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

Introduction to Menopause

In this enlightening episode of The Oprah Podcast, Oprah Winfrey teams up with Dr. Sharon Malone, a nationally renowned menopause expert, to demystify menopause—a natural phase of aging that affects all women with ovaries. Oprah emphasizes the need for a comprehensive "Menopause 101" to dispel the widespread confusion and misconceptions surrounding this topic.

Oprah Winfrey (00:00): "Menopause is not a disease or a disorder, but a natural part of aging that all women born with ovaries will eventually experience."

Understanding Menopause: The Four Stages

Dr. Malone outlines the four crucial stages of a woman's reproductive and post-reproductive life:

1. Premenopausal Phase: Begins at puberty (ages 12-13) and includes the peak reproductive years up to the early 30s.
2. Perimenopause: The transitional period leading up to menopause, starting as early as the mid-30s and lasting 4 to 10 years. Symptoms include hot flashes, fatigue, mood swings, dry skin, and low libido.
3. Menopause: Officially diagnosed after 12 consecutive months without a menstrual period.
4. Postmenopause: The period following menopause, which may still include lingering symptoms.

Dr. Sharon Malone (02:41): "Hot flashes, mood swings, sleeplessness... can start in perimenopause. Women think of menopause as something that happens to old ladies, but it can begin much earlier."

Hormone Replacement Therapy (HRT) Explained

A significant portion of the discussion revolves around Hormone Replacement Therapy (HRT), addressing common misconceptions and historical context. Dr. Malone clarifies that HRT typically includes estrogen and progestin, with some women also incorporating testosterone to address libido issues.

Oprah Winfrey (11:20): "What is HRT? Can you explain that, Dr. Malone?"

Dr. Sharon Malone (11:41): "Hormone Replacement Therapy is typically comprised of estrogen and progestin... we're finding out a lot more about testosterone because women make testosterone too."

The conversation delves into the infamous 2002 Women's Health Initiative study, which cast doubt on the safety of HRT. Dr. Malone explains that the study was flawed due to its focus on older women, leading to a widespread fear of HRT that persists today.

Dr. Sharon Malone (24:13): "The Women's Health Initiative study was misinterpreted. Starting HRT within 10 years of menopause can actually decrease the risk of cardiovascular disease by 30 to 50%."

Naomi Watts' Personal Journey and Insights

Actress and activist Naomi Watts shares her personal experiences with early menopause, inspired by her struggles with infertility and debilitating symptoms.

Naomi Watts (09:00): "I was told at 36 that I was going into early menopause... I had night sweats, disrupted sleep, anxiety, depression, brain fog, migraines, and dry, itchy skin."

Naomi discusses her positive experience with HRT and her advocacy through her wellness brand, Stripes Beauty, which focuses on hydration from scalp to vag. She emphasizes the importance of owning one's story and fostering open conversations about menopause.

Naomi Watts (12:08): "I've been on HRT successfully and safely for over 10 years."

Audience Stories and Expert Advice

The episode features heartfelt stories from listeners like Tricia from Minnesota, Kylie from Tampa, Amina from Georgia, and Esther from Maui. These narratives highlight the diverse experiences of women navigating perimenopause and menopause—from intense night sweats and mood swings to workplace challenges and the struggle to receive adequate medical support.

Tricia (26:26): "I had a 90-day period so heavy, I really thought I might have uterine cancer... experiencing intense night sweats that leave me soaked through."

Amina (41:46): "I get written up at work for not being in compliance because I had my sweater off... It was ridiculous."

Dr. Malone provides expert advice tailored to these real-life situations, advocating for early and accessible treatment options and encouraging women to seek care when symptoms impact their quality of life.

Dr. Sharon Malone (30:24): "If you are between the ages of 35 and 45 and you have any one or any combination of those 34 symptoms... then you are perimenopausal."

The Impact of Menopause on Mental Health

The discussion underscores the profound effect menopause can have on mental health, including anxiety, depression, and cognitive issues like brain fog. Dr. Malone explains that hormonal fluctuations directly impact brain function, making mood regulation challenging.

Dr. Sharon Malone (37:55): "The areas of our brains responsible for mood, sleep, and temperature regulation are responsive to estrogen or lack thereof... wild fluctuations are scrambling your brain."

Oprah shares her personal experience with depression linked to menopause symptoms, highlighting the necessity for proper diagnosis and treatment rather than misattributing these feelings to other causes.

Oprah Winfrey (40:10): "I just felt like my life went into like a flat line. I just felt like, okay, so what? I wasn't even aware that was a form of depression."

Cultural and Workplace Implications

Amina’s story brings to light the cultural and workplace challenges faced by menopausal women, including ageism and lack of understanding from employers. Dr. Malone advocates for workplace sensitivity and education, emphasizing that menopause affects a significant portion of the female workforce.

Dr. Sharon Malone (44:03): "Menopause is not a disability... workplaces need to be more aware that all female employees between certain ages will go through this phase."

Prevention and Long-Term Health

Esther from Maui raises concerns about cognitive decline and Alzheimer's disease, seeking preventative measures during menopause. Dr. Malone discusses lifestyle changes that can mitigate long-term health risks, such as regular exercise, healthy sleep patterns, and a balanced diet. She also touches on the potential protective effects of early HRT initiation.

Esther (50:12): "I feel like when I walk into a room and forget why I walked in... Is this the start of dementia?"

Dr. Sharon Malone (52:41): "Regular exercise, good night's sleep, cutting back on alcohol, don't smoke, and watch your diet are key factors."

Celebrating Menopause

In a refreshing perspective, Dr. Malone encourages viewing perimenopause as a time of celebration and empowerment rather than a period of decline. She highlights the wisdom and authenticity that come with age, urging women to embrace this natural transition.

Dr. Sharon Malone (55:17): "We should all look forward to this time of life... I am happier now at 66 than I was at 46."

Oprah Winfrey (55:23): "It gets better. We deserve a celebration."

Conclusion and Future Discussions

Oprah wraps up the episode by acknowledging the importance of these conversations and teasing upcoming discussions on newer studies about menopause symptoms in younger women. She encourages listeners to stay informed and seek support through resources like Dr. Malone's book, Grown Woman Talk.

Oprah Winfrey (56:13): "Duckenbloon's book Grown Woman Talk is available anywhere you buy your books... essential information on what it means to grow and age beautifully."

Notable Quotes with Timestamps

• Oprah Winfrey (00:00): "Menopause is not a disease or a disorder, but a natural part of aging that all women born with ovaries will eventually experience."

• Dr. Sharon Malone (05:32): "You're never over it. And people think that because your hot flashes stopped... but you did go through menopause."

• Naomi Watts (10:50): "I've been on HRT successfully and safely for over 10 years."

• Dr. Sharon Malone (24:13): "The Women's Health Initiative study was misinterpreted... starting HRT within 10 years of menopause can actually decrease the risk of cardiovascular disease by 30 to 50%."

• Dr. Sharon Malone (37:55): "The areas of our brains responsible for mood, sleep, and temperature regulation are responsive to estrogen or lack thereof... wild fluctuations are scrambling your brain."

• Dr. Sharon Malone (55:17): "We should all look forward to this time of life... I am happier now at 66 than I was at 46."

Final Thoughts

This episode serves as a comprehensive guide for women navigating menopause, blending expert insights with personal stories to foster understanding and support. Oprah and Dr. Malone empower listeners to embrace menopause with knowledge, open communication, and proactive health management.