Dr. Sharon Malone is a nationally recognized expert in women’s health, Chief Medical Advisor at Alloy Health, host of The Second Opinion with Dr. Sharon, and the New York Times bestselling author of Grown Woman Talk: Your Guide to Getting and Staying Healthy.
For nearly three decades, Dr. Malone practiced as a board-certified OB/GYN and Certified Menopause Practitioner in Washington, D.C. Today, she is focused on advocacy, education, and expanding access to evidence-based menopause care. In a conversation moderated by WIE Suite Founder Dee Poku, Dr. Malone tackled one of the most consequential—and often misunderstood—periods in a woman’s life: the transition through perimenopause and menopause.
The conversation went well beyond hot flashes and periods. Dr. Malone reframed menopause as a years-long, whole-body transition that can affect the brain, cardiovascular system, bones, metabolism, body composition, fertility, and quality of life. She also offered practical guidance on what women should know about their health before symptoms become disruptive, how to approach conversations about hormone therapy, and why women need to become better advocates for themselves in a healthcare system that does not always provide the answers they need.
One of Dr. Malone’s central messages was that menopause has traditionally been viewed too narrowly through the lens of reproduction. The reality is much broader.
Perimenopause can begin years before a woman’s final period and involves changes across multiple systems in the body. Fluctuating estrogen can affect body composition, bones, cardiovascular health, the brain, sleep, mood, and more. Because women are often taught to think of menopause as simply the point when periods stop, many of these changes can be missed or treated as unrelated problems.
Dr. Malone encouraged women to start thinking about midlife health earlier—and to recognize that subtle changes can be meaningful. A shorter menstrual cycle, sleep disruption, joint pain, palpitations, mood changes, or shifts in fertility may all be part of the larger transition.
The message is not to panic about every change. It is to understand the bigger picture.
For Dr. Malone, one of the most important things a woman can do as she approaches midlife is understand her baseline.
That starts with family history. Knowing whether cardiovascular disease, diabetes, dementia, osteoporosis, or other conditions run in your family gives you important context for the decisions you make later. She also emphasized knowing basic health markers such as cholesterol, blood sugar, and hemoglobin A1C.
These aren't simply numbers to collect. They give women a clearer picture of where they are starting from—and where they may have an opportunity to intervene.
Dr. Malone emphasized that family history is not destiny. Lifestyle factors including sleep, exercise, nutrition, stress management, and alcohol consumption can influence long-term health. Her larger point was simple: the earlier women understand their risk factors, the more opportunity they have to change the trajectory of their health.
One of the strongest themes of the conversation was Dr. Malone’s refusal to accept suffering as an inevitable part of aging.
Women do not have to wait until symptoms become unbearable before seeking treatment. Perimenopause can affect sleep, mood, anxiety, libido, bleeding, concentration, and quality of life well before menopause itself. Dr. Malone argued that if symptoms are affecting your life, that is reason enough to have a conversation about treatment.
That includes hormone therapy, which she described as a personal decision that should be made based on an individual woman's symptoms, health history, and circumstances—not fear, outdated information, or a one-size-fits-all rule.
She also challenged some of the assumptions that have shaped public understanding of hormone therapy over the past two decades. The Women's Health Initiative study of 2002 dramatically influenced how both women and physicians viewed hormone therapy, but Dr. Malone emphasized that the study's findings were more nuanced than the way they were ultimately communicated to the public.
Her broader message: understand the evidence, understand your own health history, and have an informed conversation with a clinician who understands menopause.
Dr. Malone was equally direct about the realities women face when trying to get appropriate care.
A major challenge, she explained, is that many physicians are not adequately trained in menopause care. Women may present with brain fog, joint pain, depression, sleep problems, or other symptoms and end up being treated for each issue individually rather than having someone step back and recognize the larger picture.
Her advice is practical: if you're making an appointment specifically to discuss perimenopause or menopause, say so. Ask beforehand whether the physician treats menopausal patients. Come prepared with your symptoms, questions, and relevant health history.
And if you are not getting the answers you need, keep looking.
Dr. Malone also pointed to the role of digital health in expanding access to menopause care, particularly for women who live in areas where menopause-trained clinicians are difficult to find. The goal, she argued, should not simply be access to healthcare, but access to the right expertise.
The conversation also addressed one of the most frustrating parts of midlife for many women: changes in weight and body composition.
Dr. Malone explained that metabolism naturally slows with age, but perimenopause and menopause can add another layer. Even when the number on the scale doesn't change dramatically, body composition can shift, with more fat accumulating around the middle and muscle mass declining.
That change matters for more than appearance. Abdominal fat is associated with inflammation and cardiovascular risk, making the conversation about midlife weight fundamentally a health conversation.
Her advice was less about chasing an ideal number and more about focusing on the fundamentals: maintaining muscle, exercising, getting adequate sleep, and making sustainable lifestyle choices. Sleep, in particular, can create a cascade—when women are exhausted or irritable, it becomes harder to make the choices that support health.
Brain health was another major focus of the discussion.
Dr. Malone emphasized that dementia is not an inevitable consequence of aging and that women have more agency over certain risk factors than they may realize. Blood pressure, diabetes, exercise, weight, smoking, alcohol, sleep, and depression all matter.
She also discussed the relationship between menopause and brain health, particularly for women who experience menopause unusually early. While she acknowledged that some questions around hormones and dementia remain an area of ongoing research, she emphasized the importance of addressing modifiable risk factors throughout midlife.
The takeaway is less about predicting the future and more about acting on what is within your control now.
If there was one area where Dr. Malone was particularly blunt, it was the supplement industry.
The conversation touched on NAD+, vitamins, and the growing number of products marketed to women for menopause, brain health, longevity, and weight management. Dr. Malone's advice was to ask a simple question: Where is the data?
Supplements are not held to the same evidentiary standards as medications, and marketing claims do not necessarily mean a product has been shown to work. She encouraged women to look for independent third-party testing and to be especially cautious about products purchased online.
Her broader philosophy was consistent with the rest of the conversation: don't let an overwhelming wellness marketplace distract from the fundamentals. A healthy diet, exercise, sleep, and appropriate medical care remain the foundation.
What emerged from Dr. Malone's conversation with Dee was ultimately less about menopause itself and more about taking ownership of the next phase of your health.
Know your family history. Know your numbers. Understand the signs of perimenopause. Don't dismiss changes because you're "too young." Don't assume that suffering is something you simply have to endure. And don't be afraid to ask questions when the care you're receiving doesn't make sense.
Midlife is not a moment to step back from your health. It is a moment to become more informed about it.
As Dr. Malone made clear throughout the conversation, the goal isn't simply to live longer. It's to live longer well—with the information, care, and agency to make thoughtful decisions about your health along the way.
