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Breaking Barriers: Dr. Sharon Malone on Menopause, Health Equity, and Career Changes

Breaking Barriers: Dr. Sharon Malone on Menopause, Health Equity, and Career Changes

Do you ever wish that your conversations about menopause were more open? Well, that is precisely what our latest podcast episode addresses. 

Welcome Dr. Sharon Malone as we dive deep into the pressing issue of menopause. Dr. Sharon Malone is a DC-based OB/GYN and Certified Menopause Practitioner on a mission to empower women to take charge of their health. She is a nationally known expert in women’s health, a New York Times Bestselling author, and the Chief Medical Advisor at Alloy Women’s Health.

Together, we emphasize the critical need for education and awareness among both the community and healthcare providers to better address the needs of women going through menopause.

Dr. Malone and I highlight the importance of seeking specialized care and effectively navigating the healthcare system. They discuss the challenges and limitations posed by the current insurance system, stressing the urgency of innovative solutions, including telehealth, which could democratize access to specialized care and ensure every woman gets the treatment she deserves.

The episode delves into significant findings from the SWAN study, which observed menopausal women over 25 years. Notably, it revealed black women tend to experience menopause earlier with more severe symptoms, such as hot flashes, disrupted sleep, and increased cardiovascular risks. Despite these severe symptoms, there is often a lack of adequate hormone therapy due to a combination of misinformation and the normalization of suffering.

Additionally, Dr. Malone shares her personal journey through menopause, highlighting that it can be a productive and fulfilling phase of life if women take charge of their health and well-being. She also discusses her transition from private practice to her role at Alloy Health, aiming to provide more comprehensive care for menopausal women.

Highlights:

  • The SWAN Study Findings: Learn about the long-term study that observed menopausal women and the insights gained regarding the onset and severity of symptoms. 
  • Navigating Healthcare: Tips on finding the right expertise and efficiently managing healthcare interactions.
  • Telehealth and Innovation: Explore how telehealth can improve access to specialized care for women.
  • Dr. Malone’s Personal Journey: Discover how menopause can be a creative and fulfilling phase of life when women take proactive steps for their health.
  • Aging Gracefully: Emphasize the importance of taking charge of one’s health and leveraging intergenerational conversations for cognitive fitness.

About Dr. Sharon Malone:

Dr. Sharon Malone is a DC -based OB/GYN and Certified Menopause Practitioner on a mission to empower women to take charge of their health.

Dr. Sharon Malone is a nationally known expert in women’s health and the New York Times Bestselling author of Grown Woman Talk

She is the Chief Medical Advisor at Alloy Women’s Health, a telehealth company that focuses on women over 40. Before joining Alloy, Dr. Malone was a partner at one of the oldest and most successful OB/GYN medical practices in Washington, D.C. 

She is board-certified by the American College of Obstetricians and Gynecologists and certified by the North American Menopause Society as a Certified National Menopause Practitioner. Throughout her professional career, she has been active in advocating for reproductive rights, reducing teen pregnancy, and eliminating health care disparities.

Dr. Malone is the youngest of eight children. During World War II, her parents, both of whom were raised in the rural south, moved to Mobile, Alabama, during the migration from farms to cities. She has seen health care from both sides– as a physician and a child of parents who negotiated health care for themselves and their families in the Jim Crow South. 

Despite living next door to two hospitals, preventative health care was never a part of her family’s life. As a result, Dr. Malone’s mother would lose her life to colon cancer, diagnosed too late for treatment. This searing life experience has informed how Dr. Malone has chosen to practice medicine and brought focus to the healthcare issues she has chosen to pursue.

In addition to her interest in women’s health, Dr. Malone is an avid reader, an amateur genealogist, and a lover of music. She is married to former U.S. Attorney General Eric Holder Jr. and lives in Washington, D.C. They are the parents of Maya, Brooke, and Eric III.

Remember, this podcast exists to educate so that you can advocate for yourself. Who else would you like us to interview? Please like, share, and give us a 5-star review on Apple Podcasts!

Get in touch with Dr. Sharon Malone:

Website

Book

Instagram

Twitter

Get in Touch with Dr. Rahman:

Practice

Instagram

Youtube

Transcript

Dr. Sameena Rahman [00:00:01]:

Hey, y'all, it's doctor Samina Rahman, Gyno girl. I'm a board certified gynecologist, a clinical assistant professor of Ob GYN at Northwestern Feinberg School of Medicine, and owner of a private practice for almost a decade that specializes in menopause and sexual medicine. I'm a south asian american muslim woman who is here to empower, educate, and help you advocate for health issues that have been stigmatized, shamed, and perhaps even prevented you from living your best life. I'm better than your best girlfriend and more open than most of your doctors. I'm here to educate so you can advocate. Welcome to Gynel girl presents sex, drugs, and hormones.

Dr. Sameena Rahman [00:00:47]:

Let's go. Today, I'm lucky enough to have doctor Sharon Malone, who most people don't need an introduction for, but she is DC based Ob GYN. As a certified menopause doctor, she is a nationally recognized expert and bestselling author of her book that came out this year, Grown Woman Talk. It's an amazing book. I recommend everybody to utilize and use this book as a resource, and it's fun and it's easy to read. And she actually, in the last few years, has transitioned to non clinical medicine and is a medical advisor, a chief medical advisor for Alloy Women's Health, where she is doing a lot for raising awareness about midlife women and just really changing the narrative. Changing the narrative altogether. She's been a prominent member.

Dr. Sameena Rahman [00:01:39]:

She's part of the menopause, so we love talking about our menopause. Right, Sharon? And she's just wonderful. So I will put all of her credentials in the summary. And so let's just get at it. Thank you so much, Doctor Sharon Malone, for joining me.

Dr. Sharon Malone [00:01:54]:

Well, thank you for having me. You know, this is my favorite topic. So, you know, we.

Dr. Sameena Rahman [00:01:58]:

All day, all day, every day. Well, you know, it turns out, Sharon, I actually, you know, getting to know you a little bit better through sort of the menopause, through, you know, meeting you in different places. I realize in your book, I've realized that you and I have a lot in common, actually. Like, we're both obviously women of color who do ob Gyn. And in the midlife, you started, I think, transitioning to gyne only or when your kids were in middle school. I remember you telling me that you started doing Gyne only. We both grew up in the south. My parents, when they left Pakistan, landed in Mississippi in the sixties.

Dr. Sharon Malone [00:02:29]:

Yeah, I know.

Dr. Sameena Rahman [00:02:30]:

Like, why? But I have a lot of family members who landed in Mobile, Alabama, which I know that's you know, where your family came from as well.

Dr. Sharon Malone [00:02:39]:

See, I didn't know that you have some mobile roots.

Dr. Sameena Rahman [00:02:42]:

Yeah, I have cousins there, and I have, like, a couple of aunts and uncles that are still there. So, yeah, mobile is not unknown to me. And then, you know, I think just, you know, being outspoken about menopause, I started my practice about ten years ago, and that's when I started learning about menopause, because, you know, you get your first patient in a private practice setting, and you actually have time to talk to them, and you don't know how to treat them because you never learned in residency or med school that that's when I started my journey. So I really want to talk to you a little bit about your journey. We can start with your family history because it's so intriguing, actually, a lot of what, you know, your family went through, and, you know, you have the amazing sister who made a change as well. Vivian. Right. Yeah.

Dr. Sameena Rahman [00:03:28]:

So we just, you know, whatever you want to spill with us today, tell us a little bit about your family history and your journey with menopause. We'll talk about as well.

Dr. Sharon Malone [00:03:37]:

Absolutely. You know, I grew up in Mobile, Alabama. I am the youngest of eight. Eight children. Yes. People had eight children back in that day. But more, I think the part that's more unique about my family, as opposed to just any other family of eight is that the generations that we crossed, you know, when I say I'm the youngest of eight, I'm the youngest of eight by a lot. And I am that proverbial perimenopause baby, I'm sure my mother was really not expecting.

Dr. Sharon Malone [00:04:08]:

She wasn't aiming for an even number of children. I think I just sort of showed up there. So my mother was almost 45 when I was born. And so given the fact, you know, that my mother was quite a bit older, you know, her last baby was seven years before I was born. I have seen the entire generation. So there is a generation difference between me and my oldest brother, who's 23 years older than me. So my parents were two generations and three generations beyond. So, you know, having that experience all in one household is really what motivated me, really, to write this book.

Dr. Sharon Malone [00:04:47]:

Because if you wanted to see sort of a microcosm of what has happened in the south writ large, you don't need to go any farther than to just look at my family. So, you know, how we access care and, you know, the southern way is very different. You know, the generational changes are very different in terms of how we access care. But that's really, I think, what motivated me, because I lost my mother when I was very young. And, you know, and even as a child, I sort of looked at that and I said, I'm not even sure that this is how this had to go. But the other thing that I was going to say is that, you know, not only am I the youngest of eight children, I'm the last of five girls. So my older sister Vivian, who you alluded to, she integrated the University of Alabama in 1963. So she was 17 years older than me.

Dr. Sharon Malone [00:05:39]:

And the point of this whole conversation about what happens generationally, how much do we talk to each other? And the question really comes up, do we talk about menopause? Do we talk about any of these things as we enter midlife? And the answer to that is, no, we don't. So I didn't have my mother to talk to. But the one thing that I'm pretty certain about is that even if she were alive, it still wouldn't have been a conversation that we had because I didn't have this conversation with my sisters, and they went through menopause well before me. And, you know, it just speaks to how little we talk to each other, either within families or even amongst our friend groups about what we're going through in this transition.

Dr. Sameena Rahman [00:06:22]:

Right? And I know some of that is obviously just generational. Some of that is cultural. Like, I mean, I always say I have, like, a twofold negativity towards sex because I grew up in the south where we didn't get sex education. And then on top of that, I'm attracted of immigrants who didn't talk to me about, you know, any of that or menses or no menses or what happens during that transition. And so, you know, it was a lot of self teaching. And I think, you know, you could speak to the same probably culturally as well as generationally that you didn't get it. Even, you know, if they were available.

Dr. Sharon Malone [00:06:56]:

We didn't get it. And it was the kind of, you know, menopause, anything related to women. And I say when I have a chapter in my book called Female Troubles because it used to just fall under this whole rubric, and that was everything that was fibroids and bleeding and probably perimenopause and all of these things that just got wrapped into one. And it was just like one big amorphous category, but they were things that were significantly associated with shame, you know? And one of the reasons we didn't talk about it is that not only did we not have that intergenerational knowledge. But we were raised to be embarrassed about things, about our periods, about sex, about anything that sort of uniquely identified you as female was something that we had to hide and really sort of, you know, you know how you had to hide your little menstrual products, you know, when getting your period, you're like, oh, my God, please don't let someone see what I'm going to the bathroom for and think about how crazy that is, you know?

Dr. Sameena Rahman [00:07:59]:

Right. Yeah. Like, I mean, and it's so funny because, like, even using. Well, we talk about this a lot without using anatomical terms that are, you know, of their reproductive or genitalia. Like, it's so still censored, you know, it's still to this day, like, nobody can say vagina or vulva without the world stopping and saying, why are you using those words in front of me? I know it's really ridiculous, actually. And I think the narrative is changing, but, you know, maybe not fast enough for a lot of us. But I find that, like, when we had so much sex shaming or, you know, shaming around mentor cities, like, even, like, you know, I'm muslim. And so, you know, we don't fast when we have periods or you don't pray.

Dr. Sameena Rahman [00:08:36]:

And so it's even. Even to that extent where you're. You can't even go to the prayers or to the fast, and you have to hide it. Some people like fake fasts. They do. Oh, I'm going to fake fast in front of people so they don't know I have my period. And you're like, why?

Dr. Sharon Malone [00:08:50]:

I mean, isn't that crazy? But it's like, you. This is, you know, again, not just specific to any one particular religious group. It's all over. I mean, the fact that, you know, jewish women would have to go through a mikvah, you have to have a ritual cleansing, because the assumption always is that whatever we were, it was dirty.

Dr. Sameena Rahman [00:09:09]:

Dirty.

Dr. Sharon Malone [00:09:10]:

You know, we were dirty. And we could only rejoin polite society when we had been properly cleansed and deodorized and to make sure. And, you know, I'm hopeful because, you know, I have daughters. I have. My daughters are 31 and 28, and I don't think that they don't really carry the same stigma, you know, and that's because we didn't talk about it in that way in our household, you know? And are we there? Totally? No, we're not there, but we're way better than we were, say, in my generation. So we're making progress.

Dr. Sameena Rahman [00:09:47]:

Yeah. I mean, you know, that's the whole evolution of, like, the female hygiene industry, right, is around this, like, sense of dirtiness or uncleanliness or, you know, smelly vaginal areas that you have to make smell like pineapples and it's become a multi million dollar or maybe even billion dollar.

Dr. Sharon Malone [00:10:04]:

Well, think about that. Even that you call menstrual products hygiene products. You know, like, yeah, I have, I don't know if you've had a chance to meet Jen Weiswolf.

Dr. Sameena Rahman [00:10:16]:

She is not in person, but I know of her.

Dr. Sharon Malone [00:10:19]:

You know of her. So she, her first book, and this is sort of when I met her, she has a book that's about, that actually is about the politics of periods. So imagine that. And she talked about things that you never really would have considered. Like the fact that menstrual products, there is like a, that they're taxed, that poor women who can use their, you know, they can't use their benefits, their, their cards for menstrual products. I mean, think about, so what are you supposed to do, you know, where that women in prisons don't routinely or they get rationed menstrual products. What if your period is heavier or more days, right. And you have to use your money to go do this? And so she has sort of shone a light on this whole, that whole aspect that I hadn't really thought about.

Dr. Sharon Malone [00:11:12]:

You know, like, why do they cost so much? Right. And how much does that influence women that have really, really heavy periods? I mean, that's, that's, you know, I call it, you know, the uterus tax. Just what we have to pay for being women and the stuff that we have, you know, and, you know, and there has been a little bit of a shift. And I know if you go to places now, it's not unheard of to be in public spaces where there are menstrual products in the bathroom, because when you think about it, why you don't have to pay for soap or toilet paper if you go to the bathroom.

Dr. Sameena Rahman [00:11:47]:

It's very true, actually.

Dr. Sharon Malone [00:11:48]:

You know, so for like a quarter.

Dr. Sameena Rahman [00:11:50]:

In or something like that.

Dr. Sharon Malone [00:11:51]:

Yeah. You just have to pay, you know, you don't have any change, all that stuff. So, you know, we are as we, as we normalize these conversations, and that's what we're really trying to do and move forward about menopause is to get women to really understand that this is not only is it normal, you know, you don't get to opt out of menopause. We are all going to end up on that road if we are lucky enough to live long enough, we will be there. And why we entered this space with so little information is pretty, you know, you think about it, it's like, why, you know, haven't we talked about it until now in the public sphere? We talk about it amongst ourselves.

Dr. Sameena Rahman [00:12:33]:

I am. I did a little dinner, of all the menopause, he's all over. I did a little dinner last night with Liberty Road, which I think you're going to be doing in Los Angeles. That was the whole sort of, you know, agenda when she, when Nada Jones started. It was really like this middle third of your life. You know, what can you do to change? How are you transitioning? Like, what's happening? How are you pivoting? Like, how can you empower yourself? You know, your kids are out of the house. What's next for you? You just, you know, we're not going out to pasture anymore. Like, you know, and so, and so it was a great discussion, and I think, you know, the women are just thirsty for the information.

Dr. Sameena Rahman [00:13:10]:

And I think that's why, like, books like yours and Doctor Mary Claire Haver just are selling out like crazy because women want the right information that, you know, social media has changed our lives in so many good ways as well as bad ways, I think. But, you know, one of the big ways is that everyone's talking about it, and you don't know what's the right information. Right.

Dr. Sharon Malone [00:13:29]:

I was gonna say, you know what I think, and this is something that I think that we have really gotta take some, which has it we'll take a little credit for, because I think that we have elevated the conversation, but I think, too, Samina, that we overestimate how much people are talking about it. You know, for people who come after us and then saying, oh, my goodness, you were over prescribing. It's like, no, we're not. You know, there is still, you know, this is just a sliver of the women who still have to get this information, and it transcends race, it transcends socioeconomic groups. I mean, like, generally, we are, we are making a dent. So yay on that. But there are way more women out there who still don't have the information that they need about how to navigate this phase of their life. So we've, you know, we got a lot of work to do.

Dr. Sharon Malone [00:14:22]:

Again, we were way ahead of where we were five years ago. I'll put that.

Dr. Sameena Rahman [00:14:26]:

Absolutely. And what's interesting is, like, you're right, we're making a dent. And I think because we're in this circle where we're always talking about menopause. So we think that everyone's talking about it, right? But the real is, I get DM's from, like, you know, people in, like, India, Pakistan, Turkey, whatever. And they're like, we can't even get hormones here. Like, you know, we don't even have availability. I don't even know how to get it. Can you send me hormones? Like, so we're probably doing better than some, but not enough for the worldwide woman population.

Dr. Sharon Malone [00:14:53]:

But, you know, and this is where being, you know, I'm in. I'm in the old part of the menopause, you know, so I'm the generation before you guys. And, and that's what I was telling. There was a time when there was a different conversation about hormones, you know, because when I started, I, you know, I trained in the, you know, I went to med school in the early eighties. So there was, we were talking about hormones, and we were talking about hormones positively. That was really what I was taught in residency. We were, you know, just getting to that phase where we had sorted out the okay, don't give estrogen by itself phase. We knew, don't do that.

Dr. Sharon Malone [00:15:33]:

Okay, oops. But we figured that out. But we also had gotten to the point where we had enough data and clinical experience behind us because, you know, I think for a lot of your listeners who think that hormone, we're talking about something new. Hormones have been around since 1942, and women have been complaining about menopause forever and have tried various and sundry crazy things, you know, to, to, because they have been complaining. So it's not, our complaints aren't new. And our solution, which is hormones, is not new. So we had had, by the time I came along, we had had enough clinical experience to say, wow, women who are on hormones do better. You know, they had better outcomes.

Dr. Sharon Malone [00:16:22]:

They, you know, they felt better. They looked better. They had, you know, sexual function was improved, and it was really the cardiovascular disease, the improvement in cardiovascular outcomes, that really was the driver when I started practice of why we were really actively recommending that women take hormones. So there was that. And that didn't really change until the Women's Health Initiative in 2002. We went from saying, hey, hormones, they're here. They're a great idea, and they work great for this, you know, for symptoms, which is really what most women were taking them for anyway. And that was, that's what we are trying to recover from is this 22 year period where women have been told that, you know, they don't help you hard.

Dr. Sharon Malone [00:17:16]:

They're going to give you breast cancer. And that's a hard and very deep hole to dig out of. But we're, we're getting there.

Dr. Sameena Rahman [00:17:23]:

We're trying to. Yeah, I interviewed Doctor Jim Simon last week and we talked about, you know, his whole spiel that he had had, that the government and the media conspired against women to, you know, really take hormones off the shelf and have them flush it all down the toilet, which if, you know, he's not, he's like, I'm not a conspiracy theorist, but this really happened. Like, this is the whole reason that women stopped using it. And that's exactly it. Like, you know, he would show media, media. I remember watching his lecture at issue one year, and it was, he showed all the media that came out like this information like this is going to increase your risk of breast cancer and watch out. Like, so everyone stopped doing it. And even though, and we can talk about this, even though the data now does not suggest that there is an increased risk, in fact, a decreased risk for estrogen alone, people are still living like they're in the 19, I mean, the 2000, too.

Dr. Sharon Malone [00:18:16]:

Right, right. But you know what the danger is? I mean, here's the good news and the bad news about social media. You know, the good news is that, again, you know, we have sort of democratized access to information. We've also democratized access to bad information. You know, and women are often trying, caught in the middle, trying to navigate and negotiate. Okay, well, one person said this, another person said that, you know, and, and who's going to be the arbiter of what's real and what's not. We are also the, I mean, imagine, okay, so, you know, let's go back in the way back time machine to 2002. And, you know, we had no social media.

Dr. Sharon Malone [00:18:57]:

And look at how sticky that information was when all we had were newspapers. Newspapers. And you saw it on tv, you know, and it was a blip, but it so saturated people's minds. So now, again, come forward to today and imagine how quickly bad information can disseminate in today's world. And you've got more outlets. You've got, you know, you don't just have ABC, NBC and CB's like we did. You know, back then. You have everybody who has access to, you know, a computer and, you know, a keyboard can write whatever they like.

Dr. Sharon Malone [00:19:41]:

They can say whatever they like. And a lot of the, these conversations about navigating medical findings, we did that internally.

Dr. Sameena Rahman [00:19:52]:

Right.

Dr. Sharon Malone [00:19:52]:

You know what I mean? Someone would write a paper, you know, and you look at it, and it will be peer reviewed, and someone would decide, okay, well, it's worth, you know, printing and we read it. But the reality is, is that that never got out into the general public until it was, you know, it had to be discussed and arbitrated within the medical community. All right, you found that. Well, let's do another study. You know, what's the body of evidence that says before we changed, we weren't just switching, you know, every time somebody printed a paper and you was like, oh, my God. Well, didn't do this and don't do that because, you know, you're going to have different findings. That, to me, is the danger about the time that we're living in now is that not every study is worth mentioning.

Dr. Sameena Rahman [00:20:38]:

Right. Not every have a study like whi. Again. I mean, never.

Dr. Sharon Malone [00:20:43]:

Yeah, we'll never have that. Yeah, but, but here's. And I read something very recently, and I think, I don't know what journal it might, I don't know. It was JAMA or it might have been in menopause. But the point is, is that for a lot of the questions that we have now about interventions, medicines, procedures, or whatever, you're never going to be able to do a randomized, double blind, placebo control study. It just is not feasible to do that. So we're going to have to figure out better ways and to be in a world where we say that's the only standard by which we can judge things, which is why we still continue to talk about the women's health initiative. Observational studies are going to be what we've got.

Dr. Sharon Malone [00:21:28]:

And a well designed observational study will be fine for, you know, for answering some of the questions. So we can't get hung up in, you know, the weeds about how the study was done. And to be honest with you, and I'm, you know, I'm one of those people that I talk about the women's health initiative and disservice that it did all, you know, all the time. But I don't really have a problem with how the study was constructed.

Dr. Sameena Rahman [00:21:55]:

Right.

Dr. Sharon Malone [00:21:56]:

It was how it was interpreted, but it answered. It was asking and answering the wrong questions. And the things that they answered were generalized way too far. If you had just said, take the same thing, it says four women who are 63, who don't have symptoms, who are overweight, who are hypertensive and have other health. But perhaps this was not, this would not be the case.

Dr. Sameena Rahman [00:22:16]:

Right, right.

Dr. Sharon Malone [00:22:17]:

But that's not our study population. And that's the problem, I think, with it. And so, you know, we've got a. You know, I think people like Jim Simon, and I know. I know Jim Simon quite well because I'm here in DC and he's. He's part of our. The people who are GW alums. And, you know, and, yeah, he's been talking about this.

Dr. Sharon Malone [00:22:38]:

And to be quite honest with you, I've been talking about this one on one with my patients. And then there are people out there, you know, like Aubrey blooming. They've been having these internal discussions forever, since 2002, since the moment the study came out. And it never made it out of these. Just a Nams meeting. Like, okay, well, I said this, and, you know, so, yes, so here's the good news about social media, you know, is that now we have an opportunity to take that information from people who know and were there and saw it in real time, and you can now put it out there for people to see.

Dr. Sameena Rahman [00:23:20]:

Yeah, I actually, because I was an intern when the whi came out, and it was, you know, we did a journal club on it. And I remember at the end of the journal club, we're all like, well, it's not really that statistic. I mean, it's slight statistical significance. But what's the big. Why are they making such a promotion about it?

Dr. Sharon Malone [00:23:34]:

Right?

Dr. Sameena Rahman [00:23:34]:

And I remember thinking that the whole time, and, you know, we didn't get much menopause work beyond a couple of patients here and there. But I just remember saying, like, you know, that was our conclusion at the end of the journal club. Like, why are they making.

Dr. Sharon Malone [00:23:45]:

It wasn't that bad. You know, when I finally got the journal. The problem is, you know, when you talk about pre Internet era, when they have a press conference, we had to wait. It was literally two weeks before you could even read the article.

Dr. Sameena Rahman [00:23:59]:

Exactly. Exactly.

Dr. Sharon Malone [00:24:02]:

Okay. You know, nations are calling and they're all mad. Why did you give me this? I don't know. I don't know what it said. What did it say? I've got to read the New York Times to try to figure out. But that's someone else's spin on the study. When you actually read the study, it was never how it was presented, you know?

Dr. Sameena Rahman [00:24:20]:

What do you think? I mean, I think we all have our theories around patriarchy, but it's like, they make such a deal about horrible. We give patients so many medications all the freaking time. I had a patient who was on like, a nifedipine recently, and I had started her on a patch. And, you know, they were like, oh, she got swelling. And, like, no, it's probably from the nifedipine. Like, she had these big tree trunk legs, but having. After having started it. But, you know, let's.

Dr. Sameena Rahman [00:24:44]:

Let's take the. Take her off the patch, you know, in case. And I was like, I don't think it's the patch, guys. Like, let's. You know, and then she adjusted her nifedipine dose, and her swelling was, you know, and it was just interesting. Like, we don't care as much about those side effects or we don't make, you know, world news about it, you know?

Dr. Sharon Malone [00:25:00]:

You know, I have. I have. I have a theory, and my theory is this, that we in the medical profession and that we as women generally, we have just made peace and accepted women's suffering. It's just like, what we do. Okay, well, yeah, well. Oh, it only makes you feel better. Well, then why would you do that? You know, like, like, there is no amount of risk, however small, that it's acceptable.

Dr. Sameena Rahman [00:25:26]:

Yeah.

Dr. Sharon Malone [00:25:27]:

Even if it improves the quality of your life. And that's. No, it's not okay. I think that that is part of why we don't access, because we just. We've come. We become so comfortable with suffering, you know, and it starts with our cramps, you know, as, as young girls, and it just kind of goes through our entire reproductive lives that by the time we get to menopause and there's more suffering, we're just like, oh, yeah, well, I guess that's what we do. Women suffer. And I think that.

Dr. Sharon Malone [00:26:00]:

That doctors are not as attuned to women's suffering as well, which is why, you know, there's the minimizing piece of it about, you know, even when we complain not just of menopausal things, but anything you're likely to be, you know, brushed off or people saying things like, oh, my goodness, it's all in your head, or there you go complaining again, you know?

Dr. Sameena Rahman [00:26:28]:

Yeah.

Dr. Sharon Malone [00:26:28]:

So it's a lot.

Dr. Sameena Rahman [00:26:29]:

Yeah. Yep.

Dr. Sharon Malone [00:26:30]:

But I think that we also. But, you know, there. There's a lot of societal stuff here. There is also the part about not being comfortable of addressing women's sexual issues. We. We have no problems doing that for men. But when it comes to women sex, one, we don't even ask about them for the most part, you know, and.

Dr. Sameena Rahman [00:26:53]:

You don't learn about it.

Dr. Sharon Malone [00:26:54]:

You didn't learn about it. And what I always say, you know, the reason why doctors don't like to ask questions, we don't like to ask questions that we don't know the answer to. So if you don't know how to do it, you're just like, okay, well, if you don't bring it up, I'm not brain, because so many doctors are just not really training, trained or prepared. And, you know, and I will say this, as you know, this is gyno girl, and as your moniker, and most Ob gyns are not, you know, we're the logical go to people.

Dr. Sameena Rahman [00:27:29]:

Right.

Dr. Sharon Malone [00:27:29]:

But, you know, I say this a lot in. I say in defense of my Ob gyn colleagues, because I was one for a lot of years, and we're asked to do a lot of things, you know, for, you know, to. I don't think there's another field of medicine that has the breadth of things that we care for because for our young patients, a lot of death situations, right?

Dr. Sameena Rahman [00:27:56]:

Yeah, a lot of life and death situations.

Dr. Sharon Malone [00:27:57]:

And we're doing surgery, and we're doing primary care, and we're, you know, we are counseling. We are. If you're between the ages of 20, and I'd say 40, we are serving as your primary care doctor. Yeah, absolutely. We are doing all those things because they don't see anybody, but usually in those years. So I say it's a lot. So I get it. And I know how hard it is to, you know, and the time constraints that we have in the course of a day.

Dr. Sharon Malone [00:28:25]:

So, yeah, I get it. And it's.

Dr. Sameena Rahman [00:28:27]:

It's.

Dr. Sharon Malone [00:28:27]:

It's an explanation, not an excuse.

Dr. Sameena Rahman [00:28:30]:

Exactly. That's what I tell people. I mean, like, I. Before I started my own practice, I was in academic medicine, where I had to see 35 patients a day. And if a patient brought up sexual concerns or pelvic pain, you know, you're always like. And I feel so bad about those times that I did that.

Dr. Sharon Malone [00:28:47]:

Yeah.

Dr. Sameena Rahman [00:28:47]:

And it was literally. And the reason I got into this was, it was literally my first week of my practice being open that I had a patient with sexual pain. And my second, my second or third was genital urinary syndrome or menopause. And I was like, I gotta learn how to treat these patients. And, you know, when you start a practice, you have, like, three or four the first day or whatever, and you spend, like, an hour with them, and you're like, oh, yeah, well, I'm gonna help you figure this out.

Dr. Sharon Malone [00:29:08]:

Well, you know, because menopause, perimenopause, pelvic pain, sexual dysfunction, these are not one and done.

Dr. Sameena Rahman [00:29:15]:

No.

Dr. Sharon Malone [00:29:16]:

You know, it takes time. You know, you've got to establish trust. I've got it. You know what? You may try something the first time that that may not work, come back. You're going to have to figure it out. And that's where I think it's unfortunate in today's environment where you're not rewarded for that. You know, when I say rewarded as a physician, you know, I mean, physicians are out here trying to, you know, make a living like everybody else, and you are. There's no compensation structure.

Dr. Sameena Rahman [00:29:46]:

Exactly.

Dr. Sharon Malone [00:29:47]:

That allows a really good doctor who takes the time and spends it with their patient to have that. Isn't it something that, that's not worth? That's not worth. I can go take out an organ or, you know, or give you a knee surgery, and somehow when in this world of how we value women's health, that's part of it, too. We don't. We don't value it.

Dr. Sameena Rahman [00:30:11]:

Absolutely. I mean, that was my whole, when I started my practice, I had taken insurance, and I've dropped a couple in the last few years, but I don't want to lose insurance altogether because I don't want to be inaccessible to patients. But I recognize that every time I see a patient and I spend, you know, 45 minutes to an hour with them, I'm getting not even a 10th of what I should. But we all have overhead, so we have to find ways to kind of read it. Like the government's not supplying my overhead.

Dr. Sharon Malone [00:30:36]:

Well, see, this is where I think, you know, I mean, here's the good news and the bad news, and they're always, when I give you some bad news, I usually like to follow it up with some good news. So the good news is that we are training a new generation of doctors, no more, and are able to deal with these. The bad news is that the bulk of these are really ob gyns, you know? And the bad news is that, again, when we start making this transition to saying we're going to do the hard things, you know, it almost necessitates that you come out of insurance world because we know it doesn't pay, but it just narrows the bottleneck even further for other women.

Dr. Sameena Rahman [00:31:23]:

Right. So accessible to people that need you. Right.

Dr. Sharon Malone [00:31:27]:

And so. But not only that, but you're narrow. I mean, there are a lot of things that go into this mix, you know, just in terms of what's happening politically, what's happening with access to, you know, abortion care. All this is going to influence who goes into this field and where they go geographically to practice. That's going to be real and we have to deal with that. And this is where I think that it's important to do things like have telehealth. And that's why when I left my practice, I realized, I said, you know what? I'm leaving. Because, you know, there one, I've had enough.

Dr. Sharon Malone [00:32:03]:

You know, 30 years is enough. But it was also not just the time. It was the frustration level of dealing, you know, in today's, you know, complicated, byzantine world of healthcare. But I realized, I said, you know, I'm not done. I know a lot. I've got a lot of things that I still can say and I want to share with people. And this is where telehealth is important because it's going to allow doctors to access more patients, you know, to, their patients are going to be able to access care. Because what if you can? Don't have a.

Dr. Sharon Malone [00:32:46]:

You don't have an ob gyn in your area or you don't have someone who knows how to treat menopause or perimenopause. And it's not just in rural Alabama. These are people who have access problems who live in Washington, DC and New.

Dr. Sameena Rahman [00:32:59]:

York City suburbs of Chicago.

Dr. Sharon Malone [00:33:01]:

Yeah, yeah, they can't, you know, and they've got insurance and they've got places and, or they find a doctor and the wait is six, eight months, you know, I mean, yeah, that's a problem.

Dr. Sameena Rahman [00:33:12]:

About your transition to Milo. I love my aloe. I think it's a great platform. You know, I'm on a lot of these OBGYN groups, and people get so anxious when they feel like, oh, here's a direct to consumer marketing. I'm a medical advisor for Evie, which is like a, you know, vaginal microbiome platform where you can access that as well as. And whenever one time these platforms come up for perimenopause and menopause, you know, a lot of them freak out. And I'm like, no, guys, like, there's a big need and you guys can't fill it. And it's kind of like when I started my practice ten years ago and I reached out to people to see how they could help me start it, and nobody would.

Dr. Sameena Rahman [00:33:45]:

I was like, I need like ten vulvas a day to probably make me happy. There's like 2 million here, guys. Like, let's. Yeah, you know, but see, that's the.

Dr. Sharon Malone [00:33:52]:

Thing, you know, we have to have the ability to think outside the box, you know what I mean? And that traditional get up, go to the doctor, spent, take a day off from work all that kind of thing. There are always going to be something. We need doctors. There are going to be things where you're going to have to go in, okay? But for a lot of the things that we are clogging up the system like perimenopause and menopausal care, if you're able to find someone, this works beautifully for this environment because, you know, most of it's talking, most of it's education, most of it is just, you know, being able to have the convenience. What about people who don't have insurance where it's cost prohibitive? You can't even go see a doctor anyway we want. We were trying to democratize this process, but this is also where I think it's important for when I say consumer, you know, beware. I joined alloy very, very early on. You know, it was Ann and Monica and me, basically.

Dr. Sharon Malone [00:34:57]:

And, you know, you have to have a trusted source. And, you know, and being at this point in my career, and when I was basically, I stopped practicing, not because I was joining alloy, I stopped practicing because I was done. And to have the ability to say, I want to be a part of something, but I want to make sure that the information that people have access to is science based. You know, it's not me. You don't have to take my opinion for it. You know, we are using the same protocols that I would have used if I were in my office. And so that's where you have to establish some trust and to know that there are people out there and there are people that are going to try to sell you trash. Yeah, it's out there.

Dr. Sharon Malone [00:35:47]:

You know, this is America having a.

Dr. Sameena Rahman [00:35:49]:

Moment, meaning that everyone wants to monetize.

Dr. Sharon Malone [00:35:51]:

Everybody's out there. But I want people to understand that I do this because I genuinely care. And I think most of us who are out here in part of the menopause and menopause world are out here because we are really trying to do right by women. Yeah. You know, not necessarily. Now, can you do good and do well? Yes, I hope so. You know, but that is where I think that, you know, you're going to have to be. You know, we're asking women to be a little bit discerning and just ask yourself, does this make sense? Does this person have the credentials? Do they have, you know, do they, is there some.

Dr. Sharon Malone [00:36:30]:

Do they, is there actually data behind what they're saying? And if you can do that, then I think that we as women, we're capable of being able to evaluate and.

Dr. Sameena Rahman [00:36:39]:

Make choices, you know, right exactly. I agree with you. I mean, we're talking about social media and all the noise and, like, everyone's popping up with supplements and, you know, their own, you know, gummies or whatever, you know, to help people with their symptoms. I think your book, you do a good job of, like, kind of delineating how to find a trusted source.

Dr. Sharon Malone [00:37:00]:

Right.

Dr. Sameena Rahman [00:37:00]:

If you want to review a little bit of that for the listeners, because I think it, it's really helpful to know, like, okay, if someone has 2 million followers on Instagram, but, you know, they're, you know, a wellness expert or coach, you know, are they the right people to go to just because they have age fault?

Dr. Sharon Malone [00:37:16]:

Right. Well, you know, it, when I wrote my book and I was trying to decide, I started this because, you know, if you had asked me five years ago what would I be doing today, I would have said none of this. It wasn't even in the picture. Right.

Dr. Sameena Rahman [00:37:30]:

But isn't that wonderful, like, how we, it is.

Dr. Sharon Malone [00:37:34]:

That's the other thing I want to tell women about, you know, perimenopause and menopause and being in this part of life. You know, I don't mind. I'm 65 years old. I'm 65 years old. I've had a great career. I've raised my kids, you know, but do I feel as if I'm done? No. I mean, I think this has been, like, a really creative, wonderful time of my life. And for those of you who have little children in the house, you know that a lot of times there's not the space for, to do some of the things that you might want to do.

Dr. Sharon Malone [00:38:06]:

You may not be able to do it just economically. There are a lot of factors about, you know, when you're 40 something or 30 something that will, you have to make different choices. I certainly did when I was that age, you know, but that's why I said it's so important to, when you get, finally get to this point in life and you're menopausal and you are in what I, the, the final quarter of your life or third or however long it's going to be to be able to say, wouldn't it be just a tragedy to, like, finally get the freedom and the creative energy to do what you want to do and your, your health is a problem, you know, or you've got brain fog or you don't feel well or you chronically fatigued, all of those things that get in the way, you being productive. And that's why I want to tell women, like, no, I will. Yeah. We talk about all the signs and symptoms of menopause that you can have, not that you should have.

Dr. Sameena Rahman [00:39:10]:

Yeah.

Dr. Sharon Malone [00:39:10]:

Because if you have them, you need to go get that fixed, girl. I tell people, why are you see.

Dr. Sameena Rahman [00:39:17]:

People, like, hot flashing in front of me? I'm like, come on, let's fix this. Why are you suffering?

Dr. Sharon Malone [00:39:22]:

Have something for that. You know, so, you know, so if.

Dr. Sameena Rahman [00:39:27]:

You don't, you know, like, it can, you know.

Dr. Sharon Malone [00:39:29]:

Yeah, I mean, you know how we function. So I spend a lot of time in my book and I talk about, and I, and there is, there are two chapters. There's perimenopause and menopause chapters in my book, but, but I talk about all of it. And a big message is prevention. And a big message is, what are the things you can start doing early? You know, how can you take charge of your health and your well being? Because you get to decide how you age, you know, and how you need to feel. And I think that that's where we're trying to turn that narrative around about people just have the expectation that that's just what happens to you when you're old. You get old, you get sick, you get sedentary. No, you don't.

Dr. Sharon Malone [00:40:15]:

No, you don't.

Dr. Sameena Rahman [00:40:16]:

You don't have to. At all.

Dr. Sharon Malone [00:40:17]:

No, you don't have to.

Dr. Sameena Rahman [00:40:18]:

I love what you say because you said, you're your own, you're your best caregiver, right? Like your primary care person, doctor is not, you have to take ownership of your own health. No one else is going to do it for you.

Dr. Sharon Malone [00:40:28]:

That's exactly right. And it's never been truer than in today's world. And it's, you know, healthcare is less personal now than it was 30 years ago, and it will always be so we can't belly ache and lament about, oh, back in the old days. Okay, well, the old days are the old days, and we're on to something else now. So, you know, but I think it gives us all an opportunity to take charge of our healthcare because, you know, chances are you're going to be with someone who does not know you, right. You know, you may. And so if they don't know you, what's the common denominator in all of these interactions? You. So you've got to figure out how to bring that forward and how to be efficient when you do interact.

Dr. Sharon Malone [00:41:14]:

So I start with all of that, and believe it or not, I go there. I start from, how do you pick a doctor to, you know, how to write your obituary? You know, like, all of it or I don't influence you have there. Oh, I. You know, when you're talking about heavy things and we talk about heart disease and obesity and Alzheimer's and, yeah, menopause and everything in between, and I think you have to lighten it up a little bit. And I'm not a heavy. You know, I'm not a heavy person, you know, and a doctor who's finger wagging. I really wrote the book from the perspective that, you know what? I'm a sister, I'm a friend, I'm a daughter, and I spend a lot of time navigating healthcare for my friends and family. And these are the things that I think they should know, that they don't know just how to navigate the system.

Dr. Sharon Malone [00:42:07]:

But I also wanted to write it in a way that was understandable, yet not condescending. And I also wanted to write it in a way such that it wasn't dictatorial.

Dr. Sameena Rahman [00:42:16]:

Right. You know, I love your little stories about patients in the middle you weave and all these stories that are very helpful, I think, as well. I want to talk also a little bit. I mean, do you mind telling your journey into menopause, like, what did you end up worn for yourself?

Dr. Sharon Malone [00:42:28]:

Well, you know what? Here's what. You get the advantage of having done this for many, many years before I actually went through menopause, because when I started in my current. The practice that I was in, the practice had been in existence for 30 years before I got there. So I immediately inherited patients. I had 18 year olds and 80 year olds on day one. So I had these women. These little women had been on hormones since the sixties, and they were there, and. And I would sit there and I was like, oh, my God, there's, you know, I've got all these ladies.

Dr. Sharon Malone [00:43:07]:

And so I had the luxury of knowing, okay, I saw what it looks, what women look like who'd been on for hormones, and they were like, over my dead body. No. Hell, no. You're not taking my hormones. Right?

Dr. Sameena Rahman [00:43:21]:

Yeah.

Dr. Sharon Malone [00:43:21]:

So I was like, okay, well, they're good. So. And then that went through that whole evolution of thoughts. So by the time I got to perimenopause, I had been practicing for 15 years at that point. So I'm one of those people that you don't have to tell me twice, okay? I feel the same way. Like, you know, when you deliver babies and you go in there and after you've delivered a few. You know, I delivered babies for five or six years before I had one for myself.

Dr. Sameena Rahman [00:43:47]:

Yeah.

Dr. Sharon Malone [00:43:48]:

And I said, well, that certainly looks painful. Yeah. Epidural, please. I need it, and I need it right now. I'm like, you know.

Dr. Sameena Rahman [00:43:57]:

Yeah.

Dr. Sharon Malone [00:43:57]:

And I felt that way about menopause, you know, because it comes at a time in life. It was. It was, you know, as I said, perimenopause couldn't come at a worse time. You've got.

Dr. Sameena Rahman [00:44:07]:

That's what I'm feeling right now.

Dr. Sharon Malone [00:44:09]:

You know, you got kids you're dealing with, you got homework and school projects trying to work. My husband was at a very different point in his career where he was well meaning, but absent, you know, he just couldn't be helped.

Dr. Sameena Rahman [00:44:22]:

Yeah.

Dr. Sharon Malone [00:44:23]:

And so I could not afford to be. I told my husband, I said, I can't be any madder than I already am right now, okay. It wouldn't be good for anybody.

Dr. Sameena Rahman [00:44:34]:

That's the part of it is that irritation and anger? You know, my kids call it scary Perry in my house right now. Is this scary Perry or is this mama? I don't know.

Dr. Sharon Malone [00:44:45]:

But you know what? But when I got to that point, it wasn't unfamiliar to me.

Dr. Sameena Rahman [00:44:50]:

Yeah.

Dr. Sharon Malone [00:44:50]:

You know? So I knew exactly what it was. I was like, okay, that's it. I didn't even wait, you know, because I was on birth control pills, and the only the way that I knew that I really was in perimenopause was because you. Then you would have a whole week off.

Dr. Sameena Rahman [00:45:08]:

Yes.

Dr. Sharon Malone [00:45:08]:

And, you know, any.

Dr. Sameena Rahman [00:45:09]:

No one has come.

Dr. Sharon Malone [00:45:10]:

And in my whole week off, I'm like, it's a problem. And so I went from birth control pills, you know, being well aware of what my symptoms were going to be. And I even took a little stint in between where I tried an IUD just to see would this work? And I was like, no, because you're, like, bleeding all the time. And it was terrible. And so I said, okay. So we went from birth control pills, checked a little bit, just to see, am I really done? I was. And then I went straight to hormone therapy, and I've been on hormone therapy since, and it's now been 15 years, so. And I'm fine, and I have no intention of, you know.

Dr. Sameena Rahman [00:45:50]:

No, look how good she looks. See that estrogen?

Dr. Sharon Malone [00:45:53]:

I'm going to be one of those little old ladies in the office, like, no, you can't take it.

Dr. Sameena Rahman [00:45:58]:

No, you won't be little, because I won't be literally healthy.

Dr. Sharon Malone [00:46:02]:

So.

Dr. Sameena Rahman [00:46:03]:

Yeah, yeah, but you. But you won't.

Dr. Sharon Malone [00:46:04]:

You won't.

Dr. Sameena Rahman [00:46:05]:

You won't part from the hormones. I get that. Well, that's awesome. And let's talk about, like. Because you've told me before, like, how you came to alloy, because when we're talking at the Liberty road yesterday, they're talking about the middle third and how people pivot. So you were saying that you had come to a conclusion, I think, around Covid, that you liked how it felt.

Dr. Sharon Malone [00:46:22]:

Yeah.

Dr. Sameena Rahman [00:46:22]:

But tell us how the alloy crew came to you.

Dr. Sharon Malone [00:46:25]:

You know, it's funny, because I. One of my favorite sayings is that there are no accidents in the universe. You know, things happen. You don't see it coming. I have had the. I have had the most unplanned life. You know, things happen, and you react to it in real time. And.

Dr. Sharon Malone [00:46:42]:

And I. When I was doing, you know, so I'm just practicing. I'm putting 1ft in front of the other, and I'm just going to work. Not thinking about the slightest bit of time of leaving, because at that point, I was 61. But you just do what you do, and you're going to work. I figured, I'll work until I'm 65. And then Covid happened, and then I had. Because I do gyn.

Dr. Sharon Malone [00:47:04]:

I was home for three months, and, you know, and here's something that I think it's also very important for people to understand the value of sitting still. You know, you don't have anything to do. You know, I had no work. I had no social obligations. I had no work obligations. And I'm just home, and you have time to think. And I thought. And one of the first thoughts that came to my mind is, wow, I do not hate this.

Dr. Sharon Malone [00:47:29]:

Okay. You know, I'm not one of those people, like, oh, I can't wait back to where I was like, but what really? And how I got to alloy. And this is where I said, it's no accidents in the universe, because that summer of COVID and we had just gone back to work, and my friend Michelle Obama was starting up her podcast, and she, you know, and because everything is socially distanced and you couldn't do. You know, I'm sure she had a very different vision for how she was going to do her podcast. But I'm here, you know, she's here, and we did. And she. She's very interested and very much, you know, a proponent of women's health. And this is.

Dr. Sharon Malone [00:48:12]:

This was a continuation of a conversation, conversations that she and I and our friend group have been having for years. She said, let's. She said, let's do a show about menopause. And I said, okay, so we did this little podcast that summer of 2020, and a few people listened to it. And, you know, when I went back to work, you know, I'm already churning about maybe I'll think of something else to do, I don't know what, or leave. And Ann and Monica Ann, who lives in New York City, these are the founders of Owl Ann fallen water, Monica Molinour Ann lives in New York. Monica lived in Rotterdam. And they were, they had this idea about, you know, we want to do this telehealth company, you know, for women in menopause, but we need a medical director.

Dr. Sharon Malone [00:49:00]:

So let's see, you know, let's find. They listen to the podcast, okay?

Dr. Sameena Rahman [00:49:05]:

They're like, set.

Dr. Sharon Malone [00:49:06]:

Track me down. We have a zoom. And I said, and it was, it was so funny, because when they got to me, they said, we know. Well, we're just, you know, we're just thinking about doing this thing. And I said, well, I said, it's so funny that you would come to me at this point. Timing is everything. It's everything.

Dr. Sameena Rahman [00:49:27]:

Yeah.

Dr. Sharon Malone [00:49:27]:

And so that's, that's really how we got together. Just one series of just, you know, things that were not planned, but that's how they found me. I said, I will talk to them. And then when I decided to leave my practice, I said, you know, I said, hey, let's roll the dice. Let's see what we have. I like them, you know, and even though we didn't see each other in real life for, you know, another three months after that, so. But again, I had the chance to be there on the ground floor and to join something and to create something in the image that I really felt a women's telehealth company should be, medically speaking. And they do all, you know, they are masters at all the other things that they do.

Dr. Sharon Malone [00:50:13]:

But, you know, that's why I felt, I felt totally comfortable then and still do, and now it's four years later.

Dr. Sameena Rahman [00:50:20]:

Wonderful. That's a great platform. Okay, I want to just, you know, summarize a few things about how women of color experience sort of menopause differently and then talk about access of care, because we know implicit bias kind of, you know, dictates a lot of when women of color will receive treatment or even if they access treatment. So can we talk a little bit about what we learned from the Swan study and, you know, and what you tell, what advice you give to other women?

Dr. Sharon Malone [00:50:45]:

Comment? Sure. You know, the Swan study for people who don't know what that is, a study of women across the nation and they basically just looked at women. They started them before they went through menopause, followed them through perimenopause and menopause, like 25 years, I think it was. And what they found from that study, just observationally, was that black women in particular, tended to go through menopause about a year earlier, which means just having had their last period a year earlier, their symptoms started sooner, which means that they were perimenopausal, many of them in their early forties and sometimes even their late thirties. And those symptoms lasted longer, on average, ten years before they got to their last period. And the symptoms were more severe, particularly hot flashes. And what we know about hot flashes and what that means in terms of disrupted sleep, brain fog and weight gain. And even in now, we know, increased cardiovascular disease, this puts them at significant increased risk for other poor health outcomes, high blood pressure as well.

Dr. Sharon Malone [00:51:52]:

And what we know, despite knowing this, there is probably not another demographic group in this country that gets prescribed hormones less than black women, for black women. And there's a lot of reasons why that is. One is because, again, it gets back this normalization of suffering. You know, you just think that, oh, well, that's what it is. So I should, you know, I should just suffer however long. You know, ten years is a long time not to get a good night's sleep, but there's the normalization of suffering. So a lot of times they don't bring it up because they just figure it comes with the territory. But even when they do bring it up, there are actually some studies that show that when black women bring it up to their doctors, they are only half as likely to be prescribed hormone therapy for treatment of their symptoms.

Dr. Sharon Malone [00:52:43]:

And even when they get a prescription, they're only half as likely to take it once they get home. And a lot of that has to do. Some of it's just how we talk about menopause as african american women, because we have a lot of people discouraging us, because, again, that negativity about cancer. And so there's that. But there's also, you cannot deny the fact that if you go home and you take medication and has a big warning on it that says it's going to give you a heart attack, stroke, Alzheimer's, and breast cancer, particularly when not other medications that you get, have that kind of warning on, it kind of sticks out. So the net effect of all of that is that the women who suffer the most, who are more at most at risk for the long term complications of menopause, are the ones who are getting treated least. And that's a problem. So that's sort of where we've got to really, you know, do our job in terms of, you know, sort of one, sort of tamping down the misinformation that's out there in the community to educating doctors, because, again, there are a lot of things that we were taught.

Dr. Sharon Malone [00:53:55]:

We were taught about who could and couldn't have hormones and if you had hypertension, they, there are many doctors today that won't give you, if you have diabetes, they won't give you, if you're overweight, they won't give you. And you know what? And honestly, it was, it was, I am how many years old before? You know, I was probably three years ago before I realized that smoking was not a contraindication for hormone therapy. I used to tell women, no, you smoke, you can't take it. Well, the reality is that if you are 47 years old and you smoke, you probably, one, you need to stop smoking. Okay, there's that. But two, it's also, you're more at risk for the things, you know. You are also smokers, right? Smokers have an early menopause. So you know what I say that that knowledge, the lack of knowledge is on the part of prescribers and physicians.

Dr. Sharon Malone [00:54:49]:

You know, we have been under treating, and I think that black women have been paying the price not just with their quality of life and their productivity, but with their health as well. And that's the message that I really want to get out there. And as I said, you can take it or not take it. You know, I'm not here to say that everyone must take hormone, but I do want women to have the information that they need such that the things that they think that take them out of the running for it. We don't, you know, you don't take that. You don't say, family history of breast cancer is a contraindication, too. Hormone therapy it is not. But this is still out there in the universe today.

Dr. Sharon Malone [00:55:34]:

It's not like that's two years ago or 20 years ago. There are still doctors. I just got someone who sent me a text about that very recently and said, my doctor, I have high blood pressure. I'm on medication. My doctor said, I can. Who, I've had hormone therapy. I'm like, oh, you're killing me, you know, I know.

Dr. Sameena Rahman [00:55:52]:

I think they still conflate oral contraceptive pills and the type of hormones in those with hormone therapy.

Dr. Sharon Malone [00:55:59]:

Exactly. Exactly.

Dr. Sameena Rahman [00:56:01]:

And so, you know, I think it's very important to know who you're going to see. And navigating that sort of expertise is always a challenge. You give a lot of good advice on how to find, you know, someone that has a good expertise as well in your book. So everyone check it out.

Dr. Sharon Malone [00:56:16]:

All right.

Dr. Sameena Rahman [00:56:16]:

Well, I could ask you a million other questions, but I want to be cognizant of your time. And I really appreciate you, Doctor Sharon Malone, for joining me today. I love what you say in your book, and I appreciate quoted you many times that you want to be benefactor, not a burden. And I think that that should be many of our goals. You know, Mary Claire talks about her nursing home prevention program, but it's all the same, right? You don't want to be a frail old lady that pees on herself and, you know, can't remember anything, right? So we gotta, we gotta take the bull by the horn and really get out there and, you know, do our, do our homework when it comes to taking our medications or not taking our medications, but at least making our own informed decisions.

Dr. Sharon Malone [00:56:58]:

Right? And, you know, one of the things that actually brings me a lot of joy is that we are able to have, you know, through the work that we all do, is that we are able to have an intergenerational conversation amongst physicians, you know, and that we are all sort of in this together. And I think that to, you know, for me, like I said, I'm in the old people group, but for those of us to be able to see that the future is secure, you know, and there are people who are out there, and we don't have many opportunities, particularly as women, to connect this way. So this has also been the joy and the beauty of, you know, the Internet and social media is that we've been able to find one another, otherwise, we never would have.

Dr. Sameena Rahman [00:57:44]:

Yeah, yeah, absolutely. And that's a big part of cognitive fitness, is your social interactions and keeping friendships up. And so it's that, you know, dementia prevention program, right, absolutely. But anyway, you know, I really appreciate you coming on today and telling us your story and, you know, dropping knowledge like you always do. Everyone should check out this New York Times selling book, Grown woman talk. It's really amazing, and it's very easily digestible, and you just feel like you're talking to a friend. So it's awesome. But this concludes my podcast today.

Dr. Sameena Rahman [00:58:19]:

I'm guy no girl doctor Samina Rahman. I'm here to educate so you could advocate for yourself. And that is always been my goal, being on social media as well. But I appreciate you guys tuning in, and please tune in next week for another great episode. Thank you Doctor Schoenmore.

Dr. Sharon Malone [00:58:35]:

Thank you.

Dr. Sameena Rahman [00:58:35]:

If you have a second, please subscribe to this podcast.

Dr. Sameena Rahman [00:58:38]:

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Dr. Sameena Rahman [00:58:49]:

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Dr. Sameena Rahman [00:58:52]:

Comment tell me what else you want to hear to get more information. My practice website is www.cgccago.com. my website for Gynel Girl is www.gynegirltv.com. my instagram is Gynell Girl so please follow me for some good content. Additionally, I have a YouTube channel, Gyno Girl TV, where I love to talk about all these things on YouTube. And please subscribe to my newsletter, Gynel Girl News which will be available on my website. I will see you next time.