Menopause, Misogyny and the Medical System: Dr Sharon Malone Sets the Record Straight

Malone says she used to give this ‘heads‑up’ to her patients in their late 30s and early 40s, telling them that even if they did everything right, the body changes. The advice included specifics: adjust diet, increase exercise, manage expectations. She also used that moment to discuss family history and screening (colonoscopy if parent had colon cancer, breast screening if family history, etc.) and to introduce the concept of hormone therapy so that when symptoms hit they would already be informed. She stresses that this proactive discussion calms women when later they experience brain fog or weight changes, because they know it's normal and treatable.

Malone explains that many doctors think they know everything and will not suggest a second opinion. Yet medicine is full of opinions, and a patient should not be afraid of hurting a doctor’s feelings. She tells the story of her friend who was berated by an endocrinologist for taking HT, even though her primary doctor had prescribed it. Malone also shares that she herself would sometimes recommend a second opinion when a patient wasn't comfortable with her surgical plan, because she wanted them to feel confident.

Malone acknowledges this is ‘not rocket science’ but stresses that starting early is essential. She also ties this advice to the broader social determinants of health: zip code matters more than genetic code. Women need health insurance, safe neighborhoods to exercise, and grocery stores with whole foods. The conversation cannot stop at individual responsibility; it must include advocacy to remove structural barriers.

Malone walks through the WHI misinterpretation to explain why the fear is unwarranted, then lays out the modern understanding: HT is safe and evidence‑based for symptom management and prevention. She emphasizes that all women should have the opportunity to learn the facts and make their own decision. She is not saying everyone should take HT, but that the decision should be free of misinformation. She also warns that many clinicians outside of OB/GYN (endocrinologists, cardiologists) are still repeating the 2002 scare lines.

Malone says that the first step is awareness, and that social media and podcasts have been a huge boon for amplifying women’s shared experiences (frozen shoulder, hair changes) that were previously dismissed as unrelated. She encourages women to approach doctors with data and questions, not to accept ‘it’s just your age’.

Malone recounts how the WHI’s announcement instantly changed clinical practice: phone lines lit up, women stopped taking hormones overnight, and residency programs stopped teaching nuanced menopause care. She emphasizes that the breast cancer finding was not statistically significant and was less than one extra case per 1,000 women per year, with no increase in breast cancer mortality. Yet the fear was so pervasive that it halted not only prescribing but also ongoing international studies, and to this day no large‑scale study of postmenopausal women has been conducted by the NIH. She notes that even in 2024, specialists like endocrinologists are still telling patients to stop HT based on the same outdated fears, demonstrating how deeply the misinformation is entrenched.

She draws the analogy of a pause button: while on hormone therapy, symptoms and some aging processes are arrested, but once HT is stopped, the underlying biology resumes, often leading to a return of hot flashes and rapid bone loss. She stresses that women who have been on HT for years are often shocked when their symptoms return after stopping, because they believed they were ‘done’ with menopause. This misunderstanding undermines their long‑term health planning.

Malone says she was ‘way happier at 66 than I was at 46’ because she is no longer in the overwhelm of raising children and juggling a demanding marriage with a high‑profile partner. She now controls her own schedule, has grown children, and gets to work on a mission she deeply believes in: making menopause care accessible. She urges other midlife women not to think their professional lives are over, as they have more wisdom and judgment than ever.

Malone says that change is always difficult and that many of the leaders are older and more entrenched. She notes that while she and Dr. Mary Claire Haver are a ‘different generation’ medically, a lot of committee members are older still and don't want to be told they were wrong. She states that the ACGME at one point claimed there wasn't enough information to include menopause in medical school curricula. She argues that if you want to have a debate about data, let's have it, but don't shut down the conversation just because it challenges authority.

She argues that women have been socialized to view suffering as part of life and are often rewarded for ‘toughing it out.’ This mentality leads to delayed diagnosis and treatment. She says there is no suffering Olympics; you don't get a medal for enduring 20 years of hot flashes. The goal should be zero unnecessary suffering, but that requires both individual advocacy and systemic change to validate women’s pain.