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

Summary

Podcast Summary: The Oprah Podcast
Episode: Oprah & Dr. Sharon Malone: Menopause Solutions for Millennials, Your Weight, Sleep, Mood & Intimacy
Release Date: May 27, 2025

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Introduction

In this insightful episode of The Oprah Podcast, host Oprah Winfrey engages in a comprehensive discussion with renowned menopause expert, Dr. Sharon Malone. The conversation delves into the increasingly prevalent issue of menopause symptoms emerging in younger women, particularly millennials, and explores solutions for managing weight, sleep disturbances, mood swings, and intimacy challenges during this transitional phase.

Rising Early Menopause Symptoms Among Millennials

Oprah opens the dialogue by presenting alarming statistics: over 47 million women enter menopause each year, yet only 6% receive the necessary support. Moreover, new studies indicate that women as young as their early 30s are experiencing perimenopausal symptoms (Oprah [00:56]).

Dr. Sharon Malone attributes this early onset to factors such as increased stress, environmental influences, and exposure to endocrine-disrupting chemicals. She emphasizes the need for further research to understand why aging processes may be accelerating in modern times (Dr. Malone [02:30]).

Oprah underscores the importance of Dr. Malone's expertise, highlighting endorsements from influential figures like Michelle Obama. She encourages young women by sharing that menopause does not signify the end but rather a continuation of life with new opportunities and improved well-being (Oprah [03:03]).

Listener Questions and Expert Responses

Chandler’s Question: Differentiating Menopausal Symptoms from Normal Mood Swings

Chandler, a listener in her early 30s, expresses concern about distinguishing menopausal symptoms from typical emotional fluctuations. Dr. Malone clarifies that while both experiences share similar symptoms, perimenopausal symptoms are more persistent and occur without apparent external causes (Chandler [05:23]).

She advises that younger women experiencing these symptoms should consider other medical conditions like Premenstrual Dysphoric Disorder (PMDD) or Polycystic Ovarian Syndrome (PCOS) before attributing them to menopause (Dr. Malone [07:05]).

Fallon’s Question: Endometriosis and Its Impact on Menopause Symptoms

Fallon, aged 35, shares her diagnosis of endometriosis and inquires about its influence on her menopausal journey. Dr. Malone explains that while endometriosis itself may not directly alter menopause onset, treatments for severe cases—such as Lupron shots or hysterectomies—can induce early menopause (Fallon [12:00]).

She highlights the importance of hormone therapy post-surgery to manage menopausal symptoms effectively (Dr. Malone [16:27]).

Sasha’s Question: Later Childbearing, Fibroids, and Menopause

Sasha raises concerns about the relationship between delayed childbirth, fibroids, and menopause, noting that fibroids are more common in Black women. Dr. Malone references studies showing that Black women tend to experience menopause earlier, with more severe and prolonged symptoms. She advises women to consider egg freezing as a proactive measure to preserve fertility (Sasha [17:13]; Dr. Malone [17:49]).

Trisha and Layla’s Questions: Weight Gain and Preparing for Menopause

Trisha, turning 50, discusses significant weight gain and frequent restroom visits, seeking advice on managing these symptoms. Dr. Malone explains that declining estrogen levels affect metabolism, leading to increased fat deposition and muscle loss, which exacerbate weight gain and fatigue (Trisha [32:02]; Dr. Malone [33:11]).

Layla, a college student, asks young women how to ease the transition into menopause. Dr. Malone emphasizes maintaining good health through diet and exercise and fostering empathy towards aging mothers experiencing menopause-related changes (Layla [35:51]; Dr. Malone [36:14]).

Impact of Perimenopause on Relationships: Conversation with Kim and Penn Holderness

Internet sensations Kim and Penn Holderness join the conversation to discuss how perimenopause is affecting their marriage. Kim humorously describes her mood swings by introducing a fictional character, "Perry Menopause," to represent her fluctuating emotions (Kim [22:43]).

Raymond, Kim's husband, shares his journey of understanding and empathizing with his wife’s experiences, highlighting the importance of communication and adjusting expectations within the marriage (Raymond [46:06]).

Dr. Malone offers practical advice for couples, suggesting hormone therapies like estrogen and testosterone treatments, as well as lifestyle adjustments to improve intimacy and sexual health (Dr. Malone [42:55]; [43:10]).

Final Advice and Empowerment

As the episode concludes, Dr. Malone delivers a powerful message encouraging women to take charge of their health and advocate for themselves. She reiterates that while menopause is inevitable, suffering is not, urging women to educate themselves and seek appropriate treatments to manage symptoms effectively (Dr. Malone [49:35]).

Oprah reinforces this message, promoting Dr. Malone's book, Grown Woman Talk, as an essential manual for navigating menopause with confidence and grace (Oprah [50:38]).

Notable Quotes

• Oprah Winfrey: "Every woman should have Grown Woman Talk." ([00:56])

• Dr. Sharon Malone: "Menopause is inevitable. Suffering is not." ([49:35])

• Kim Holderness: "We just decided, like, if I was in a rage, he's like, well, Perry maybe is gonna leave soon, so let's just say that person is Perry." ([22:49])

• Dr. Sharon Malone: "The healthier you are coming into it, the better you're going to weather this process." ([36:14])

• Raymond: "Once we began to realize what was happening and that this had nothing to do with me or with her, I wasn't the problem. Nikki wasn't the problem. The problem was the problem." ([47:25])

Conclusion

This episode of The Oprah Podcast provides valuable insights and practical solutions for millennials navigating the early onset of menopause symptoms. Through expert advice, personal anecdotes, and interactive discussions, listeners gain a comprehensive understanding of menopause's impact on physical health, mental well-being, and personal relationships. Dr. Sharon Malone's expertise, combined with Oprah's empathetic hosting, offers a supportive guide for women seeking to manage menopause with knowledge and empowerment.

For more information, listeners are encouraged to read Dr. Malone's book, Grown Woman Talk, and subscribe to The Oprah Podcast for future episodes tackling essential life topics.

Transcript

[Oprah Winfrey]

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. Talking with the audience was one of my favorite things during the years of the OPRAH Show. So it's been fun vibing with you all here on the OPRAH podcast. Welcome back. Dr. Sharon Malone. Her New York Times bestselling 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 perimenopause. Dr. Sharon Malone is here for it. She has the answers for all your questions.

[Dr. Sharon Malone]

You don't know when your ovaries are going to expire. Every person has a different end date on that.

[Oprah Winfrey]

As a certified menopause practitioner at OBGYN, Dr. Malone has been empowering women to take charge of their health for more than three decades. Dr. Malone is the chief medical advisor for Alloy Women's Health and the New York Times best selling author of Grown Women Talk. Every woman should have It. Grown Woman Talk. Your diet 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 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 gonna dig into it. Dr. Malone, can you talk about these studies? What is your take on that?

[Dr. Sharon Malone]

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 environment that we're in, you know, who knows, maybe it is some of the endocrine disrupting chemicals that women are exposed to that are causing this. So it is a very interesting area that needs to be explored further because we are aging ourselves faster than I think that we should be given this day and time.

[Oprah Winfrey]

Well, one of the reasons why you should listen to Dr. Sherrod 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 COVID 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 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.

[Dr. Sharon Malone]

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. 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.

[Oprah Winfrey]

That's right.

[Dr. Sharon Malone]

But to be able to take that message and to amplify it and to.

[Oprah Winfrey]

Get out, doesn't it feel like your life kind of blew up?

[Dr. Sharon Malone]

Oh, absolutely. And that's what I wanna tell young women. Don't think that you need to know everything that's gonna happen to you and to your Life. When you're 30 years old, you will 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 wanna live. And we're doing it on our terms.

[Oprah Winfrey]

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.

[Dr. Sharon Malone]

Thank you. 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.

[Kim Holderness]

Hear about like right before you're about.

[Dr. Sharon Malone]

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 when you're perimenopausal is 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?

[Oprah Winfrey]

Let's talk about what the symptoms are. You talk about 34 symptoms in grown women. Talk.

[Dr. Sharon Malone]

Mood swings, hot flashes, depression, anxiety, 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 are 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 have.

[Oprah Winfrey]

But it does mean your hormones are.

[Dr. Sharon Malone]

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? Is it an overlap? But I think one of the things that young women tend to show up with sometimes and that is infertility. That's the thing about 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 delay in getting pregnant that is the first sign that things are going on.

[Oprah Winfrey]

Something is going wrong. Something's off.

[Dr. Sharon Malone]

Yeah.

[Oprah Winfrey]

Yes. Not wrong, but off. Yes, Off. Off. Thank you so much. Did that help?

[Penn Holderness]

Yes.

[Oprah Winfrey]

Okay. Thank you so much. Thank you so much. After these messages, we have more of my conversation about how to treat the symptoms of menopause with Grown Woman Talk author Dr. Sharon Malone. There is no need to suffer in silence. There just isn't any need for it. And if you're suffering, come back and find out how to stop, because there's help for you. That's next.

[Penn Holderness]

This episode of the Oprah podcast is sponsored in part by Alloy Women's Health. Are you confused about menopause and perimenopause? Alloy has all the answers and experts you need to feel like yourself again. Think of Alloy as your total holistic solution for health and wellness throughout midlife. With evidence based medicines, science backed solutions and reliable expertise, they are your ally. Helping navigate and relieve menopausal symptoms, improve skin, hair, sexual health, gut health, and now manage weight. With Alloy, you get safe, effective, FDA approved solutions to your menopause and perimenopause symptoms prescribed by menopause trained doctors with unlimited ongoing care with your assigned own Personal doctor. You can message them anytime, from anywhere for no extra cost. Menopause is inevitable, but suffering doesn't have to be. Alloy has everything you need to age happily and healthily. Feel like yourself again. Go to myalloy.com to start your consult with a menopause trained expert today. Use code Oprah to get $20 off your first order.

[Oprah Winfrey]

Thank you for joining us. I'm talking to women's health expert Dr. Sharon Malone. If you were born with ovaries, you will one day face the impact of perimenopause and menopause on every part of your body. I am so glad you're here because this conversation is intended to empower you with information about your own well being. Let's get back to it. Fallon is 35, and I hear you actually had an aha moment during that ABC special. Fallon, hello.

[Dr. Sharon Malone]

Hi.

[Fallon]

Yes, I did. You may even catch me crying somewhere in the audience. Yes, my aha moment was that I finally found some understanding and a new sense of sympathy for my mother and what she went through going, you know, through menopause. Because 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 just 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 because I wanted to hug.

[Oprah Winfrey]

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 Hula. So I'm glad you had that aha moment. Do you have a question?

[Fallon]

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 if that's something that's bringing, you know, the premenoplasm on sooner.

[Oprah Winfrey]

Before you answer that, can you tell our audience what endometriosis is?

[Dr. Sharon Malone]

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.

[Oprah Winfrey]

And.

[Dr. Sharon Malone]

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 cycle, but it has nowhere to go.

[Oprah Winfrey]

Got it.

[Dr. Sharon Malone]

So it actually, it can be on your bladder, your bowel, and it causes pain and 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.

[Fallon]

It took three years.

[Dr. Sharon Malone]

Yeah, took three years. And that is typical, to be quite honest with you.

[Oprah Winfrey]

All right, so I interrupted so you could explain what it was to the audience. Now, what's the answer to her question?

[Dr. Sharon Malone]

But endometriosis in and of itself, we don't know that that is going to alter the course of. Of menopause for you. Not necessarily. It may not come earlier, it's gonna 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, is actually a medication that puts you in menopause, which is Lupron. 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 that's going on 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 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.

[Oprah Winfrey]

The ovaries, which means now you're going.

[Dr. Sharon Malone]

Now you're in 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.

[Oprah Winfrey]

Yeah, yeah, yeah. Childbearing.

[Dr. Sharon Malone]

Yeah.

[Oprah Winfrey]

Yes.

[Dr. Sharon Malone]

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 are on and it ends up with the hysterectomy, you can be treated with menopausal hormone therapy. 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.

[Oprah Winfrey]

Does that answer your question?

[Fallon]

It does. Thank you so much.

[Oprah Winfrey]

Thank you so much.

[Fallon]

Having that information helps so much. Thank you.

[Oprah Winfrey]

Thank you, Fallon. Thank you. 35 year old Sasha says she found the special inspiring also in education. I'm so glad to hear that. Sasha, what's your question?

[Dr. Sharon Malone]

No, well, I found it inspiring and very informative. I love that everyone was so vulnerable and sharing so much I'm 35.

[Fallon]

I would like to have kids, but.

[Dr. Sharon Malone]

That probably wouldn't be for a couple years. And that would put me into my, like, late 30s. And I'm a black woman. So, you know, fibroids are more common among black women. And I'm wondering the relationship between child, like, later childbirth and fibroids and how that might affect menopause and kind of.

[Fallon]

What that would look like.

[Dr. Sharon Malone]

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 gonna go through menopause earlier, that means that perimenopause starts earlier. Cause you back that up 10 years. If you're gonna be menopausal at 45, then you are perimenopausal at 35.

[Oprah Winfrey]

Yes.

[Dr. Sharon Malone]

One of the things that I always tell 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 challenges more than someone whose mother had menopause at 55. Do you see what I mean? So, yes, it has a direct implication on when your symptoms start, 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. Technology.

[Oprah Winfrey]

Harvest those eggs.

[Dr. Sharon Malone]

Egg freezing might be something that you would do, because that 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.

[Oprah Winfrey]

Okay, that's helpful, right? 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. I am so glad you could join us for this episode of the Oprah podcast. Next, Dr. Sharon Malone and I are joined by Internet sensations Kim and Penn Holderness for a candid conversation about how perimenopause is impacting their marriage. I know this is relatable for so many couples. That's right.

[Penn Holderness]

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[Oprah Winfrey]

Back to the Oprah Podcast. I'm with OB GYN Dr. Sharon Malone. She's answering your questions about everything related to menopause. This conversation is so important because there's still confusion and misinformation around this health issue that every woman will face. Let's get back to our conversation. We're gonna move on to women beyond their 30s. I know you'll recognize Internet stars in Kim and Pen 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 Pen.

[Kim Holderness]

Hi.

[Oprah Winfrey]

I I I hear you calling perimenopause the third person in your marriage. How is that?

[Kim Holderness]

It felt like I had turned into a different person. There was another person in our marriage, but not in, like, the fun way.

[Dr. Sharon Malone]

Sorry.

[Kim Holderness]

And 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, like, why don't we just call that person Perry? It's Perry's fault. So we just decided, like, if I was in a rage, he's like, well, Perry maybe is gonna leave soon, so let's just st. So, yes, we created a whole entire character on our platform called Perry for Perry Madpaws. What is wrong with me? Brian and Gilmore Girls again, huh? Wait, who are you?

[Dr. Sharon Malone]

Sorry.

[Kim Holderness]

I'm Perry. Perry Menopause.

[Oprah Winfrey]

Her name is Perry Menopause.

[Kim Holderness]

Can you get out of my house? Absolutely not. I'm gonna 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.

[Oprah Winfrey]

What is amazing is how well people responded to it. Cause I guess a lot of guys are like you who are going through it or have been through it with their partners.

[Kim Holderness]

That's you.

[Dr. Sharon Malone]

Yeah.

[Raymond]

Oh, yeah.

[Oprah Winfrey]

Okay.

[Nikki]

So look, 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, 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, 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.

[Oprah Winfrey]

I hear you're dealing with a lot of fatigue too, Kim. Right?

[Kim Holderness]

Oh, my goodness. I think there was a time in my life where I could just go to bed and sleep, 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. And I'm filled with rage. I cannot sleep unless I finally found a doctor who has given me some wonderful medication. The real stuff.

[Nikki]

That's the real stuff.

[Kim Holderness]

But without it, I cannot sleep. And so that means during the day, I'm so tired, and then that just compounds every other symptom. So that has been. That honestly has been my biggest struggle.

[Oprah Winfrey]

Yeah, I know. That was it for me, too. I didn't sleep for two years during the Oprah show, and I thought I was gonna lose my mind. Do you have a question for Dr. Malone, either of you?

[Kim Holderness]

Okay, here's my question. 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. 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?

[Dr. Sharon Malone]

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 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 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.

[Kim Holderness]

Yeah, there is. I have pcos, and my estrogen levels are actually wildly high. And I have 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.

[Dr. Sharon Malone]

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 excited about that 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 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 five, six 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 ways amount there's more of it when you're perimenopausal.

[Oprah Winfrey]

And 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, you know, how do you find a doctor?

[Kim Holderness]

A doctor Malone told me, do that.

[Oprah Winfrey]

Do that.

[Dr. Sharon Malone]

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. 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 gonna take care of the other things. So don't be afraid of using the type of estrogen that is appropriate for what your symptoms are. And once you get to, you know, cross that line in your menopausal, then we can switch it up and go back to menopausal hormone therapy.

[Oprah Winfrey]

Thank you so much for that information. That feels solid. Pen, any advice do you have for men, Penn? Because we keep hearing, guys have no idea how to handle this. Well, okay.

[Nikki]

The. A 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 zero, zero. And I gotta 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. Malone 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.

[Oprah Winfrey]

Yes.

[Nikki]

And the fact that 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 gonna be grateful. And it's great when your wives are grateful.

[Oprah Winfrey]

Thank you so much for joining us. Kim and Pin. 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. Tricia and Layla, tell us what's going on with you guys.

[Dr. Sharon Malone]

Sure. So, hi.

[Fallon]

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 had 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 pounds, and I have no idea how to stop it. I've gone up two sizes and counting. And I feel like I really need to understand all of these symptoms, 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 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. I'm like, I've got to go again. And they're looking at me like, what's wrong with you? And my answer is always, I have not 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.

[Oprah Winfrey]

Okay, the weight. Why the weight gain?

[Dr. Sharon Malone]

You know, that is one of the most common complaints that women come in with when 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 pounds 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 redistributed. And then now it's like, why do I have this belly fat? Why are my boobs bigger? 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.

[Oprah Winfrey]

Level is low certainly increases your irritability.

[Dr. Sharon Malone]

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 gonna 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. It's a 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 really complicated system, but it all goes together. And it happens to women. I would say, nine times out of ten, this is the complaint.

[Oprah Winfrey]

Layla, 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.

[Dr. Sharon Malone]

Yeah, I do.

[Fallon]

So everything that I've learned about menopause has 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 start doing now to make that transition easier when it does come?

[Dr. Sharon Malone]

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 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. 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 I'm gonna let you distinguish between the two. But just understand that your mom has a whole lot less than tolerance for the stuff that you do now than she may have had 10 years ago.

[Oprah Winfrey]

I also think that having the information makes everything so much more palatable. So I hope you have grown Women Talk. If not, we'll send it to you because it is a manual for being able to live well and we'll make sure you get it.

[Fallon]

Thank you, Oprah.

[Oprah Winfrey]

Thank you, Dr. Malone. Thank you, Layla and Trisha, thank you. Thank you for zooming in from school. Thank you.

[Fallon]

Yeah, thanks for having me.

[Oprah Winfrey]

All right, next up in my menopause talk with Dr. Sharon Malone. We're going into the bedroom. Yes, we'll talk to a couple about how to navigate sex after 50. Stay tuned.

[Penn Holderness]

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[Oprah Winfrey]

We'll be right back. I welcome you back to the Oprah podcast and more of my conversation about how to navigate the most frustrating symptoms of menopause. I'm with renowned menopause expert, Dr. Sharon Malone. Nikki 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.

[Dr. Sharon Malone]

Hi.

[Oprah Winfrey]

Thank you so much for having us.

[Raymond]

We appreciate it.

[Oprah Winfrey]

Excited. 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, it's just non existent. And so my question is about, is there a magic potion, are there drugs, are there herbs, what pills? And I've learned so much today in this conversation. So now I know what to ask my doctor. And I am using the estradiol cream and just wondering, is there something more I should be taking, asking for to help me with these symptoms?

[Dr. Sharon Malone]

I'm gonna say this, and this will surprise no one. I don't know how you are, but I know how I am. But I can tell you from personal experience that sex is 6 at 60 is not sex at 25. It's different. And you just accept that different does not mean worse. Now, I didn't say this. 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 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 are 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 vaginal estradiol. And the estrogen in the vaginal estrogen is so low, it doesn't get absorbed systemically such that 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. 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 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, it's still not where I want.

[Oprah Winfrey]

Pain, discomfort, dryness.

[Dr. Sharon Malone]

Dry.

[Kim Holderness]

Yes, yes.

[Dr. Sharon Malone]

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.

[Oprah Winfrey]

Hypoactive sexual disorder means I'm not just.

[Dr. Sharon Malone]

Low libido, 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 and 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 gonna say this to you, husband, remember when you used to date your wife when you before you, you know.

[Oprah Winfrey]

Raymond, remember those days? Yes.

[Dr. Sharon Malone]

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 is 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 Omazing, 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, you know, you realize it's. Yeah, it's gonna require some potions.

[Oprah Winfrey]

It's called O bazing. I should have branded that.

[Dr. Sharon Malone]

Omazing. Exactly.

[Oprah Winfrey]

I should have branded that.

[Dr. Sharon Malone]

You know what? You're absolutely right. You can be our spokesperson.

[Oprah Winfrey]

Omazing. How does all this sound to you, Raymond?

[Raymond]

It sounds great. It sounds wonderful that 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 wives, with our wives and our partners.

[Oprah Winfrey]

That's why we keep saying it, you know.

[Raymond]

Her lack of interest, I felt, was my fault. I thought I wasn't doing enough. I thought I wasn't being there, or I thought she didn't love me anymore. 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 once told me that the room that we were our bedroom was painted a chocolate brown. And she said, oh, the rooms. 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 took care of things. I was like, oh, no. If that's the problem, then let me go ahead and solve the problem. Once we began to realize what was happening and that this had nothing to do with me or with her, 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 how she was feeling, what we were going through.

[Oprah Winfrey]

I heard you shifted your own expectations about sex too, Raymond.

[Raymond]

Absolutely, 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.

[Oprah Winfrey]

That's great.

[Raymond]

It became a better. A better experience for both of us.

[Dr. Sharon Malone]

Right.

[Raymond]

Because communication for Dr. Maloney is grown Talk for Women. Recommended reading for men or should we have a Grown Talk about Women for Men book coming out? And what more can we do to begin to understand? 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 menopause.

[Oprah Winfrey]

What do they say? I'm curious.

[Raymond]

I was shocked to see that everybody was very willing to talk about it because no one ever talks about it.

[Oprah Winfrey]

Oh, that's great.

[Raymond]

Men 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 should I be doing? And it was a great conversation. And they even said, 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.

[Oprah Winfrey]

Yeah.

[Raymond]

And we had a great conversation.

[Oprah Winfrey]

I think that's great. That's great, Raymond. That's great to hear. Thank you. Thank you both. I'm going to make sure you get the book. Do you have the book?

[Dr. Sharon Malone]

No.

[Oprah Winfrey]

So thank you. So, okay. We will make sure you get the book. Thank you so much. Thank you. I think I'll send two copies, because 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, weeks ago, who are trying to figure it out for themselves?

[Dr. Sharon Malone]

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, in 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.

[Oprah Winfrey]

And it's all right here in Grown Woman Talk. Thank you all. Thank you again, Dr. Malone. 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.