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The end of your periods is not the only sign of perimenopause – a doctor explains

Quoted as being the “steadying force” in Michelle Obama’s life, Dr. Sharon Malone is an internationally renowned expert and author on menopause and women’s health. 

It was during her 30 years practicing as an Ob/Gyn in Washington DC that Dr. Malone became a close friend and trusted advisor to Michelle and has since become the “first person” the former First Lady turns to for “a whole host of issues, especially my health.”

Speaking about their friendship in a recent interview, Dr. Malone explained how Michelle’s willingness to share her menopause symptoms with the world has been critical in getting “the ball rolling on the topic of menopause.”

The end of your periods is not the only sign of perimenopause – a doctor explains© Weiss Eubanks/NBCUniversal via G
Michelle Obama says that Dr. Sharon Malone is her ‘steadying force’ and helped her navigate her menopause journey

“She’s one of the first people who really admitted to having menopausal symptoms,” Dr. Malone noted while referring to her guest appearance on a 2020 episode of the Michelle Obama: The Light podcast. 

Since then, Dr. Malone has become one of Oprah Winfrey’s go-to menopause advisors too, and has shared her expertise on the media mogul’s channels numerous times. 

But it is her most recent role as Chief Medical Advisor at Alloy, the amazingly supportive and accessible online menopause healthcare platform, which allows American women to tap into her unique know-how, that she is hugely proud of. Why? Because it gives every woman access to the right information and care so they can take control of their health, and not have to suffer in silence. 

Dr. Sharon Malone became a close friend to Michelle and is the “first person” the former First Lady turns to© Getty Images
Dr. Sharon Malone became a close friend to Michelle and is the “first person” the former First Lady turns to

“What I do, and what all of us at Alloy do, is make sure that every woman has equal access to the information about perimenopause,” Dr. Malone explains to HELLO! “There are some things that we can’t do anything about, but for goodness sake, the things that we do have a solution for, why don’t we access the care for that? That’s the part that really gets me. There’s enough suffering that you can’t do anything about. Let’s fix the ones we can.”

 Dr. Malone admits that her work for Alloy is a crucial step towards changing the tide in menopausal healthcare. Helping women navigate this phase of their lives with the right information, especially when so many cannot depend on doctors, or even family or friends to help them with a diagnosis, is a great place to start. 

READ: Are you in your ‘Millenopause’ era? 

“If your doctor finished training in the past 20 years or so, they may not know the signs and symptoms of perimenopause,” she explains. “Because if you go in and complain of [symptoms], and your doctor is saying, ‘Well, you’re still getting regular periods,’ or they do a blood test and the blood test is normal, then they will tell you you’re not in perimenopause.”

Dr. Malone explains that it is because of these common misunderstandings that so many women suffer through perimenopause and menopause. But she is adamant that the suffering needn’t be endured, and instead women should be informed and encouraged to thrive.

“The misperception that this is something that’s happening to old ladies, or [that] you’re going to be somehow diminished or less than yourself, because you’re in this phase of life [is wrong],” she explains.

“We must own up to the stage of life that we’re in, and embrace it and show younger women it’s something to look forward to, not fear, is so important.” 

To help you get there, Dr. Malone says that these are the things that every woman needs to know about this often-misunderstood phase of life…

Dr. Sharon Malone says that it's more important to track symptoms rather than periods during perimenopause© Shutterstock / New Africa
Dr. Sharon Malone says that it’s important to track symptoms rather than periods during perimenopause

Track symptoms, not periods, to first diagnose perimenopause

“You may be having your periods regularly or irregularly,” Dr Malone explains. “[But] if you’re between 35 and 45 and you’re having symptoms, then it’s really a self-diagnosis. You don’t need to have a blood test, you don’t need to have a sonogram, you don’t need any of those things to confirm it for you.”

Still getting periods at 45 and symptom-free? You’re in perimenopause

Dr. Malone explains that even women who are experiencing regular periods can still be classified as ‘perimenopausal’. It’s their age that provides the clue. 

“If you are 45 years old and you’re not having any symptoms whatsoever, you’re still perimenopausal,” she explains. “That period starts anywhere from about four to 10 years before you’ve had your last menstrual period. So even if you’re saying, ‘Oh, I’ve got nothing,’ you’re still in perimenopause.”

You must look out for lesser known symptoms like joint pain© Shutterstock / Jo Panuwat D
You must look out for lesser known symptoms like joint pain

Those achy joints are likely a symptom too

It’s not just mood swings and hot flashes that are signs of perimenopause. “Vaginal dryness, night sweats, brain fog, all those things can happen in perimenopause,” Dr Malone explains. “[But] I kid you not, the list gets longer every week!”

Joint pain for example, can often be diagnosed as something else, which is why finding the right perimenopausal care is so important. “A lot of times women consult their doctors and the next thing you know, you’re on three different medications from three different doctors, and they’re not talking to each other and realizing that it all falls under the umbrella of perimenopause.”

READ: How I knew I was going through perimenopause: the 12 debilitating signs

There are more reasons to have hormone therapy, than not

For those suffering from perimenopausal symptoms, Dr. Malone is adamant that there is no need to suffer in silence. As a huge advocate for hormone therapy, she is quick to dispel myths that may put women off from exploring it as a solution. 

“There are only four contraindications [to hormone therapy] as listed by the FDA, and they are if you personally have had breast cancer or estrogen-dependent cancer; if you personally have had a heart attack or stroke; if you have active liver disease, or if you have, and some of these are even changing, a history of blood clots in your legs or lungs before.”

READ: 7 women share their honest response to hormone therapy in menopause 

“The only other reason why you should not, or at least would consider not doing right away, is if you’ve had undiagnosed vaginal bleeding, and that’s why the distinction between perimenopause and menopause is important,” she adds.

Smoking or being overweight are not valid reasons to avoid hormone therapy

 “There are no more contraindications to the use of HRT. Smoking or being overweight are not reasons to avoid the medication.

 Dr. Malone stresses that with the right care, starting hormone therapy can be a game-changer. She just wishes that more women would try it.

“No matter how you look at it, [the percentage of women on hormones is] still no more than 6% and if you’re an African American woman or a woman of color, then that number is at least half, if not a quarter of that,” she notes. 

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