. And if you're unsure, I mean, I. have a lot of daughters that I mentor. and several of them are, you know, 29, 30 and already have done the procedure. to harvest the eggs because they're not. sure when or how or if they really want. kids, but at least are prepared. Are prepared. Something to think about. Something to think about. Thank you so. much. Thank you so much, Sasha.

We're going to move on to women beyond. their 30s. I know you're recognized. internet stars Kim and Penn Holderness. They won the Amazing Race on CBS and. their song parodies have billions of. views including a series about. perimenopause. Kim and Penn join us from North. Carolina, one of my favorite states. Hi, Kim and Penn. Hi. I I I hear you call perimenopause the. third person in your marriage. How is. that?

Uh it felt like I had turned into a. different person. There was another. person in our marriage, but not in like. the fun way. Sorry, babe. And I there were moments where the mood. swings were so wild. I was saying things. and screaming things that were just not. It was like out-of-body experience. I. wasn't really a crier, and everything. was making me cry. So, my darling. husband, who's been very understanding. through this process, he said, "Look, why don't we just call that person. Perry. It's Perry's fault." So,

[laughter]. um. she So, we just decided like if I was in. a rage, he's like, "Well, Perry, um. maybe it's going to leave soon, so let's. just stick it out." So, yes, we created. a whole entire character on our platform. called Perry for perimenopause. My daughter is so cute. What is wrong with me? Crying at Gilmore. Girls again, huh? Wait, who are you? Sorry, I'm Perry. Perry menopause. Her name [music] is Perry menopause. [singing]. Can you get out of my house?

Absolutely not. I'm going to be here for. a while. How long? 15 years, give or take. You're making me really anxious. You catch on quick. What? I'm the reason you're feeling everything. right now. What do you mean everything? Probably easiest if I just give you this. brochure. Oh, thanks. What is amazing is that how well people. responded to it cuz I guess a lot of. guys are like you who who are going. through it or have been through it with. their partners. That's you. Yeah, oh yeah. Okay. So, [laughter]. look, I I love my wife and, you know,

she has anxiety, and I've known that for. a long time. And when you get an. explanation of something, it's so much. easier to live with, uh to understand, and also to be able to provide some. empathy. And so, it was really nice for. me to learn a little bit about. perimenopause so that not only could I. understand and have empathy, but also, and we do this a lot in our life as long. as she's okay with it, um to laugh at. it. And we want to give people. permission to have a little fun and. maybe laugh at it as well, which is kind. of how our content came about about. perimenopause.

I hear you're dealing with a lot of. fatigue, too, Kim, right? Oh my goodness, I I there there was a. time in my life where I could just go to. bed and sleep. Um, but that was so long. ago. Sometimes I'll look over at him in. the middle of the night and he's just. sleeping. Just uninterrupted. Yeah. And I'm filled with rage. I I I cannot. sleep unless I finally found a doctor. who has uh given me some wonderful. medication. The real stuff. That's the real stuff. Um, but without it, I cannot sleep. And. so that means during the day I'm so I'm.

so tired. And then that just compounds. every other symptom. So that has been. That honestly has been my biggest. struggle. Yeah, I know that was it for me, too. I. didn't sleep for 2 years. During the. Oprah show. I I. and I thought I was going to lose my. mind. Do you have a question for Dr. Malone, either of you? Okay, here's my question. Um, we're we're I found a great doctor. I'm on some progesterone now. I found. medication to sleep. I finally got on. some medication for anxiety because that.

was just out of control. I'm still in. perimenopause. Is it Can you give me a glimmer of hope? Like once I hit menopause, like that. full 12 months, does any of this get. better? Or is this just my life now? Oh my, where to begin with that one? You're on at least three different. medications, right? You've got. progesterone, you've got something for. anxiety, something for sleep. If we know that it's all perimenopause,

then why don't we treat the. perimenopause, which is with hormones? Estrogen is the the common denominator. of all the symptoms that you have there. And this is not uncommon during. perimenopause where. women will say, "Okay, well, I need. something for sleep. And then I'm. depressed. And I need something for. this." Right. And and by the time you. look at it, you're on five different. medications for your five different. symptoms and still haven't adequately. solved the problem. And I think that the.

first go-to ought to be able to say, "It's perimenopause. Let's go to the most effective treatment. for the symptoms of menopause and. perimenopause, which is estrogen. therapy, and don't be afraid of that if. there is, you know, unless there is a. reason that I don't know why you should. not.". Yeah, there is I I have PCOS and my. estrogen levels are actually wildly high. and I have I had them tested throughout. the month just to confirm so that but.

that's I think that is more rare, but I. went to the doctor begging for estrogen. I'm not opposed to it at all. Well, let me say that there is a. different way that we give estrogen for. women who are perimenopausal. I've said. all the time that in perimenopause your. estrogen levels aren't consistently low, sometimes they're too high, sometimes. they're too low and everything in. between and in no particular order. So, what works well for women who don't, you. know, who are having these persistently. high estrogens, you know what you do?

You use a low-dose birth control pill, just a plain old oral contraceptive. because what it does is that it shuts. down all that extraneous estrogen. production in your ovaries and it will. give you back what you need to quiet. your ovaries and give you enough. estrogen and progestin. So, what you're. doing is that you're tamping down all. that background noise and just giving. back the estrogen as you need it and you. can take birth control pills every day.

and when I say every day, you don't even. have to stop them to have your period. You can just go straight through. You're. like, "I would prefer not to be off the. pill for a week a month" because your. symptoms will come back when you're off. your estrogen. Birth control pills is a. very. is a very easy way that we use commonly. for women in perimenopause, particularly. when one of the other symptoms in. perimenopause tends to be irregular. bleeding or sometimes the bleeding is.

too heavy. and or you need birth control. In those. instances, a birth control pill, a. low-dose birth control pill, works. better. because you are getting cycle control. and you're also controlling your. symptoms and you get birth control. So, very commonly to stay on that and then. once you're finally menopausal, which. who knows, maybe 5, 6 years from now, then that's when we make the transition. from birth control pills to menopausal.

hormone therapy. But, I don't want you. to think that those are two things that. are separate and apart. Birth control. pills have estrogen and progestin in. them. It's a different estrogen than. what we take at menopause and it's in. different amounts. There's more of it. when you're perimenopausal. But, suppose she goes to her doctor and. says this and the doctor says, "I don't. even believe in that." or "I don't know. about that." or. Well, Yeah, yeah, yeah, how do you find a doctor? they doctor Malone told me. Do that. Do that. Do that. Do that.

There's a whole section in there on. that. It is true. But, that is again. Oprah, we get back to our same access. problem. Finding doctors who understand. the subtleties of how to treat because. yes, you can you take the levels of. menopausal hormone therapy when you're. perimenopausal? Yes, you can. But, not. if you need birth control, not if you. have bleeding problems because there's. not enough estrogen in the menopausal. hormone therapy to control those other.

symptoms. It may take care of your hot. flashes, but it's not going to take care. of the other things. So, don't be afraid. of of using the type of estrogen that is. appropriate for what your symptoms are. And once you get to, you know, cross. that line and you're menopausal, then we. can switch it up and go back to. menopausal hormone therapy. Thank you so much for that information. I that feels solid. Penn, any advice do. you have for men, Penn? Because we keep. hearing. guys have no idea how to handle this.

Well, okay. The couple weeks ago you. said that we all need a we need a 101 on. menopause. Men need I guess whatever's. below that like a 000. We need to learn, right? Yeah. And I got to give Dr. Malone credit. The. one of the first times I really started. to learn about perimenopause, we were at. South by Southwest and we went to a. symposium where Dr. was with Dr. Haver. and a hundred other women who were all. very outspoken. They were very. frustrated with the way that healthcare. has let them down. And the fact that.

they they were being marginalized by. doctors sometimes, but they were not mad. at me. They were thrilled that I was. there. I was the only dude there. And. almost every single one of them came up. to me and thanked me. So guys, if you. show a little curiosity and a little bit. of empathy, your wives are going to be. grateful. And it's great when your wives. are great. [laughter]. Thank you so much for joining us, Kim. and Penn. Thank you so much. Thank you. guys. Trisha joins us from Woodland Hills, California and her daughter Layla is.

zooming in from her college campus in. New Orleans. Trisha and Layla, tell us. what's going on with you guys. Sure. So, hi. Um. Hi. I turned 50 last year and right before I. turned 50 in August, I started getting a. lot of different perimenopausal symptoms. like hot flashes. Many of my friends had. gotten them long before me and I thought. I'd escaped, but not so much. And the. hot flashes kind of take hold sometimes.

In addition to that, the last year I've. put on 30 lb and I have no idea how to. stop it. I've gone up two sizes and the. counting and I feel like I really need. to understand all of these symptoms, uh. the impact it's having on me, in. particular the weight gain and what I. can do about it. I do walk, I do a. little bit of exercise, but it seems. like nothing is enough to curb some of. the issues um, that I'm having, including constant need to go and go use.

the restroom, and I just went, and I'm. in the car with my family, and like, I. got to go again, and they're looking at. me like, what's wrong with you? And my. answer is always, I have no idea. So, I. would love to get a sense of why all of. this is happening, and in particular the. weight gain and what I could do about. it, if anything. Okay. The weight Why the weight gain? You know, that is one of the most common. complaints that women come in with. during the perimenopausal phase, when. they start gaining the weight, and. they're like, what is going on? I'm.

eating the same thing, I'm exercising. the same way, and I've gained 10 lbs. just for breathing. And I believe I believe you, because, you know, I've been through that myself. I, too, no longer weigh what I weighed. 20 years ago. But, the key to this is to. understand what is happening to your. metabolism, and what is happening as. your estrogen levels fall. Well, whether. you have symptoms or not, and now you're. having hot flashes, but let me just sort. of walk you through the cascade of. events that happens. Your estrogen.

levels fall. One thing that happens is that your body. composition changes. So, even when you. don't gain a pound, and most people do, but even when you don't gain weight, you. tend to lose muscle, and you put on fat. And so, that weight gets dis-. redistributed. Yeah. And then now, it's like, why do I have. this belly fat? Why am I Why are my. boobs bigger? Yeah. That's also happening, because that's. just deposition of body fat. That's a.

response to the lack of estrogen. So, that's one. You have hot flashes, night sweats, you. can't sleep. Sleeplessness and hot. flashes lead to fatigue. It increases. your blood pressure. Women who are. estrogen when their estrogen level is. low. increases your irritability. Oh, absolutely. And it also increases. insulin resistance, so more people will. start to develop type 2 diabetes after. menopause. So, guess what happens when you're.

irritable, you're tired, guess what. you're not going to do the next day? Exercise. Now you're fatigued, now you've got more. fat and less muscle, so everything that. you eat, you don't have you don't have. muscle is more metabolically active than. fat. So, it just continues to make more. fat. And then the more depressed you. are, and guess what happens when you are. depressed and you're tired, you make bad. choices the next day. You're not going.

to exercise, you're like, I know exactly. what this feels like because as a. resident when I would be up all night. cycle. Yeah, I'd be up all night and you make. bad choices about what you eat, what you. drink, what your behaviors are. So, it's. a it's a really complicated system, but. it all goes together and it happens to. women, I would say, nine times out of 10. that this is the complaint. you're you're in college, very neat dorm. room. You must have known we were. zooming in. Very neat. Uh but you also. have a question for Dr. Malone.

Yeah, I do. So, everything that I've. learned about menopause is definitely. been through my mom and just hearing. about her experiences with hot flashes. and moodiness and just feeling overall. uncomfortable in her body. Um but even though menopause isn't. really on my radar right now, my. question is what can young people like. myself um start doing now to make that. transition easier when it does come? Well, knowing what you know now, I can say this, the better health you.

are in leading into this perimenopause. and menopausal phase, the better you are. going to be able to endure it. It won't. to say that you won't eliminate the need. for medications, but the healthier you. are coming into it, the better you're going to weather this. process. But I would say as a young. woman who is watching her mother go. through this, the one thing you can do. is give her a little grace. and understand that, you know, your. mother's not maybe she's not snapping at. you because.

of something you did. Uh it may be the. day and you just have to sometimes maybe. go up to your mom and give her a hug and. say, "Hey, Mom, I understand this may be. a bad day for you today." And sometimes. it may be something you did now. So, let's you I'm going to let you. distinguish between the two. But just understand that your mom has a. whole lot less tolerance for the stuff. that you do now than she may have had 10. years ago. I also think that having the information. makes everything so much more palatable.

So, I hope you have Grown Woman Talk. If. not, we'll send it to you because it is. it is a manual for being able to live. well. And uh. we'll make sure you get it. Thank you, Oprah. Thank you, Dr. Malone. Thank you, Layla and Trisha. Thank you. Thank you for zooming in from school. Thank you. Yeah, thanks for having me. All right. Mickey and Raymond are the. parents of a 13-year-old boy and they're. zooming in from Thomasville, North. Carolina. Hi, guys. What's going on? Hi.

Hi. Welcome. much for having us. Yeah, we appreciate it. Uh excited. Um so, my issue is. I. vaginal dryness, lack of libido, lack of interest, you. know, I thought it was something wrong. with us. Is it, you know, Our marriage is solid. However, the. intimacy, the interest, um. it's just. nonexistent. And so, my question is.

about Is there a magic potion? Is there. are there drugs? Are there. herbs? You know, what pills? And I've. learned so much today in this. conversation, so now I know what to ask. my doctor. And um. I am using the estradiol cream. Um. and just wondering is there something. more I should be taking, asking for. um.

to to help me with these symptoms. I'm going to I'm going to say this and. this will surprise no one. I don't know how you are, but I know I. am. But I can tell you from personal. experience that sex is six at 60 is not. sex at 25. It's different. And you just. accept that different does not mean. worse. Now, that didn't say it's so. There are two things that you need to. understand that are happening. hormonally. What's happening with your. estrogen and the lack of estrogen after. menopause is really responsible for.

things like vaginal pain, dryness, the. discomfort. Now, it does not it stands. to reason that if sex is painful, you don't want to have it. You know, we. are all sort of you know, we're a. programmed to avoid pain and go towards. pleasure, right? So, the first part of what we need to do. is to eliminate those barriers that are. causing the discomfort. And vaginal. estrogen is a great place to go at at.

vaginal estradiol. And the estrogen in. the vaginal estrogen is so low, it. doesn't get absorbed systemically. So, so you don't need to take a progestin if. you are just using vaginal estrogen. Sometimes that's enough. And you can say, "Well, look at that. I'm not in pain, and you know, this. isn't difficult. I'm not getting a. urinary tract infection every time I. have sex. I'm not avoiding it the way that I. would.". Okay? There's also the issue of. testosterone. And testosterone has been.

we you know we talk about it a lot, but. it's not readily accessible for most. people because there is no FDA approved. version of testosterone that women can. take. There is one for men, but not for. women. So that would involve you know. after you have taken care of the pain. and discomfort issues and you say still. not where I want to be. Pain and discomfort, dryness you're. talking about. Yes. And you know you need a good lube. And then you say well okay well then.

maybe testosterone might be appropriate. for you for treating just the what we. call the hypoactive sexual. disorder. Okay? That's one. Hypoactive sexual disorder means I'm not. interested. libido. Yeah low libido. I don't I'm not. thinking about sex. I don't want it. But. here's another. I want to give you. another frame for how to think about sex. after 50 or sex after 60. Most women. once you eliminate their discomfort,

okay? So we've taken that off you're. treated and you're fine. Most women will find that there's a. difference in your desire where there's. a difference between spontaneous desire. where I'm just sitting here and oh I. can't wait to go for my husband to come. home or my partner to come home and have. sex. But there is what changes as we age. is more responsive desire. And by that I. mean I called it the build it they will. come theory. And that is.

I wasn't thinking about sex. But if you bring it up and I'm going to. say this to you. husband. remember when you used to date your wife. when you before you you know. Raymond remember those days? Yes. Then you create the scenario. by which your wife would be responsive. to you. And most women will find under. that circumstances like, "Well, I wasn't. thinking about it, but look at that. You. put the dishes in the dishwasher, and.

you came over, and you were nice to me.". All of those things. that will make her more receptive. when you initiate. So, there is a lot. It's more complicated, and that is also. That will get you in the right space. Novelty is important. You can't do the. same things over and over and over again. and expect anybody to get excited. That's just It doesn't matter what. you're talking about. Once you've done. it a million times, you're not going to. get the same response. So, novelty,

role-playing, sometimes you need a. sexual therapist. But, let me say this, what's really important, and I go back. to for women, there's also a problem with arousal. And. there's also the problem with inability. to have an orgasm just because, you. know, things are just less responsive. And to that, I would say, be playful. Invest If you don't have one, get. yourself a good vibrator. There are lots of good lubes you can.

use. There are We at Alloy, we have a. cream called Amazing, which is actually. a cream that's topical sildenafil, which. is the same thing as topical Viagra, but. it's for women. It's the same So, it's a. cream that you use externally, and it increases arousal. So, they you. know, you realize it's Yeah, it's going. to require some potions and. Obazing. I should have branded that. Obazing. Exactly. I should have branded that. You You know what? You're absolutely.

right. You can be our spokesperson. [laughter]. Obazing. How does all this sound to you, Raymond? Uh it sounds great. Um it sounds. wonderful. But, everything that we've. been learning today and listening to the. conversation has been extremely helpful. But, I also want to say that as men, we. don't often get the information so that. we understand what's happening with our. with our wives. That's why we keep saying it. Her lack of. of interest, I thought was my fault. I. thought I wasn't doing enough. I thought.

I wasn't uh being there or or or I. thought she didn't love me anymore. Um and truth be told, Nikki even thought. it was me. Like, you're not doing. enough. Maybe you need to do this. Maybe. you need to do more. She She once told. me that um you know, the room that we. were our bedroom was painted a chocolate. brown. She said, "Oh, the room's The. room's too dark. It's too gloomy." And. she went away for a weekend and came. back and the room was painted. So, I I took care of things. [laughter]. I was like, "Oh, no. I You know, I If. that's the problem, then let me go ahead.

and solve the problem." But once we. began to realize what was happening and. that this had nothing to do with me or. with her, you know, I wasn't the. problem. Nikki wasn't the problem. The. problem was the problem. And we began to. understand I began to understand what. was happening with her body. Then I. began to understand and be a little bit. more sympathetic to to how she was. feeling or what we were going through. I heard you shifted your own. expectations about sex, too, Raymond. Absolutely. I I shifted my own. expectations because there was a part of.

me that thought she didn't love me. But. no, everything else that she does shows. me that she loves me. So, when I shifted. my expectations, actually she began to. meet me. meet me in the middle. That's great. a better a better experience for both of. us. Right, cuz communication is. My question for Dr. Malone is is. um. you know, grown talk for women. recommended reading for men or should we. have a grown talk about women for men? Um book coming out. And and what more.

can we do to begin to understand? I Let. me just include I have a husband's group. that I meet with and we met last night. and I brought this whole topic of of of. um of of menopause and. What did. they say? I'm curious. I. I was shocked to see that everybody was. very willing to talk about it because. nobody ever talks about it. Oh, that's great. And then in the 60s, three men in their. 50s, and the young man in his 30s was. taking feverish notes because he was. like, "Oh my goodness, what's going on?

What do I have to look forward to? What. I What should I be doing?" And it was a. great It was a great conversation and. they even said, "Uh we we need to talk about this more. because if women aren't talking about it. with other women, just know that men. aren't talking about it at all.". Yeah. And we had a great conversation about. last night. That's great, Raymond. That's great to. hear. Thank you. Thank you both. I'm I'm. going to make sure you get the book. Do. you have the book? No. So, thank you so. Okay, we will make sure you get the. book. Thank you so much. Thank you both.

I I think I'll send two copies cuz when. once you read the book, you will be so. informed, you will be jazzed about the. information and how that information. applies to your own life. I'm really. excited. Really excited to be able to. send it to you. All right, thank you. both. Thank you. Okay. So, I'm going to give you, Dr. Malone, the final word. What do you want. to say to all the people like Raymond. and Nikki, like all the women we spoke. to this week and weeks ago, who are.

trying to figure it out for themselves? The one message that I really want women. to have is this. Is that menopause is. inevitable, suffering is not. And I. think that every woman has a line drawn. somewhere in the sand between what's. tolerable and what's not. You don't let. someone else tell you how you feel or. how you're supposed to feel. If you are. bothered, if you are having any one of. those 34 symptoms in any particular.

order, or if you're not having those. symptoms and you're at risk for things. like cardiovascular disease or. osteoporosis, you need to educate. yourself and advocate for yourself. because that's a big message that I want. women to get is that don't be passive. sort of participants in your own life. and your own health. You have way more. power than you think. You just don't. know how to exercise it. And so, my book. and my message and my mission is to make.

sure that women have all the information. they need to be able to make good. decisions for themselves and for their. families. And it's all right here in Grown Woman. Talk. Thank you all. Thank you again, Dr. Malone. Uh thank you our guests for being so. open with us about your experiences. Dr. Malone's book Grown Woman Talk, grown. woman, grown folks, okay? Is available. anywhere you buy books. It has lots of. important information about how we.

navigate the aging process from. perimenopause and beyond. If you're. listening to this podcast, you can head. over to YouTube to watch the full video. Talk to you next week, everybody. Go. well. 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.