1 00:00:11,000 --> 00:00:14,640 Speaker 1: Welcome to the Therapy for Black Girls Podcast, a weekly 2 00:00:14,720 --> 00:00:19,480 Speaker 1: conversation about mental health, personal development, and all the small 3 00:00:19,520 --> 00:00:22,680 Speaker 1: decisions we can make to become the best possible versions 4 00:00:22,680 --> 00:00:26,800 Speaker 1: of ourselves. I'm your host, doctor joy Hard and Bradford, 5 00:00:27,160 --> 00:00:32,239 Speaker 1: a licensed psychologist in Atlanta, Georgia. For more information or 6 00:00:32,360 --> 00:00:35,760 Speaker 1: to find a therapist in your area, visit our website 7 00:00:35,880 --> 00:00:39,600 Speaker 1: at Therapy for Blackgirls dot com. While I hope you 8 00:00:39,640 --> 00:00:43,639 Speaker 1: love listening to and learning from the podcast, it is 9 00:00:43,680 --> 00:00:46,600 Speaker 1: not meant to be a substitute for a relationship with 10 00:00:46,640 --> 00:00:57,320 Speaker 1: a licensed mental health professional. Hey, y'all, thanks so much 11 00:00:57,320 --> 00:00:59,600 Speaker 1: for joining me for Session three seventy six of the 12 00:00:59,600 --> 00:01:02,720 Speaker 1: Therapy for Black Girls Podcast. We'll get right into our 13 00:01:02,760 --> 00:01:04,880 Speaker 1: conversation after a word from our sponsors. 14 00:01:05,280 --> 00:01:07,880 Speaker 2: Hi. I'm doctor Sharon Malone and I'm on the Therapy 15 00:01:07,920 --> 00:01:12,400 Speaker 2: for Black Girls Podcast. I'm in session today unpacking how 16 00:01:12,440 --> 00:01:34,479 Speaker 2: our sex lives change as we age. 17 00:01:24,520 --> 00:01:27,119 Speaker 1: And yet another episode themed to our twenty twenty four 18 00:01:27,240 --> 00:01:31,480 Speaker 1: Sex Positive September celebrations, our annual campaign centering the importance 19 00:01:31,520 --> 00:01:35,320 Speaker 1: of black women's pleasure, agency and sexual liberation. We're discussing 20 00:01:35,319 --> 00:01:37,880 Speaker 1: the ways in which our sex lives change and evolve 21 00:01:38,000 --> 00:01:41,240 Speaker 1: as we get older. While the symptoms women experience during 22 00:01:41,280 --> 00:01:44,520 Speaker 1: menopause and perimenopause can cause our sex lives to shift 23 00:01:44,520 --> 00:01:47,360 Speaker 1: in some challenging ways, that doesn't mean you still can't 24 00:01:47,400 --> 00:01:50,680 Speaker 1: embrace sexual vibrancy no matter the age. Joining me for 25 00:01:50,760 --> 00:01:53,960 Speaker 1: today's conversation is the New York Times bestselling author of 26 00:01:54,000 --> 00:01:57,800 Speaker 1: Grown Women Talk, Doctor Sharon Malone. Doctor Malone is a 27 00:01:57,880 --> 00:02:01,360 Speaker 1: nationally known expert in women's health, serving as the chief 28 00:02:01,400 --> 00:02:04,960 Speaker 1: Medical Advisor at Alloy Women's Health, a telehealth company that 29 00:02:05,000 --> 00:02:08,359 Speaker 1: focuses on women over forty. Doctor Malone and I chatted 30 00:02:08,360 --> 00:02:11,760 Speaker 1: about all things menopause and sex, including how to combat 31 00:02:11,800 --> 00:02:13,800 Speaker 1: some of the various symptoms that can make the idea 32 00:02:13,800 --> 00:02:16,799 Speaker 1: of having sex less than appealing. We also discussed the 33 00:02:16,840 --> 00:02:20,280 Speaker 1: importance of continued obgy in visits even as you reach 34 00:02:20,360 --> 00:02:23,280 Speaker 1: the end of your reproductive years, plus all the reasons 35 00:02:23,280 --> 00:02:26,280 Speaker 1: why grown womanhood is something to look forward to, not 36 00:02:26,440 --> 00:02:29,880 Speaker 1: to fear. If something resonates with you while enjoying our conversation, 37 00:02:30,480 --> 00:02:33,200 Speaker 1: please share with us on social media using the hashtag 38 00:02:33,320 --> 00:02:36,680 Speaker 1: TVG in Session, or join us over in the Sister 39 00:02:36,720 --> 00:02:39,239 Speaker 1: Circle To talk more about the episode. You can join 40 00:02:39,320 --> 00:02:42,480 Speaker 1: us at Community dot Therapy for Blackgirls dot Com. Here's 41 00:02:42,520 --> 00:02:48,120 Speaker 1: our conversation. Thank you so much for joining me today, 42 00:02:48,120 --> 00:02:49,040 Speaker 1: doctor Malone. 43 00:02:49,240 --> 00:02:50,240 Speaker 2: Thank you for having me. 44 00:02:50,880 --> 00:02:53,239 Speaker 1: Yes, we had a chance to chat briefly. We met 45 00:02:53,240 --> 00:02:56,760 Speaker 1: earlier this year at the Accelerator conference in Florida. I 46 00:02:56,800 --> 00:02:58,519 Speaker 1: didn't get a chance to hear you talk, so I'm 47 00:02:58,560 --> 00:03:00,000 Speaker 1: excited to chat with you today. 48 00:03:00,800 --> 00:03:03,160 Speaker 2: Well, I've got lots to say. So you're in love, 49 00:03:05,080 --> 00:03:05,840 Speaker 2: So I wonder. 50 00:03:05,600 --> 00:03:07,520 Speaker 1: If you could start by telling us a little bit 51 00:03:07,560 --> 00:03:10,080 Speaker 1: about what sparked your interest in women's health. 52 00:03:10,639 --> 00:03:12,400 Speaker 2: You know what, I have been in women's health for 53 00:03:12,440 --> 00:03:15,440 Speaker 2: so long I can't even remember the beginning of it. 54 00:03:15,480 --> 00:03:18,520 Speaker 2: But I'm an obgyn. I had been in private practice 55 00:03:18,560 --> 00:03:22,280 Speaker 2: for almost thirty years and had been in residency for 56 00:03:22,360 --> 00:03:26,919 Speaker 2: four years before that. But even before becoming a doctor, 57 00:03:27,440 --> 00:03:31,520 Speaker 2: I am the youngest of eight children, and I am 58 00:03:31,680 --> 00:03:35,520 Speaker 2: the last of five girls in a row. So my 59 00:03:36,440 --> 00:03:40,640 Speaker 2: entire upbringing has been very, let's just say, woman centric, 60 00:03:41,840 --> 00:03:45,280 Speaker 2: and I think that my family history really as I've 61 00:03:45,320 --> 00:03:49,240 Speaker 2: watched my older brothers and sisters, in particularly my mother, 62 00:03:49,360 --> 00:03:52,920 Speaker 2: who passed away at the young age now of fifty seven, 63 00:03:53,360 --> 00:03:56,840 Speaker 2: I grew up understanding that there was really something that 64 00:03:56,920 --> 00:03:59,440 Speaker 2: was getting in the way of our health and how 65 00:03:59,480 --> 00:04:04,120 Speaker 2: we were able to survive or thrive. And my job 66 00:04:04,240 --> 00:04:06,920 Speaker 2: was to make sure that the kinds of things and 67 00:04:06,960 --> 00:04:09,040 Speaker 2: the care that my mother got, which I think was 68 00:04:09,120 --> 00:04:13,280 Speaker 2: really insufficient, didn't get replicated in the next generation. So 69 00:04:13,760 --> 00:04:16,520 Speaker 2: that's really the core of why I got involved in 70 00:04:16,520 --> 00:04:19,200 Speaker 2: women's health, and I have never looked back. It has 71 00:04:19,240 --> 00:04:20,880 Speaker 2: been really the joy of my life. 72 00:04:21,360 --> 00:04:23,760 Speaker 1: I love that. And not only are you focused on 73 00:04:23,800 --> 00:04:26,520 Speaker 1: women's health, but you have a particular specialty in working 74 00:04:26,520 --> 00:04:29,200 Speaker 1: with women over the age of forty. So tell me 75 00:04:29,200 --> 00:04:31,520 Speaker 1: more about that, Niche. 76 00:04:30,920 --> 00:04:33,479 Speaker 2: As I told you, I started practicing. Oh my god, 77 00:04:33,520 --> 00:04:36,359 Speaker 2: it's hard to believe you'd have to apply the COVID discount. 78 00:04:36,360 --> 00:04:38,039 Speaker 2: When you realize it's like, oh yeah, you got to 79 00:04:38,040 --> 00:04:41,160 Speaker 2: add those four years onto anything else you've been doing. 80 00:04:41,760 --> 00:04:47,200 Speaker 2: But I started practicing back in nineteen ninety two, and 81 00:04:47,520 --> 00:04:51,680 Speaker 2: when I joined my practice, I inherited the practice of 82 00:04:51,760 --> 00:04:55,800 Speaker 2: two much older physicians. So from the moment I started, 83 00:04:55,960 --> 00:04:59,279 Speaker 2: I had patients of all ages. So usually as a 84 00:04:59,279 --> 00:05:01,599 Speaker 2: young physician, you start out and you start out with 85 00:05:01,640 --> 00:05:04,000 Speaker 2: young patients and then you all grow up and get 86 00:05:04,040 --> 00:05:07,279 Speaker 2: older together. But on day one I had eighty year olds, 87 00:05:07,279 --> 00:05:09,520 Speaker 2: I had fifty year olds, and I had eighteen year olds. 88 00:05:09,880 --> 00:05:14,440 Speaker 2: So being involved in menopause and perimenopausal care has always 89 00:05:14,520 --> 00:05:18,680 Speaker 2: been a part of my practice in obgyn. It's not 90 00:05:18,839 --> 00:05:22,440 Speaker 2: just the delivering baby's part, it's what happens to women 91 00:05:23,080 --> 00:05:26,279 Speaker 2: after they're done with their reproductive years. And I think 92 00:05:26,320 --> 00:05:31,599 Speaker 2: that today that art has really been lost because we 93 00:05:32,000 --> 00:05:35,320 Speaker 2: don't talk as much about women's health over forty what 94 00:05:35,480 --> 00:05:39,160 Speaker 2: happens when you're done, And I think most of us 95 00:05:39,240 --> 00:05:42,480 Speaker 2: think of going to the obgyn for a couple of reasons. 96 00:05:42,520 --> 00:05:44,600 Speaker 2: You go for your pap smear, you go to make 97 00:05:44,640 --> 00:05:47,280 Speaker 2: sure you get contraception, and you get through a pregnancy. 98 00:05:47,839 --> 00:05:51,640 Speaker 2: And then once women get done with their childbearing, they 99 00:05:51,680 --> 00:05:55,080 Speaker 2: tend to fall off and they don't follow up as much. 100 00:05:55,240 --> 00:05:57,919 Speaker 2: And I think that there are a couple of reasons 101 00:05:57,920 --> 00:05:59,880 Speaker 2: for that. One, you think you don't need to go 102 00:06:00,160 --> 00:06:02,000 Speaker 2: because why do I need to do that now I'm 103 00:06:02,040 --> 00:06:05,719 Speaker 2: done with my children. But there's also a lack of 104 00:06:05,800 --> 00:06:09,159 Speaker 2: guidance that really happens for women after they're forty. It 105 00:06:09,200 --> 00:06:11,919 Speaker 2: seems as if the things that were interesting about you 106 00:06:12,080 --> 00:06:15,159 Speaker 2: are no longer And I think that nothing could be 107 00:06:15,279 --> 00:06:17,880 Speaker 2: farther from the truth. So if you have a doctor 108 00:06:18,000 --> 00:06:21,120 Speaker 2: who is really not speaking to you about what that 109 00:06:21,200 --> 00:06:24,680 Speaker 2: means to age and to age healthfully, then you need 110 00:06:24,720 --> 00:06:28,120 Speaker 2: to really reassess whether or not that particular doctor is 111 00:06:28,200 --> 00:06:31,159 Speaker 2: right for you, because this is the most important time 112 00:06:31,200 --> 00:06:33,960 Speaker 2: of your life. This is where what you do and 113 00:06:34,000 --> 00:06:37,039 Speaker 2: how you do it really really matters. 114 00:06:37,440 --> 00:06:39,440 Speaker 1: Can you say more about that doctor, Malone? Because I 115 00:06:39,440 --> 00:06:41,600 Speaker 1: think you're right there's a lot of focus on those 116 00:06:41,760 --> 00:06:45,920 Speaker 1: child rearing child age years, but when you are starting 117 00:06:45,960 --> 00:06:48,719 Speaker 1: mini hall then later there isn't as much conversation. So 118 00:06:49,080 --> 00:06:51,600 Speaker 1: what makes that such a critical point in a woman's life. 119 00:06:52,160 --> 00:06:55,320 Speaker 2: Well, because you don't think about it, but we are 120 00:06:55,440 --> 00:06:59,320 Speaker 2: going to spend anywhere from a third to half of 121 00:06:59,320 --> 00:07:03,800 Speaker 2: our lives in our post reproductive years. You're going to 122 00:07:03,839 --> 00:07:07,800 Speaker 2: spend more time there. And as we couple that with aging, 123 00:07:08,440 --> 00:07:11,040 Speaker 2: that is when you can get away with murder until 124 00:07:11,040 --> 00:07:13,600 Speaker 2: you're forty. You can not care of your gil self, 125 00:07:13,680 --> 00:07:16,080 Speaker 2: not get enough sleep, not do all the things you're 126 00:07:16,080 --> 00:07:20,160 Speaker 2: supposed to do, and really function relatively well. But when 127 00:07:20,200 --> 00:07:22,840 Speaker 2: you get to be over forty, that's when you really 128 00:07:22,880 --> 00:07:25,400 Speaker 2: start to pay the price for some of these behaviors, 129 00:07:25,480 --> 00:07:28,760 Speaker 2: and that's when it matters. It matters how you take 130 00:07:28,800 --> 00:07:33,400 Speaker 2: care of yourself. It matters what kind of guidance you get, 131 00:07:33,480 --> 00:07:36,200 Speaker 2: because I think most of us want to do better. 132 00:07:36,720 --> 00:07:40,360 Speaker 2: Who wants to feel bad? No one, But I think 133 00:07:40,400 --> 00:07:43,760 Speaker 2: what happens to us as we age, particularly as women, 134 00:07:44,440 --> 00:07:50,280 Speaker 2: we accept that feeling bad is part of just growing old. 135 00:07:50,440 --> 00:07:54,240 Speaker 2: I don't think that we envision another way to age, 136 00:07:54,800 --> 00:07:58,080 Speaker 2: and particularly when we come from families where we have 137 00:07:58,200 --> 00:08:01,720 Speaker 2: seen what aging looks like, and for most of us, 138 00:08:01,760 --> 00:08:05,280 Speaker 2: particularly in black families, it's usually not good. We are 139 00:08:05,320 --> 00:08:08,200 Speaker 2: dealing with chronic illnesses. By the time you look at 140 00:08:08,200 --> 00:08:12,080 Speaker 2: your parents, it's high blood pressure, it's diabetes, it's dialysis, 141 00:08:12,080 --> 00:08:15,760 Speaker 2: it's strokes, it's all of those things that we think 142 00:08:15,840 --> 00:08:20,600 Speaker 2: are inevitable. But leading up to that, those real, honest 143 00:08:20,640 --> 00:08:24,120 Speaker 2: to God productive years that you have between say forty 144 00:08:24,160 --> 00:08:28,040 Speaker 2: and sixty sixty five before you sit down to retire, 145 00:08:28,920 --> 00:08:31,000 Speaker 2: those are the years when you should be at your 146 00:08:31,240 --> 00:08:35,680 Speaker 2: peak functioning. So I don't want any woman to go 147 00:08:35,800 --> 00:08:41,160 Speaker 2: into perimenopause and menopause one unaware of the kinds of 148 00:08:41,200 --> 00:08:44,680 Speaker 2: things that you will encounter. That's number one and two. 149 00:08:45,200 --> 00:08:47,679 Speaker 2: If you do encounter these things. I want you to 150 00:08:47,720 --> 00:08:51,760 Speaker 2: know that, yes, it's normal, but suffering is not normal. 151 00:08:52,720 --> 00:08:54,559 Speaker 2: And that is where we have got to get out 152 00:08:54,559 --> 00:08:58,240 Speaker 2: of that mindset that as you enter perimenopause and menopause, 153 00:08:58,920 --> 00:09:04,000 Speaker 2: suffering is just the latest in the continuum of things 154 00:09:04,040 --> 00:09:07,840 Speaker 2: that women suffer from, starting from the moment we get 155 00:09:07,840 --> 00:09:11,079 Speaker 2: our periods, and we just sort of take that as normal. 156 00:09:11,160 --> 00:09:14,480 Speaker 2: And I'm here to say, no, no, no, let's not 157 00:09:14,600 --> 00:09:18,320 Speaker 2: do that. Let's understand that this is the time when 158 00:09:18,400 --> 00:09:21,760 Speaker 2: we really can have a lot more control over our 159 00:09:21,800 --> 00:09:23,200 Speaker 2: lives and how we age. 160 00:09:23,720 --> 00:09:25,840 Speaker 1: Thank you so much for that. So we've had a 161 00:09:25,840 --> 00:09:28,719 Speaker 1: couple of conversations here on the podcast about menopause and 162 00:09:28,800 --> 00:09:31,439 Speaker 1: that whole process. But for those who maybe haven't listened 163 00:09:31,760 --> 00:09:33,760 Speaker 1: or haven't heard you explain it, can you say a 164 00:09:33,800 --> 00:09:35,959 Speaker 1: little bit about what signals to us that we are 165 00:09:36,080 --> 00:09:37,679 Speaker 1: entering a period of perimenopause. 166 00:09:37,720 --> 00:09:41,600 Speaker 2: In menopause, Yes, perimenopause is a word that a lot 167 00:09:41,640 --> 00:09:44,640 Speaker 2: of women hadn't even heard of before let's say four 168 00:09:44,720 --> 00:09:47,160 Speaker 2: or five years. It didn't really enter the lexicon. We 169 00:09:47,240 --> 00:09:50,160 Speaker 2: kind of knew what menopause was, but we thought that 170 00:09:50,240 --> 00:09:53,120 Speaker 2: menopause was something that happened to old ladies. It's like, 171 00:09:53,160 --> 00:09:56,440 Speaker 2: oh yeah, menopause. You know you're fifty sixty when that happens, 172 00:09:56,920 --> 00:10:02,640 Speaker 2: and not really the tran transition, which is what perimenopause is. 173 00:10:03,280 --> 00:10:07,760 Speaker 2: It is that time between your peak reproductive years, which 174 00:10:07,960 --> 00:10:11,280 Speaker 2: usually they start at puberty and probably peaks in about 175 00:10:11,280 --> 00:10:15,600 Speaker 2: your early to mid thirties. So perimenopause is that period 176 00:10:15,640 --> 00:10:19,559 Speaker 2: between your peak reproductive years and the end of your 177 00:10:19,600 --> 00:10:23,360 Speaker 2: reproductive years, which is what really marks the beginning of menopause. 178 00:10:23,880 --> 00:10:27,240 Speaker 2: So menopause is easy because we know what that looks 179 00:10:27,320 --> 00:10:30,560 Speaker 2: like and what it means. Menopause means the age at 180 00:10:30,600 --> 00:10:34,520 Speaker 2: which you've had your last period, and it's confirmed when 181 00:10:34,520 --> 00:10:37,280 Speaker 2: you've gone twelve months and you haven't had another period, 182 00:10:37,840 --> 00:10:42,719 Speaker 2: but in that perimenopausal phase, which for most women can 183 00:10:42,800 --> 00:10:46,120 Speaker 2: last anywhere from four to seven years, but for African 184 00:10:46,160 --> 00:10:50,440 Speaker 2: American women that transition can take ten years. So let's 185 00:10:50,600 --> 00:10:52,679 Speaker 2: do a little simple math. If I tell you the 186 00:10:52,800 --> 00:10:56,120 Speaker 2: average age of menopause, which means the aged which you've 187 00:10:56,120 --> 00:10:59,680 Speaker 2: had your last period, is fifty one, that means for 188 00:10:59,720 --> 00:11:03,960 Speaker 2: Black back women, the average age of starting that process 189 00:11:04,080 --> 00:11:07,600 Speaker 2: can be as early as your early forties or in 190 00:11:07,640 --> 00:11:11,600 Speaker 2: some women even their mid thirties. Because the one thing 191 00:11:11,640 --> 00:11:14,600 Speaker 2: that we do know about how the lived experience of 192 00:11:14,640 --> 00:11:17,760 Speaker 2: being a black woman in this country affects us and 193 00:11:17,800 --> 00:11:20,520 Speaker 2: it affects all of our aspects of our health, but 194 00:11:20,640 --> 00:11:24,400 Speaker 2: it actually shows itself in perimenopause as well. We tend 195 00:11:24,440 --> 00:11:28,560 Speaker 2: to enter that phase earlier, it tends to last longer, 196 00:11:29,200 --> 00:11:32,760 Speaker 2: and the symptoms that we normally associate with menopause, like 197 00:11:32,800 --> 00:11:36,760 Speaker 2: hot flashes and night sweats and mood swings, those symptoms 198 00:11:36,800 --> 00:11:40,840 Speaker 2: tend to be more severe for African American women. Now 199 00:11:41,480 --> 00:11:44,200 Speaker 2: did anybody tell you that? Did anyone mention, Oh, by 200 00:11:44,280 --> 00:11:46,880 Speaker 2: the way, not only is this going to happen for 201 00:11:46,920 --> 00:11:49,280 Speaker 2: you earlier, but it's going to last longer, and it's 202 00:11:49,320 --> 00:11:53,720 Speaker 2: going to be more debilitating. And we've all seen someone 203 00:11:53,800 --> 00:11:56,760 Speaker 2: they've got their fan out, you know, they're fan in 204 00:11:57,120 --> 00:12:02,000 Speaker 2: their sweating. There are clearly not having an enjoyable moment, 205 00:12:02,480 --> 00:12:04,880 Speaker 2: but they don't know what to do about it. Whenever 206 00:12:04,920 --> 00:12:06,400 Speaker 2: I see that, I want to go and tap them 207 00:12:06,400 --> 00:12:09,000 Speaker 2: on the shoulder and say, girl, this can go on 208 00:12:09,160 --> 00:12:12,600 Speaker 2: for a very very long time. And not only that, 209 00:12:13,120 --> 00:12:16,679 Speaker 2: but we know what to do about it because hot 210 00:12:16,720 --> 00:12:18,959 Speaker 2: flashes and I want to say this again and again 211 00:12:19,000 --> 00:12:24,439 Speaker 2: throughout this conversation. Hot flashes are not benign. They're not 212 00:12:24,600 --> 00:12:29,199 Speaker 2: just annoying, and they are, but they are sometimes harbingers 213 00:12:29,280 --> 00:12:32,959 Speaker 2: of things that can affect your long term health, such 214 00:12:33,000 --> 00:12:38,320 Speaker 2: as it increases your risk for cardiovascular disease, increases your 215 00:12:38,400 --> 00:12:42,719 Speaker 2: risk for sleep disturbance, which of course creates fatigue and 216 00:12:42,760 --> 00:12:46,439 Speaker 2: stress and lack of performance on the job, you get 217 00:12:46,559 --> 00:12:50,000 Speaker 2: brain fog, on and on. But I think the big 218 00:12:50,040 --> 00:12:53,880 Speaker 2: things increases your risk for type two diabetes and increases 219 00:12:53,920 --> 00:12:57,880 Speaker 2: your risk for Alzheimer's. So there are a thousand and 220 00:12:57,960 --> 00:13:02,480 Speaker 2: one reasons why if you are bothered by the hot flashes, 221 00:13:02,640 --> 00:13:07,720 Speaker 2: you at least deserve a conversation with your doctor about 222 00:13:07,800 --> 00:13:10,800 Speaker 2: how to treat them and what the hot flashes mean. 223 00:13:11,400 --> 00:13:13,720 Speaker 2: Because it gets back to what I was saying, is 224 00:13:13,720 --> 00:13:17,920 Speaker 2: that we expect to suffer and we think of perimenopause 225 00:13:18,000 --> 00:13:20,800 Speaker 2: and menopause and all the symptoms that we have, and 226 00:13:21,360 --> 00:13:25,640 Speaker 2: actually they're over thirty four. Symptoms of menopause is not 227 00:13:25,840 --> 00:13:29,760 Speaker 2: just the hot flash, but we don't realize it because 228 00:13:30,040 --> 00:13:32,680 Speaker 2: just because you're not having hot flashes does not mean 229 00:13:32,760 --> 00:13:36,200 Speaker 2: you are not in perimenopause. You're still imperimenopause, even if 230 00:13:36,240 --> 00:13:38,920 Speaker 2: you never have a hot flash. But all of these 231 00:13:38,920 --> 00:13:44,960 Speaker 2: things brain fog, changes in libido, dry itchy skin, loss 232 00:13:44,960 --> 00:13:47,880 Speaker 2: of hair. I mean, that's a big problem for women 233 00:13:47,880 --> 00:13:51,120 Speaker 2: who are transitioning. I say, hair loss where you want 234 00:13:51,160 --> 00:13:54,120 Speaker 2: it and hair growth where you don't. There is also 235 00:13:54,400 --> 00:13:57,760 Speaker 2: the aging of your skin. And a lot of women 236 00:13:57,840 --> 00:14:03,120 Speaker 2: have libido and vaginal dryness, irritation, and urinary symptoms as 237 00:14:03,120 --> 00:14:06,640 Speaker 2: a result of this. So it's a lot. It's a lot. 238 00:14:07,280 --> 00:14:12,000 Speaker 2: And because we don't really know that these things have 239 00:14:12,360 --> 00:14:16,000 Speaker 2: easy remedies. And the easy remedy for it is since 240 00:14:16,000 --> 00:14:19,120 Speaker 2: it's a hormonal issue, you know, what's happening to you 241 00:14:19,200 --> 00:14:23,480 Speaker 2: in perimenopause is not that your hormones are gone. Well, 242 00:14:23,520 --> 00:14:27,440 Speaker 2: they're not gone, they're just erratic. And that's why. Also 243 00:14:27,680 --> 00:14:31,120 Speaker 2: one of the symptoms that women get during perimenopause is 244 00:14:31,600 --> 00:14:36,320 Speaker 2: very irregular periods. Your periods may come too soon, they 245 00:14:36,360 --> 00:14:39,560 Speaker 2: may last too long, it may be too heavy. Women 246 00:14:39,600 --> 00:14:41,920 Speaker 2: will come in and said, I've been bleeding for three weeks. 247 00:14:42,440 --> 00:14:46,160 Speaker 2: All of these things are indicators that your hormones are 248 00:14:46,400 --> 00:14:49,880 Speaker 2: just out of whack. They're too high one day, too 249 00:14:49,920 --> 00:14:54,200 Speaker 2: low the next, and everything in between. And for women 250 00:14:54,240 --> 00:14:56,880 Speaker 2: who are complaining when they go to their doctor and 251 00:14:56,880 --> 00:15:00,760 Speaker 2: they'll say, well, doctor, I have hot flashes, or I'm 252 00:15:00,800 --> 00:15:04,040 Speaker 2: gaining weight, or any of the other thirty four symptoms 253 00:15:04,040 --> 00:15:06,800 Speaker 2: that you may have. A lot of times the doctor 254 00:15:06,920 --> 00:15:09,840 Speaker 2: that you see does not recognize it as such, because 255 00:15:10,000 --> 00:15:12,440 Speaker 2: all they're thinking about as well, are you getting your 256 00:15:12,480 --> 00:15:16,400 Speaker 2: period or is your period regular? And if you answer yes, 257 00:15:16,560 --> 00:15:19,120 Speaker 2: then it would not be uncommon for you to get 258 00:15:19,160 --> 00:15:23,360 Speaker 2: an answer like, well, it can't be menopause. It's like no, 259 00:15:23,480 --> 00:15:28,400 Speaker 2: but it's menopause adjacent this thing called perimenopause. And so 260 00:15:28,880 --> 00:15:33,000 Speaker 2: after you've gone through this entire transition, which like I said, 261 00:15:33,040 --> 00:15:36,280 Speaker 2: can take as long as ten years, then what happens 262 00:15:36,440 --> 00:15:39,720 Speaker 2: are you over it? Well, a lot of women will 263 00:15:39,760 --> 00:15:44,400 Speaker 2: continue to have symptoms even after they've had their last period. 264 00:15:44,840 --> 00:15:47,680 Speaker 2: So this notion that it is something to be endured 265 00:15:48,480 --> 00:15:51,440 Speaker 2: or something that you will get over, I want to 266 00:15:51,480 --> 00:15:55,960 Speaker 2: sort of disabuse everyone of that notion. Because menopause process 267 00:15:56,040 --> 00:16:00,760 Speaker 2: is complete, you will continue to have the us of 268 00:16:00,800 --> 00:16:04,280 Speaker 2: that lack of estrogen and you will be that way 269 00:16:04,360 --> 00:16:06,960 Speaker 2: for the rest of your life. So for anybody who says, oh, 270 00:16:07,000 --> 00:16:10,840 Speaker 2: I didn't have menopause or I'm over it now. No, 271 00:16:10,960 --> 00:16:13,080 Speaker 2: you may be over your hot flashes, but you are 272 00:16:13,160 --> 00:16:17,840 Speaker 2: not over all the other signs and symptoms and health 273 00:16:17,840 --> 00:16:19,720 Speaker 2: issues that are associated with menopause. 274 00:16:20,760 --> 00:16:23,760 Speaker 1: Got it, so, doctor Malone, how often are people coming 275 00:16:23,800 --> 00:16:26,400 Speaker 1: to you to talk about So you gave some symptoms 276 00:16:26,440 --> 00:16:29,880 Speaker 1: around vaginal dryness, changes in libido, which is of course 277 00:16:29,880 --> 00:16:32,120 Speaker 1: what we want to spend more time talking about today. 278 00:16:32,360 --> 00:16:34,520 Speaker 1: How often are patients coming to you talking to you 279 00:16:34,560 --> 00:16:36,400 Speaker 1: about those symptoms in particular? 280 00:16:36,800 --> 00:16:38,720 Speaker 2: Well, you know whether they bring it up or not. 281 00:16:39,000 --> 00:16:43,880 Speaker 2: Eighty percent of women will experience either vaginal dryness, painful sex, 282 00:16:44,280 --> 00:16:49,640 Speaker 2: itchy dry vulva, or urinary symptoms as in frequent urinary 283 00:16:49,680 --> 00:16:54,680 Speaker 2: tract infections or urinary frequency and urgency. And that has 284 00:16:54,800 --> 00:16:58,520 Speaker 2: even a separate name for itself. It's called the genital 285 00:16:58,800 --> 00:17:02,040 Speaker 2: urinary Syndrome of menopause. Now that's a mouthful, so we 286 00:17:02,200 --> 00:17:05,879 Speaker 2: just say GSM. That means that the lack of estrogen 287 00:17:05,920 --> 00:17:09,800 Speaker 2: will affect your genital system. It affects your urinary system 288 00:17:10,119 --> 00:17:14,359 Speaker 2: and even your external genitalia. So I told you eighty 289 00:17:14,400 --> 00:17:17,800 Speaker 2: percent of women will experience, in some form of fashion 290 00:17:18,160 --> 00:17:22,399 Speaker 2: some combination of those symptoms well, a lot of women 291 00:17:22,560 --> 00:17:25,760 Speaker 2: are embarrassed. You may not bring it up, and you 292 00:17:25,840 --> 00:17:29,520 Speaker 2: look at what is advertised on TV, and you'll understand 293 00:17:29,640 --> 00:17:33,840 Speaker 2: how common the problem is. And remember how many incontinence 294 00:17:33,880 --> 00:17:37,520 Speaker 2: products there are advertised every time you look around, gotta go, 295 00:17:37,520 --> 00:17:40,959 Speaker 2: gotta go, and here's some new underwear that you can 296 00:17:41,040 --> 00:17:45,400 Speaker 2: put on because you're leaking. But no one really talks about, Okay, 297 00:17:46,200 --> 00:17:50,560 Speaker 2: why and better still, if that many women are having 298 00:17:50,640 --> 00:17:54,040 Speaker 2: these problems, what are we doing about it? And again 299 00:17:54,160 --> 00:17:57,639 Speaker 2: it gets back to the same thing that we're talking about. 300 00:17:57,640 --> 00:18:01,480 Speaker 2: What undergirds all of this is at menopause, the lack 301 00:18:01,720 --> 00:18:05,760 Speaker 2: of estrogen. So when you're having painful sex, when you 302 00:18:05,800 --> 00:18:10,240 Speaker 2: are having dry, itchy volvas, it is the lack of 303 00:18:10,440 --> 00:18:14,159 Speaker 2: estrogen because all of that tissue is estrogen sensitive. And 304 00:18:14,200 --> 00:18:17,119 Speaker 2: as a matter of fact, when you are just using 305 00:18:17,280 --> 00:18:21,600 Speaker 2: lubricants or creams or gels or that kind of stuff 306 00:18:21,640 --> 00:18:25,439 Speaker 2: to treat the symptoms, you're doing just that. You're just 307 00:18:25,480 --> 00:18:29,200 Speaker 2: treating the symptoms. You are not addressing the root cause. 308 00:18:29,800 --> 00:18:32,960 Speaker 2: And for most women, the simple solution is you can 309 00:18:33,080 --> 00:18:36,880 Speaker 2: use topical or local estrogen, which means just an estrogen 310 00:18:37,000 --> 00:18:41,440 Speaker 2: cream or tablet or a ring just in the vagina. 311 00:18:41,520 --> 00:18:44,800 Speaker 2: And this is even for women who either choose not 312 00:18:44,960 --> 00:18:49,960 Speaker 2: to take hormone replacement therapy after menopause or have reasons 313 00:18:50,000 --> 00:18:54,520 Speaker 2: why they should not take. But at a minimum, every 314 00:18:54,560 --> 00:18:58,320 Speaker 2: woman should have these issues addressed. And if you don't 315 00:18:58,320 --> 00:19:01,280 Speaker 2: bring it up to your doctor, it's not uncommon that 316 00:19:01,359 --> 00:19:04,480 Speaker 2: doctors won't ask because we've got so many other things 317 00:19:04,520 --> 00:19:06,800 Speaker 2: to talk about. And I have to give my colleagues 318 00:19:06,840 --> 00:19:10,480 Speaker 2: a little bit of a break here, not my gyn colleagues, 319 00:19:10,560 --> 00:19:15,800 Speaker 2: because they should be asking. But you're internist or you're cardiologists, 320 00:19:15,800 --> 00:19:17,600 Speaker 2: they're never going to ask you about whether or not 321 00:19:17,680 --> 00:19:20,800 Speaker 2: you have painful sex, or whether or not your vagina's dry. 322 00:19:21,480 --> 00:19:25,040 Speaker 2: But your gynecologists should, which is why I get back 323 00:19:25,080 --> 00:19:30,000 Speaker 2: to you can't stop going to the gynecologists just because 324 00:19:30,000 --> 00:19:32,920 Speaker 2: you're done having your kids, because there are other things 325 00:19:32,960 --> 00:19:36,119 Speaker 2: that come up in midlife that do need to be addressed, 326 00:19:36,200 --> 00:19:39,000 Speaker 2: and a lot of times your gynecologist is the most 327 00:19:39,040 --> 00:19:41,720 Speaker 2: appropriate person to bring that up with. HM. 328 00:19:42,560 --> 00:19:44,399 Speaker 1: You know, doctor Malone, as you're talking about some of 329 00:19:44,400 --> 00:19:47,639 Speaker 1: these other thirty four symptoms of menopause, you're sharing, like 330 00:19:47,720 --> 00:19:51,560 Speaker 1: the mechanics that may make sex painful or difficult. But 331 00:19:51,640 --> 00:19:53,920 Speaker 1: some of the other things that you're mentioning, like hair 332 00:19:54,040 --> 00:19:57,080 Speaker 1: laws or weight gain like also play into I think 333 00:19:57,119 --> 00:19:59,680 Speaker 1: some of the mental health components that may be connected 334 00:19:59,720 --> 00:20:03,280 Speaker 1: to sexual activity. Can you speak to that a little absolutely? 335 00:20:03,520 --> 00:20:06,639 Speaker 1: I mean, think about none of these things happens in isolation, 336 00:20:06,920 --> 00:20:09,719 Speaker 1: and one thing affects the other. And the thing that 337 00:20:09,760 --> 00:20:12,520 Speaker 1: I didn't mention of those thirty four symptoms, the other 338 00:20:12,560 --> 00:20:16,679 Speaker 1: thing that really picks up in perimenopause is really a 339 00:20:16,720 --> 00:20:22,640 Speaker 1: lot of either depression, anxiety, irritability. I mean, they really 340 00:20:22,760 --> 00:20:27,560 Speaker 1: peak in midlife as you are making this transition. So imagine, 341 00:20:28,080 --> 00:20:31,040 Speaker 1: let's just start with the hot flesh, because everybody understands it, 342 00:20:31,320 --> 00:20:34,399 Speaker 1: all right, you have a hot flash. Now you've got 343 00:20:34,520 --> 00:20:38,439 Speaker 1: night sweats, you didn't get a good night's sleep, You're fatigued, 344 00:20:39,200 --> 00:20:43,320 Speaker 1: you're irritable, you got brain fog. And you go through 345 00:20:43,359 --> 00:20:47,920 Speaker 1: this day after day, month after month. You're not feeling 346 00:20:47,960 --> 00:20:51,480 Speaker 1: your best self. You're certainly not going to exercise because 347 00:20:51,520 --> 00:20:54,880 Speaker 1: you're tired, and you're gonna make bad choices. You don't 348 00:20:54,920 --> 00:20:58,280 Speaker 1: feel well. So we self medicate with things, some people 349 00:20:58,320 --> 00:21:01,560 Speaker 1: with alcohol, some people with food, some people with drugs, 350 00:21:02,080 --> 00:21:04,919 Speaker 1: whatever it is. We are constantly trying to get to 351 00:21:04,960 --> 00:21:08,200 Speaker 1: a point where we say, I just need to feel better. Now, 352 00:21:08,560 --> 00:21:11,119 Speaker 1: is that any recipe for anybody who wants to be 353 00:21:11,320 --> 00:21:13,520 Speaker 1: very sexual? When you think about it, it's like. 354 00:21:13,760 --> 00:21:17,600 Speaker 2: I'm mad, I'm hot, I'm tired, And at the end 355 00:21:17,680 --> 00:21:19,679 Speaker 2: of the day, after you've gone through all of that, 356 00:21:19,880 --> 00:21:22,840 Speaker 2: then somebody says, oh, yeah, wouldn't this be a great idea? 357 00:21:23,280 --> 00:21:29,440 Speaker 2: Probably not, okay. I mean, a tired woman is not 358 00:21:29,640 --> 00:21:33,560 Speaker 2: going to be at her peak sexual best. And that's 359 00:21:33,560 --> 00:21:36,520 Speaker 2: why you can't just say I'm just going to take 360 00:21:36,520 --> 00:21:40,040 Speaker 2: care of the weight gain issue. Okay, well that's fine, 361 00:21:40,080 --> 00:21:42,760 Speaker 2: but what about all the other stuff? Because they all 362 00:21:42,800 --> 00:21:45,600 Speaker 2: play into each other, and they feed into each other, 363 00:21:45,680 --> 00:21:49,359 Speaker 2: and it really creates a really negative doomsday loop for 364 00:21:49,440 --> 00:21:53,520 Speaker 2: women in terms of how we feel. And as I said, 365 00:21:53,600 --> 00:21:56,200 Speaker 2: this is something that if there's a message there, and 366 00:21:56,200 --> 00:21:57,679 Speaker 2: there are a lot of messages I want to get 367 00:21:57,720 --> 00:22:01,200 Speaker 2: out there. But the good news is that we are 368 00:22:01,320 --> 00:22:07,159 Speaker 2: really trying to show women a different path forward and 369 00:22:07,480 --> 00:22:10,000 Speaker 2: to get you out of the mindset that old. I'm 370 00:22:10,080 --> 00:22:13,520 Speaker 2: old and creaky. I'm sixty five years old. I mean, 371 00:22:13,720 --> 00:22:18,280 Speaker 2: Kamala Harris is almost sixty. Michelle Obama, all of these 372 00:22:18,320 --> 00:22:22,040 Speaker 2: women who are out there that are saying, no, this 373 00:22:22,280 --> 00:22:25,000 Speaker 2: can and should be the best time of your life. 374 00:22:25,600 --> 00:22:28,600 Speaker 2: It should be something to look forward to, not something 375 00:22:28,640 --> 00:22:32,240 Speaker 2: to dread. And whether or not this part of your 376 00:22:32,240 --> 00:22:35,480 Speaker 2: life is good or bad is really going to be 377 00:22:35,560 --> 00:22:39,439 Speaker 2: dependent upon how we navigate it, and a lot of 378 00:22:39,480 --> 00:22:42,920 Speaker 2: times most of us just don't know how. And it's 379 00:22:42,960 --> 00:22:45,720 Speaker 2: not your fault. This is the kind of thing that 380 00:22:45,880 --> 00:22:50,400 Speaker 2: we don't talk enough amongst ourselves, and we don't talk 381 00:22:50,560 --> 00:22:54,720 Speaker 2: enough intergenerationally because I think for many of our mothers, 382 00:22:55,640 --> 00:22:58,520 Speaker 2: they didn't really know that there was an option, and 383 00:22:58,600 --> 00:23:00,879 Speaker 2: for many of them there really was. That's not an option. 384 00:23:01,800 --> 00:23:05,840 Speaker 2: So you know, that kind of acceptance of not being 385 00:23:05,880 --> 00:23:08,640 Speaker 2: your best self is something we've got to get out 386 00:23:08,640 --> 00:23:11,399 Speaker 2: of the mindset of. And so that's why if I 387 00:23:11,480 --> 00:23:15,800 Speaker 2: sound passionate about this, it's because I am. Because I 388 00:23:15,920 --> 00:23:20,200 Speaker 2: really want every woman to make the decision that's right 389 00:23:20,280 --> 00:23:22,600 Speaker 2: for you. And I think for all of these thirty 390 00:23:22,600 --> 00:23:25,520 Speaker 2: four symptoms of menopause that we talked about, the most 391 00:23:25,560 --> 00:23:31,560 Speaker 2: effective treatment for the symptoms of menopause is hormone therapy. 392 00:23:32,400 --> 00:23:36,760 Speaker 2: You know who gets that message least of all Black women, 393 00:23:37,600 --> 00:23:41,960 Speaker 2: but that's my job. Make sure you know when to 394 00:23:42,000 --> 00:23:46,000 Speaker 2: access what is important. What are the things that you 395 00:23:46,080 --> 00:23:49,520 Speaker 2: think are the reasons why you can't take unless knock 396 00:23:49,600 --> 00:23:51,399 Speaker 2: down those myths one at a time. 397 00:23:51,960 --> 00:23:54,919 Speaker 1: More from our conversation after the break, but first, a 398 00:23:55,000 --> 00:23:58,639 Speaker 1: quick snippet of what's coming next week on TVG My. 399 00:23:58,760 --> 00:24:02,159 Speaker 3: Mom's sister was and is a journalist. Her name is 400 00:24:02,160 --> 00:24:06,720 Speaker 3: Soladette O'Brien, and she traveled to cover Hurricane Katrina, and 401 00:24:07,000 --> 00:24:10,920 Speaker 3: she was there for months on end, at times living 402 00:24:11,000 --> 00:24:14,080 Speaker 3: out of cars, to cover the story, to put other 403 00:24:14,240 --> 00:24:19,200 Speaker 3: people's voices out on a national platform. And I don't 404 00:24:19,200 --> 00:24:20,720 Speaker 3: think I would have had the words for this at 405 00:24:20,720 --> 00:24:25,199 Speaker 3: the time, but I do remember getting the impression or 406 00:24:25,240 --> 00:24:28,600 Speaker 3: just having the feeling that, Wow, it is so amazing 407 00:24:28,640 --> 00:24:30,800 Speaker 3: that when there is a problem, there are people who 408 00:24:30,880 --> 00:24:34,080 Speaker 3: run toward it instead of running away from it, and 409 00:24:34,640 --> 00:24:36,240 Speaker 3: that at a time when so many people were trying 410 00:24:36,280 --> 00:24:38,920 Speaker 3: to figure out how to leave this city, I had 411 00:24:39,080 --> 00:24:42,200 Speaker 3: a loved one, an aunt, who was there actually recording 412 00:24:42,200 --> 00:24:45,359 Speaker 3: and documenting and showing people every day why they couldn't 413 00:24:45,400 --> 00:24:48,560 Speaker 3: look away from what was happening there. 414 00:25:00,800 --> 00:25:03,720 Speaker 1: So, doctor Malone, can you talk about why black women 415 00:25:03,760 --> 00:25:06,600 Speaker 1: are not getting prescribed it as much. Is it just 416 00:25:06,640 --> 00:25:09,600 Speaker 1: good old fashioned racism or is there something else going on? 417 00:25:09,800 --> 00:25:13,200 Speaker 2: Oh? Yeah, two things can be true. Okay, And let 418 00:25:13,200 --> 00:25:15,360 Speaker 2: me tell you there was actually a study that came 419 00:25:15,400 --> 00:25:19,040 Speaker 2: out twenty two years ago, the Women's Health Initiative, which 420 00:25:19,240 --> 00:25:22,760 Speaker 2: put this out there in the universe that estrogen causes 421 00:25:22,800 --> 00:25:27,080 Speaker 2: cancer and it doesn't have any benefit in long term help. 422 00:25:27,240 --> 00:25:31,199 Speaker 2: That study came out twenty two years ago. Well, I 423 00:25:31,280 --> 00:25:35,240 Speaker 2: had been practicing for ten years before that study came out, 424 00:25:35,480 --> 00:25:38,440 Speaker 2: and so I had a very different experience. And remember 425 00:25:38,520 --> 00:25:40,720 Speaker 2: I told you I had been treating women with menopause 426 00:25:40,760 --> 00:25:43,720 Speaker 2: since the first day I started, and so we were 427 00:25:43,760 --> 00:25:47,600 Speaker 2: taught something very different in terms of how to prescribe 428 00:25:47,600 --> 00:25:51,199 Speaker 2: hormone therapy what it was for. We were taught that 429 00:25:51,359 --> 00:25:54,479 Speaker 2: not only did it relieve the symptoms it does it 430 00:25:54,520 --> 00:25:57,680 Speaker 2: did then still does, but it also decreased the risk 431 00:25:57,720 --> 00:26:01,240 Speaker 2: of cardiovascular disease. And that was the big push about 432 00:26:01,240 --> 00:26:04,720 Speaker 2: why we were really advocating that women take it, because 433 00:26:04,880 --> 00:26:08,440 Speaker 2: more women die from heart disease every year, anywhere from 434 00:26:08,480 --> 00:26:12,080 Speaker 2: two to seven times more women die of heart disease 435 00:26:12,119 --> 00:26:15,879 Speaker 2: than die of breast cancer. So if you had something 436 00:26:15,920 --> 00:26:20,160 Speaker 2: that was going to decrease your risk of cardiovascular disease. Yay, 437 00:26:20,520 --> 00:26:24,200 Speaker 2: everybody should take it, right, But that study that came 438 00:26:24,240 --> 00:26:28,560 Speaker 2: out twenty two years cast doubt on that assertion that 439 00:26:28,600 --> 00:26:32,000 Speaker 2: it decreased the risk of cardiovascular disease. But it did 440 00:26:32,040 --> 00:26:34,840 Speaker 2: more than that. It cast doubt on that, and it 441 00:26:34,960 --> 00:26:37,560 Speaker 2: also throughout there. Oh yeah, and by the way, it 442 00:26:37,600 --> 00:26:40,919 Speaker 2: increases your risk of breast cancer. Now, neither of those 443 00:26:41,320 --> 00:26:44,879 Speaker 2: turned out to be true, and there was argument about 444 00:26:44,880 --> 00:26:47,320 Speaker 2: it from the very beginning. But you know how it is, 445 00:26:47,440 --> 00:26:52,240 Speaker 2: bad news travels fast and it's sticky. Even though we 446 00:26:52,560 --> 00:26:56,919 Speaker 2: in medicine and even in academic circles have been refuting 447 00:26:57,080 --> 00:27:01,800 Speaker 2: that for twenty two years, ever really made it out 448 00:27:01,920 --> 00:27:06,320 Speaker 2: into the universe. Everybody remembers when you get indicted. Nobody 449 00:27:06,359 --> 00:27:09,199 Speaker 2: remembers when you got to quit it. And that's the 450 00:27:09,240 --> 00:27:13,600 Speaker 2: hormone story. So we have an entire generation of doctors 451 00:27:13,640 --> 00:27:16,400 Speaker 2: that don't know how to prescribe and still will tell 452 00:27:16,440 --> 00:27:19,000 Speaker 2: you that to this day, Oh no, you can't have 453 00:27:19,080 --> 00:27:24,280 Speaker 2: hormones because your mother had breast cancer. That kind of problem. 454 00:27:24,520 --> 00:27:28,639 Speaker 2: So that is true for all women, okay, all women. 455 00:27:28,760 --> 00:27:31,840 Speaker 2: And here's where the racism piece comes. In if it's 456 00:27:31,880 --> 00:27:34,720 Speaker 2: true for all women, then it's twice as bad when 457 00:27:34,720 --> 00:27:39,360 Speaker 2: it comes to Black women. And that is culturally educationally, 458 00:27:39,600 --> 00:27:42,200 Speaker 2: both on the part of physicians and on the part 459 00:27:42,240 --> 00:27:45,760 Speaker 2: of women. It sort of creates that perfect storm for 460 00:27:45,880 --> 00:27:49,399 Speaker 2: the people suffering the most getting the least. And that 461 00:27:49,560 --> 00:27:52,800 Speaker 2: is the story of just about any condition that you're 462 00:27:52,840 --> 00:27:55,399 Speaker 2: talking about when we're talking about African American women. 463 00:27:56,400 --> 00:28:00,119 Speaker 1: Got it. So, when the chances of getting pregnant are 464 00:28:00,200 --> 00:28:04,320 Speaker 1: less likely, right, typically in perimenopause menopause age, I think 465 00:28:04,320 --> 00:28:06,080 Speaker 1: a lot of women say like, oh, I don't need 466 00:28:06,160 --> 00:28:08,439 Speaker 1: kind OFMS, I don't need other protections, but we know 467 00:28:08,520 --> 00:28:12,720 Speaker 1: that the rate of STIs are also higher in older populations. 468 00:28:12,720 --> 00:28:14,800 Speaker 1: Can you talk a little bit about the continue need 469 00:28:14,840 --> 00:28:15,400 Speaker 1: for protection. 470 00:28:16,000 --> 00:28:19,320 Speaker 2: Yes, okay, there are two kinds of protection, and perimenopausal 471 00:28:19,400 --> 00:28:22,400 Speaker 2: women need both because remember I told you that that 472 00:28:22,800 --> 00:28:27,520 Speaker 2: period of time between your peak reproductive years and no reproduction. Okay, 473 00:28:27,640 --> 00:28:31,679 Speaker 2: well that's a long span in between, and decreased fertility 474 00:28:31,760 --> 00:28:35,080 Speaker 2: does not mean no fertility. So even when you are 475 00:28:35,080 --> 00:28:39,800 Speaker 2: in perimenopause, you still should be using some reliable birth control. 476 00:28:40,240 --> 00:28:44,400 Speaker 2: And if you don't believe it, well, yours truly I 477 00:28:44,480 --> 00:28:47,320 Speaker 2: am that child that my mother was probably wishing for 478 00:28:47,440 --> 00:28:50,240 Speaker 2: menopause and she got me instead. My mother was almost 479 00:28:50,240 --> 00:28:53,280 Speaker 2: forty five when I was born. And it's funny because 480 00:28:53,520 --> 00:28:56,920 Speaker 2: now the family stories make sense to me because as 481 00:28:56,960 --> 00:28:58,880 Speaker 2: I was growing up, and I told you, I'm eight 482 00:28:58,920 --> 00:29:01,680 Speaker 2: of eight and the next sibling to me is seven 483 00:29:01,800 --> 00:29:05,080 Speaker 2: years older than me, and so the family stories I 484 00:29:05,120 --> 00:29:07,960 Speaker 2: always heard were, oh, we didn't even know your mother 485 00:29:08,080 --> 00:29:10,240 Speaker 2: was pregnant, And I was like, she probably didn't know 486 00:29:10,320 --> 00:29:13,360 Speaker 2: either until it was too You know, here, I am 487 00:29:13,920 --> 00:29:19,080 Speaker 2: so to all my perimenopausal ladies, it's decreased fertility, not 488 00:29:19,320 --> 00:29:24,120 Speaker 2: no fertility. So if you need reliable birth control, use that. Now, 489 00:29:24,760 --> 00:29:28,920 Speaker 2: if you have a male partner, and you and that 490 00:29:29,000 --> 00:29:33,200 Speaker 2: male partner are not in a monogamous relationship, then in 491 00:29:33,240 --> 00:29:36,040 Speaker 2: addition to whatever you're using, like if you want to 492 00:29:36,120 --> 00:29:38,640 Speaker 2: use birth control, or you have an IUD or whatever 493 00:29:38,720 --> 00:29:41,600 Speaker 2: is your primary mode of birth control, even if you've 494 00:29:41,600 --> 00:29:45,880 Speaker 2: had your tubes tied, if you're in a non monogamous relationship, 495 00:29:46,200 --> 00:29:49,680 Speaker 2: you need to use condoms to make sure that you 496 00:29:49,920 --> 00:29:54,520 Speaker 2: are not getting infected with sexually transmitted infections. Because here's 497 00:29:54,560 --> 00:30:01,480 Speaker 2: the deal. The ratio of males to females, and particularly 498 00:30:01,560 --> 00:30:05,400 Speaker 2: for black women, that ratio gets less and less favorable 499 00:30:05,440 --> 00:30:07,840 Speaker 2: as we get older. We know that, all right, So 500 00:30:07,880 --> 00:30:10,640 Speaker 2: you take out all the reasons why black men if 501 00:30:10,640 --> 00:30:14,480 Speaker 2: that is your preference, fall out of that equation. If 502 00:30:14,520 --> 00:30:17,080 Speaker 2: you are not in a monogamous relationship and you're in 503 00:30:17,120 --> 00:30:21,760 Speaker 2: the dating world, it is not unlikely that one functioning 504 00:30:21,880 --> 00:30:27,160 Speaker 2: male may be servicing a few others. And that is 505 00:30:27,240 --> 00:30:29,800 Speaker 2: why you need to make sure that at least you're 506 00:30:29,920 --> 00:30:33,640 Speaker 2: clear what type of relationship is this before you say, 507 00:30:33,680 --> 00:30:36,640 Speaker 2: all right, we can be condom free, and there are 508 00:30:36,680 --> 00:30:38,640 Speaker 2: ways to do it. But I want women to be 509 00:30:38,720 --> 00:30:40,920 Speaker 2: aware of that that you're still at risk for the 510 00:30:40,960 --> 00:30:45,240 Speaker 2: things that you would tell your teenage daughter about. Beware 511 00:30:45,280 --> 00:30:51,200 Speaker 2: of pregnancy, beware of sexually transmitted infections. HIV rates are 512 00:30:51,240 --> 00:30:55,280 Speaker 2: the highest in African American women in this country. So 513 00:30:55,480 --> 00:30:58,080 Speaker 2: we tend to think that that's not a thing anymore. No, 514 00:30:58,200 --> 00:31:01,480 Speaker 2: it's still a thing. If you had gonnarear chlamydia, we 515 00:31:01,600 --> 00:31:04,440 Speaker 2: know how to treat that. We forget about the other 516 00:31:04,480 --> 00:31:09,120 Speaker 2: things that are much more serious, herpies and HIV and 517 00:31:09,200 --> 00:31:10,960 Speaker 2: things that can be problematic for you. 518 00:31:11,760 --> 00:31:14,120 Speaker 1: I'm curious, doctor Malone because you also mentioned that there's 519 00:31:14,120 --> 00:31:16,880 Speaker 1: a higher rate of increased urinary tract infections. Is there 520 00:31:16,920 --> 00:31:20,280 Speaker 1: a connection between that and then the increase in sis 521 00:31:20,320 --> 00:31:20,960 Speaker 1: in that ee? 522 00:31:21,320 --> 00:31:23,840 Speaker 2: Well, you know what, think about this. When you are 523 00:31:24,000 --> 00:31:27,959 Speaker 2: a young person, your vagina is thick, it has the 524 00:31:28,000 --> 00:31:32,800 Speaker 2: ability to lubricate really well. As you get older, and 525 00:31:33,080 --> 00:31:36,560 Speaker 2: if you do not have estrogen on board, the vagina 526 00:31:36,600 --> 00:31:42,240 Speaker 2: gets thinner, it's more easily irritated, it's easier to be traumatized. 527 00:31:42,280 --> 00:31:44,720 Speaker 2: That's why sex is so painful because now those nerve 528 00:31:44,800 --> 00:31:47,840 Speaker 2: endings are closer to the skin than they were before 529 00:31:48,200 --> 00:31:51,920 Speaker 2: and you have no protection, so you're more susceptible to 530 00:31:52,120 --> 00:31:55,640 Speaker 2: STIs because again you don't have as healthy a vagina 531 00:31:56,080 --> 00:31:59,800 Speaker 2: as you had twenty years before. And the same thing 532 00:31:59,840 --> 00:32:03,840 Speaker 2: is true with urinary tract infections. You need a healthy 533 00:32:04,520 --> 00:32:09,560 Speaker 2: vaginal tissue. You need healthy urinary tissue, and when that 534 00:32:09,640 --> 00:32:13,240 Speaker 2: fends and it's easily irritated, it's so easy for bacteria 535 00:32:13,320 --> 00:32:15,760 Speaker 2: to get into your bladder. So all of that, you 536 00:32:15,800 --> 00:32:19,200 Speaker 2: think of it all together that the less healthy the tissue, 537 00:32:19,360 --> 00:32:22,680 Speaker 2: the more likely you are to be infected with bacteria 538 00:32:23,240 --> 00:32:24,120 Speaker 2: or with viruses. 539 00:32:24,640 --> 00:32:27,240 Speaker 1: So that's malone. I'm also curious is there a concern 540 00:32:27,320 --> 00:32:30,560 Speaker 1: about the physical exertion that is connected to sex as 541 00:32:30,600 --> 00:32:33,680 Speaker 1: we get older. You mentioned like cardiovascular kinds of things, 542 00:32:33,720 --> 00:32:37,080 Speaker 1: So is there concerned around like the exertion of actual 543 00:32:37,200 --> 00:32:39,000 Speaker 1: sex being a concern as we get older? 544 00:32:39,520 --> 00:32:41,880 Speaker 2: So what are you doing? I'm just no, I'm just saying, 545 00:32:42,400 --> 00:32:44,560 Speaker 2: y'all do I'm just trying to figure you know, regular 546 00:32:44,760 --> 00:32:48,880 Speaker 2: old people says, no, you fine, You fine? Okay. I 547 00:32:48,920 --> 00:32:51,920 Speaker 2: mean if you had to go do some acromatics, perhaps, 548 00:32:52,040 --> 00:32:55,880 Speaker 2: but no, if you are a healthy person, then there 549 00:32:55,960 --> 00:32:58,760 Speaker 2: is really nothing that you have unless we know that 550 00:32:58,800 --> 00:33:02,160 Speaker 2: you have some under lying severe heart disease. But no, 551 00:33:02,320 --> 00:33:06,880 Speaker 2: the amount of exertion for normal sexual activity, which actually 552 00:33:07,560 --> 00:33:11,160 Speaker 2: is good for you. Women and men who are sexually 553 00:33:11,200 --> 00:33:15,560 Speaker 2: active longer actually have better health span and lifespan. So no, 554 00:33:15,760 --> 00:33:18,120 Speaker 2: there's really not a whole lot to be worried about 555 00:33:18,200 --> 00:33:21,600 Speaker 2: unless you have serious other complications. 556 00:33:22,120 --> 00:33:23,960 Speaker 1: So I would imagine that a part of your role 557 00:33:24,000 --> 00:33:28,200 Speaker 1: as obgyn also sometimes is a bit of therapy as well, right, 558 00:33:28,520 --> 00:33:30,000 Speaker 1: And so I wonder if you can talk a little 559 00:33:30,040 --> 00:33:33,040 Speaker 1: bit about some of the other stigmas are conversations you're 560 00:33:33,080 --> 00:33:35,800 Speaker 1: having with your patients around getting older and what it 561 00:33:35,840 --> 00:33:38,560 Speaker 1: means to feel sexy and even have interest in sex. 562 00:33:39,440 --> 00:33:42,880 Speaker 2: The one thing that I loved about my job and 563 00:33:43,000 --> 00:33:48,360 Speaker 2: that I really may be missing in future relationships is 564 00:33:48,360 --> 00:33:50,920 Speaker 2: that I stayed in one place for thirty years and 565 00:33:51,000 --> 00:33:53,840 Speaker 2: I had a lot of the same patients for thirty years, 566 00:33:53,840 --> 00:33:57,240 Speaker 2: so I knew them, they knew me, and an obgyan 567 00:33:57,560 --> 00:34:03,200 Speaker 2: is the most intimate medical relationship you're ever going to 568 00:34:03,280 --> 00:34:06,280 Speaker 2: have with a doctor. So yes, on any given day, 569 00:34:06,360 --> 00:34:09,640 Speaker 2: I always kept a box of tissues just right there. 570 00:34:09,800 --> 00:34:11,839 Speaker 2: I would come in, I'd say, hey, how you doing, 571 00:34:11,920 --> 00:34:15,840 Speaker 2: and I go I'm fine, and I'm like, really, okay, 572 00:34:15,920 --> 00:34:18,160 Speaker 2: let me get my tissues here, and we would sit. 573 00:34:18,840 --> 00:34:22,000 Speaker 2: Because there are a lot of things that happen in 574 00:34:22,040 --> 00:34:27,000 Speaker 2: midlife in addition to perimenopause and menopause and all the 575 00:34:27,040 --> 00:34:30,359 Speaker 2: sort of trials and tribulations that that brings, It's an 576 00:34:30,680 --> 00:34:33,879 Speaker 2: emotionally fraught time of life. That is, when we are 577 00:34:33,960 --> 00:34:39,279 Speaker 2: generally dealing with aging parents. We still have children who 578 00:34:39,360 --> 00:34:42,600 Speaker 2: are adolescents and who are usually pains and the ads 579 00:34:42,640 --> 00:34:45,360 Speaker 2: at that point marriages may not be going well, so 580 00:34:45,520 --> 00:34:48,479 Speaker 2: there's a lot So yes, you have to know how 581 00:34:48,560 --> 00:34:54,600 Speaker 2: to be sensitive to the total person who is presenting 582 00:34:54,680 --> 00:34:56,200 Speaker 2: to you, not just I'm going to come in here 583 00:34:56,200 --> 00:34:58,839 Speaker 2: and do your pap smear and we're gone and all 584 00:34:58,920 --> 00:35:03,040 Speaker 2: of that. That You're mental health matters, how you are 585 00:35:03,200 --> 00:35:07,560 Speaker 2: moving about in the world, also affects your sexuality, how 586 00:35:07,600 --> 00:35:10,520 Speaker 2: you are feeling. You have to realize that there is 587 00:35:10,560 --> 00:35:14,360 Speaker 2: a very different relationship that you have to your libido 588 00:35:14,520 --> 00:35:17,120 Speaker 2: when you're fifty than when you're twenty. I mean, it 589 00:35:17,239 --> 00:35:20,319 Speaker 2: just is. And that doesn't mean there's anything wrong with you. 590 00:35:20,440 --> 00:35:23,040 Speaker 2: And it means that how you approach things and what 591 00:35:23,080 --> 00:35:27,120 Speaker 2: your expectations are are different. And I think that as 592 00:35:27,160 --> 00:35:31,640 Speaker 2: long as women understand that, and even after you understand 593 00:35:31,640 --> 00:35:35,520 Speaker 2: that it's different, if it's bothersome to you, to know 594 00:35:35,640 --> 00:35:38,800 Speaker 2: that there are again therapy that we can offer. Sometimes 595 00:35:38,880 --> 00:35:42,640 Speaker 2: it's a marital counselor sometimes it's sex therapy, sometimes it's 596 00:35:42,719 --> 00:35:47,120 Speaker 2: hormone therapy or any combination thereof about how to address it. 597 00:35:47,440 --> 00:35:51,680 Speaker 2: But know that it's different, it's not just you. And 598 00:35:51,719 --> 00:35:54,279 Speaker 2: I think that if we don't talk about menopause, we 599 00:35:54,320 --> 00:35:59,320 Speaker 2: don't talk about our sexual difficulties with our peers, because 600 00:35:59,360 --> 00:36:01,720 Speaker 2: we tend to think that everybody's having a great time 601 00:36:01,920 --> 00:36:05,480 Speaker 2: except me, And you have to be able to be 602 00:36:05,640 --> 00:36:09,879 Speaker 2: vulnerable with someone and to be able to explain, hey, 603 00:36:10,440 --> 00:36:13,400 Speaker 2: is this normal? What can I do to have that 604 00:36:13,520 --> 00:36:16,120 Speaker 2: kind of relationship? And what happens to a lot of 605 00:36:16,160 --> 00:36:18,640 Speaker 2: women in midlife, as I told you, is we start 606 00:36:18,760 --> 00:36:23,160 Speaker 2: experiencing a lot of these mental health issues like depression, anxiety. 607 00:36:23,680 --> 00:36:25,480 Speaker 2: One of the first things that a doctor wants to 608 00:36:25,520 --> 00:36:28,880 Speaker 2: do is put you on an SSRI or the antidepressants, 609 00:36:28,960 --> 00:36:35,600 Speaker 2: things like paxel zolof medications like that, and okay, yeah, 610 00:36:35,719 --> 00:36:37,680 Speaker 2: it might help a little bit, it might take the 611 00:36:37,840 --> 00:36:40,760 Speaker 2: edge off. But the thing that most women don't realize 612 00:36:40,840 --> 00:36:44,279 Speaker 2: is that they also have some sexual side effects. And 613 00:36:44,760 --> 00:36:47,760 Speaker 2: you've now taken a problem and you may have fixed 614 00:36:47,800 --> 00:36:51,719 Speaker 2: one thing and you've made another thing worse. So long 615 00:36:51,760 --> 00:36:54,160 Speaker 2: answer to a short question, but yes, how we deal 616 00:36:54,520 --> 00:36:59,160 Speaker 2: with ourselves sexually at fifties different. I think that we 617 00:36:59,320 --> 00:37:02,200 Speaker 2: also have to understand that this is a time when 618 00:37:02,360 --> 00:37:05,680 Speaker 2: many women are entering this phase of life and we 619 00:37:05,719 --> 00:37:09,680 Speaker 2: don't have partners. That's the reality. Okay, well, just because 620 00:37:09,680 --> 00:37:12,040 Speaker 2: you don't have a partner doesn't mean that you can't 621 00:37:12,080 --> 00:37:14,560 Speaker 2: be sexual. Sometimes that means you need to be sexual 622 00:37:14,600 --> 00:37:18,640 Speaker 2: with yourself understand what that means. We can all wish 623 00:37:18,680 --> 00:37:22,759 Speaker 2: for certain things, but at the very least know how 624 00:37:22,800 --> 00:37:25,920 Speaker 2: to take care of things for yourself. M h. 625 00:37:26,640 --> 00:37:39,040 Speaker 1: More from our conversation after the break. You know, doctor Malone, 626 00:37:39,080 --> 00:37:41,160 Speaker 1: I'm sure you are aware of like the certain general's 627 00:37:41,200 --> 00:37:44,400 Speaker 1: conversations around loneliness and what an epidemic this has become 628 00:37:44,400 --> 00:37:47,160 Speaker 1: for us. Can you talk a little bit about loneliness 629 00:37:47,239 --> 00:37:49,720 Speaker 1: as it impacts women, especially in this age. 630 00:37:50,200 --> 00:37:53,440 Speaker 2: Yes, COVID made it all worse. I think we were 631 00:37:53,480 --> 00:37:58,000 Speaker 2: already becoming more isolated as we spend more time with 632 00:37:58,080 --> 00:38:01,480 Speaker 2: our devices, because you can retain yourself just looking at 633 00:38:01,520 --> 00:38:04,840 Speaker 2: a movie or I'm going to scroll through Instagram or TikTok, 634 00:38:05,920 --> 00:38:09,360 Speaker 2: forgetting the fact that even though that may be entertaining 635 00:38:09,360 --> 00:38:13,000 Speaker 2: in the short term, it's not sustaining when it comes 636 00:38:13,080 --> 00:38:16,680 Speaker 2: to our physical and mental well being. And there have 637 00:38:16,800 --> 00:38:20,800 Speaker 2: been numerous studies that have actually shown that people who 638 00:38:20,960 --> 00:38:25,440 Speaker 2: do best are people that have large social networks, be 639 00:38:25,520 --> 00:38:27,880 Speaker 2: it at your school, be it your colleagues, be it 640 00:38:27,960 --> 00:38:31,439 Speaker 2: your family. We really need each other because that's how 641 00:38:31,480 --> 00:38:35,040 Speaker 2: we're wired. We're wired for community, and if you want 642 00:38:35,080 --> 00:38:37,440 Speaker 2: to age well, then you need to make sure that 643 00:38:37,600 --> 00:38:43,239 Speaker 2: your network, your sisterhood is strong, because that's more important 644 00:38:43,360 --> 00:38:48,000 Speaker 2: even than having a spouse or a romantic partner, of 645 00:38:48,080 --> 00:38:50,840 Speaker 2: having that just network of sisterhoods and friends. 646 00:38:51,320 --> 00:38:53,759 Speaker 1: You've mentioned a couple of times around you know, if 647 00:38:53,760 --> 00:38:56,080 Speaker 1: your doctor's not having these kinds of conversations, maybe it's 648 00:38:56,080 --> 00:38:58,600 Speaker 1: time to find another doctor. I wonder what kinds of 649 00:38:58,640 --> 00:39:01,800 Speaker 1: things can you suggest for people of how to vet 650 00:39:02,120 --> 00:39:05,759 Speaker 1: their healthcare professionals so that they are feeling comfortable that 651 00:39:05,800 --> 00:39:07,439 Speaker 1: they're able to take care of them in this next 652 00:39:07,440 --> 00:39:08,120 Speaker 1: phase of life. 653 00:39:08,480 --> 00:39:11,680 Speaker 2: Oh oh, if only someone had written a book about that. 654 00:39:11,760 --> 00:39:13,560 Speaker 2: Oh oh, that would be me. Oh that would be me. 655 00:39:15,960 --> 00:39:18,600 Speaker 2: Thank you for that. No, When I wrote my book, 656 00:39:18,640 --> 00:39:21,600 Speaker 2: and it's called Grown Woman Talk for a reason, and 657 00:39:21,640 --> 00:39:25,520 Speaker 2: that is because it's not just about menopause. There is 658 00:39:26,080 --> 00:39:28,759 Speaker 2: clearly a component. There are two chapters on there about 659 00:39:28,760 --> 00:39:33,480 Speaker 2: perimenopause and menopause. But I organize the book with two 660 00:39:33,520 --> 00:39:36,560 Speaker 2: thoughts in mind. One that no one really talks to 661 00:39:36,600 --> 00:39:39,480 Speaker 2: you when you're over forty because so much of our 662 00:39:39,520 --> 00:39:42,839 Speaker 2: time has been spent around reproductive issues and we deal 663 00:39:42,880 --> 00:39:48,120 Speaker 2: with that. But also to give you heads up on 664 00:39:48,200 --> 00:39:51,400 Speaker 2: how medicine has changed. And I think a lot of 665 00:39:51,440 --> 00:39:56,080 Speaker 2: the assumptions that we make about what your relationship is 666 00:39:56,120 --> 00:39:58,400 Speaker 2: going to be like with your doctor, those are no 667 00:39:58,520 --> 00:40:01,640 Speaker 2: longer valid. And like I said, I'm very grateful for 668 00:40:01,680 --> 00:40:04,719 Speaker 2: the thirty years that I had with my patients. You're 669 00:40:04,719 --> 00:40:06,840 Speaker 2: not going to have thirty years with a doctor anymore. 670 00:40:07,200 --> 00:40:10,160 Speaker 2: There's a doctor shortage. The amount of FaceTime that you 671 00:40:10,200 --> 00:40:12,560 Speaker 2: get with a doctor is less and less and less. 672 00:40:13,080 --> 00:40:15,799 Speaker 2: So I wrote the book to say two things. One, 673 00:40:15,920 --> 00:40:18,160 Speaker 2: I give you an idea of the kinds of things 674 00:40:18,239 --> 00:40:20,520 Speaker 2: that are important. How do you pick a doctor, how 675 00:40:20,520 --> 00:40:23,920 Speaker 2: do you assemble a team? What's important about your history? 676 00:40:24,000 --> 00:40:27,239 Speaker 2: Your family history. So it's that you can show up 677 00:40:27,520 --> 00:40:30,200 Speaker 2: better for your doctor's appointment because you're not going to 678 00:40:30,239 --> 00:40:32,600 Speaker 2: get a lot of time. So if you've got five 679 00:40:32,640 --> 00:40:35,360 Speaker 2: to seven minutes, make sure that you've invested on the 680 00:40:35,400 --> 00:40:39,480 Speaker 2: front end and your homework and you are prepared. Very important. 681 00:40:40,239 --> 00:40:42,719 Speaker 2: And I think the other thing that we have got 682 00:40:42,719 --> 00:40:45,960 Speaker 2: to realize is that medicine has changed and we're not 683 00:40:46,120 --> 00:40:49,080 Speaker 2: going back. We are dealing with the fact that we're 684 00:40:49,080 --> 00:40:53,120 Speaker 2: going to have to incorporate more telehealth into our visits. 685 00:40:53,440 --> 00:40:56,319 Speaker 2: There's going to be a component of artificial intelligence that's 686 00:40:56,360 --> 00:40:59,200 Speaker 2: going to be part of how medical care is delivered. 687 00:40:59,760 --> 00:41:03,879 Speaker 2: And that's good news and bad news. Bad news. Okay, yeah, 688 00:41:03,920 --> 00:41:06,040 Speaker 2: it's not as personal as it once was, but the 689 00:41:06,080 --> 00:41:09,080 Speaker 2: good news is that that means that gives you more 690 00:41:09,120 --> 00:41:11,880 Speaker 2: of an opportunity to be able to direct your care. 691 00:41:12,400 --> 00:41:15,600 Speaker 2: So I would say, in an ideal world, yes, everyone 692 00:41:15,640 --> 00:41:20,120 Speaker 2: should be able to find a caring, culturally competent doctor 693 00:41:20,760 --> 00:41:25,080 Speaker 2: who takes your insurance, who sees you and hears you. 694 00:41:25,800 --> 00:41:29,440 Speaker 2: If you find that hold on tight. But for a 695 00:41:29,480 --> 00:41:33,080 Speaker 2: lot of people that's not going to be what's out there. 696 00:41:33,480 --> 00:41:36,200 Speaker 2: And it's not because doctors are really trying to do 697 00:41:36,239 --> 00:41:40,160 Speaker 2: a bad job. Doctors are being squeezed and pulled every 698 00:41:40,160 --> 00:41:44,000 Speaker 2: way possible. But I say don't give up the fight, 699 00:41:44,120 --> 00:41:47,200 Speaker 2: because if you have someone and you know that they're 700 00:41:47,280 --> 00:41:51,239 Speaker 2: not right for you, then move on. And if you 701 00:41:51,440 --> 00:41:55,520 Speaker 2: cannot find someone, even within that framework, then that's one 702 00:41:55,520 --> 00:41:58,600 Speaker 2: of the reasons why when I left my private practice 703 00:41:58,640 --> 00:42:01,440 Speaker 2: in addition to writing my book to give you that 704 00:42:01,640 --> 00:42:04,680 Speaker 2: guide and the navigational tool that you need to get 705 00:42:04,719 --> 00:42:09,400 Speaker 2: through this confusing system that we have. But I also 706 00:42:09,560 --> 00:42:13,080 Speaker 2: wanted to say I want every woman to have access 707 00:42:13,120 --> 00:42:17,400 Speaker 2: to at least the minimum care and access to hormone 708 00:42:17,480 --> 00:42:21,120 Speaker 2: therapy and to understand perimenopause and menopause. And that's why 709 00:42:21,560 --> 00:42:25,280 Speaker 2: I'm the chief medical Advisor at Alloy Women's Health, because 710 00:42:25,360 --> 00:42:29,880 Speaker 2: I want all women to be able to get information. 711 00:42:30,000 --> 00:42:32,600 Speaker 2: It shouldn't matter whether you live in Arkansas or you 712 00:42:32,719 --> 00:42:36,160 Speaker 2: live in New York City. There should be a standard 713 00:42:36,320 --> 00:42:39,360 Speaker 2: quality of care. And that's my job to make sure 714 00:42:40,000 --> 00:42:43,680 Speaker 2: that the information that we give you is science based, 715 00:42:44,680 --> 00:42:47,920 Speaker 2: that it is accurate. I'm not trying to sell you something. 716 00:42:48,440 --> 00:42:51,279 Speaker 2: Because here's the other thing. As we said, we're in 717 00:42:51,320 --> 00:42:54,920 Speaker 2: this sort of real inflection point now where we're trying 718 00:42:54,920 --> 00:42:58,279 Speaker 2: to decide how is this all going to shake out? Well, 719 00:42:58,280 --> 00:43:00,239 Speaker 2: there are a lot of people who have awaken to 720 00:43:00,280 --> 00:43:03,400 Speaker 2: the fact that women in midlife have money to spend, 721 00:43:04,000 --> 00:43:06,800 Speaker 2: and the same things that we've been complaining about forever, 722 00:43:06,920 --> 00:43:11,040 Speaker 2: we're still complaining about. But now everybody's got a potion 723 00:43:11,480 --> 00:43:14,719 Speaker 2: or a lotion or a pill or something for you 724 00:43:14,800 --> 00:43:17,400 Speaker 2: to buy. How do you know whether or not that works, 725 00:43:17,520 --> 00:43:20,160 Speaker 2: or whether or not they are just trying to profit 726 00:43:20,360 --> 00:43:24,560 Speaker 2: off your misery. You don't unless you have a trusted 727 00:43:24,640 --> 00:43:28,919 Speaker 2: source for that information. And if I had to say, 728 00:43:28,960 --> 00:43:31,520 Speaker 2: what is my goal? My goal is to be that 729 00:43:32,160 --> 00:43:35,759 Speaker 2: I do what I do because I feel passionately about it, 730 00:43:36,400 --> 00:43:38,799 Speaker 2: and I want to make sure the information is out there. 731 00:43:38,840 --> 00:43:41,040 Speaker 2: And if you're not getting it from your doctor, then 732 00:43:41,120 --> 00:43:41,799 Speaker 2: nowhere to go. 733 00:43:42,320 --> 00:43:44,799 Speaker 1: Thank you so much for that, doctor Malone. I wonder 734 00:43:44,840 --> 00:43:47,920 Speaker 1: if you could share any affirmations that maybe you've shared 735 00:43:47,960 --> 00:43:52,600 Speaker 1: with patients before around entering menopause or continuing to stay 736 00:43:52,600 --> 00:43:56,640 Speaker 1: connected to sexuality and sexual viovence throughout their lives. 737 00:43:56,840 --> 00:43:59,319 Speaker 2: I'd say two things. One, just in terms of how 738 00:43:59,360 --> 00:44:03,160 Speaker 2: to enter this process and what your expectation should be. 739 00:44:03,920 --> 00:44:07,640 Speaker 2: I think you should enter perimenopause and menopause with the 740 00:44:07,840 --> 00:44:11,120 Speaker 2: expectation that I'm going to feel good. I'm going to 741 00:44:11,239 --> 00:44:13,200 Speaker 2: be good, and I'm going to come out on the 742 00:44:13,280 --> 00:44:16,879 Speaker 2: other side of this thing, and I'm going to be 743 00:44:16,880 --> 00:44:20,840 Speaker 2: better than I started. That should be your goal, not 744 00:44:20,960 --> 00:44:23,120 Speaker 2: that I'm going to be worse. I tell people all 745 00:44:23,160 --> 00:44:25,160 Speaker 2: the time, I said, look, I'm sixty five years old. 746 00:44:25,239 --> 00:44:28,640 Speaker 2: I am much happier now than I was when I 747 00:44:28,680 --> 00:44:31,920 Speaker 2: was forty five. But to be able to be happier 748 00:44:32,000 --> 00:44:35,400 Speaker 2: and to be productive at sixty five means that you 749 00:44:35,680 --> 00:44:39,719 Speaker 2: have to enter this process and know what to do 750 00:44:39,920 --> 00:44:43,680 Speaker 2: and how to navigate it, because, let me say, it's liberating. 751 00:44:43,719 --> 00:44:45,640 Speaker 2: And I want to say to all the young women 752 00:44:45,680 --> 00:44:49,280 Speaker 2: out there who are entering this phase, just know that, yeah, 753 00:44:49,800 --> 00:44:53,520 Speaker 2: you can be good if you just knew what to 754 00:44:53,600 --> 00:44:56,560 Speaker 2: do and how to do it. And the other thing. 755 00:44:56,640 --> 00:44:59,799 Speaker 2: I would say, sexuality at sixty is not what it 756 00:44:59,920 --> 00:45:03,799 Speaker 2: was thirty, Okay, and that's what it is, But it 757 00:45:03,840 --> 00:45:07,600 Speaker 2: doesn't mean that it's over. And if there are things 758 00:45:07,640 --> 00:45:11,600 Speaker 2: that are getting in the way, like you don't feel well, 759 00:45:12,160 --> 00:45:16,200 Speaker 2: like you can't sleep, like you have vaginal dryness, like 760 00:45:16,239 --> 00:45:19,920 Speaker 2: you have painful sex, then go fix those things. Go 761 00:45:20,040 --> 00:45:24,400 Speaker 2: fix them. It's easy, and it involves hormones, not always 762 00:45:24,440 --> 00:45:27,680 Speaker 2: systemic hormones, even though that's helpful for women who have 763 00:45:27,760 --> 00:45:31,480 Speaker 2: hot flashes, but sometimes it's just vaginal estrogen for women 764 00:45:31,520 --> 00:45:34,400 Speaker 2: who have frequent urine air tract infections and painful sex. 765 00:45:34,719 --> 00:45:37,799 Speaker 2: So no, it ain't over till it's over. You know 766 00:45:37,880 --> 00:45:41,880 Speaker 2: when that time is. But don't let the things that 767 00:45:41,960 --> 00:45:46,240 Speaker 2: are fixable get in the way. That's all I say. 768 00:45:46,680 --> 00:45:49,080 Speaker 1: Thank you so much, flackh alone. I know people will 769 00:45:49,120 --> 00:45:51,319 Speaker 1: want to stay connected with you. So where can we 770 00:45:51,400 --> 00:45:53,880 Speaker 1: find your website. Where can we grab a copy of 771 00:45:53,880 --> 00:45:56,360 Speaker 1: the book in any social media handles you'd like to share. 772 00:45:56,760 --> 00:46:00,800 Speaker 2: You can get my book Grown Woman Talk any place 773 00:46:00,920 --> 00:46:03,200 Speaker 2: you get books, so you can get it on Amazon, 774 00:46:03,239 --> 00:46:07,000 Speaker 2: you get a Target, Walmart, in your local bookstore. You'd 775 00:46:07,000 --> 00:46:10,839 Speaker 2: be surprised at what's in my book because one thing 776 00:46:10,880 --> 00:46:13,600 Speaker 2: that I've found over the years is that people don't 777 00:46:13,680 --> 00:46:16,480 Speaker 2: like to be lectured to. They like to have a conversation. 778 00:46:17,239 --> 00:46:20,920 Speaker 2: And that's the tone of my book. It's conversational. I 779 00:46:20,920 --> 00:46:23,239 Speaker 2: think there's a little bit of humor there. There's even 780 00:46:23,239 --> 00:46:26,000 Speaker 2: a playlist, so you can go to Grown Woman Talk 781 00:46:26,080 --> 00:46:29,880 Speaker 2: Book on Apple Music or Spotify, and I have some 782 00:46:30,120 --> 00:46:32,719 Speaker 2: music in there that anytime as subject gets too hard, 783 00:46:32,800 --> 00:46:34,359 Speaker 2: you can just step away, go listen to some music, 784 00:46:34,360 --> 00:46:37,520 Speaker 2: and come back later. But it's really a book to 785 00:46:37,560 --> 00:46:41,560 Speaker 2: be shared. Certain chapters will speak to you at different 786 00:46:41,560 --> 00:46:45,600 Speaker 2: points in your life. I think the earlier you read them, 787 00:46:46,000 --> 00:46:49,840 Speaker 2: the more proactive you're able to be. So that's how 788 00:46:49,880 --> 00:46:52,759 Speaker 2: you can deal with my book. And then as far 789 00:46:52,840 --> 00:46:57,080 Speaker 2: as following me, we are out there on myalloy dot com, 790 00:46:57,080 --> 00:47:00,640 Speaker 2: which is the telehealth company that I'm the medical advisor for. 791 00:47:01,200 --> 00:47:05,479 Speaker 2: You can follow me on Instagram at s Malone, MD, 792 00:47:06,239 --> 00:47:08,600 Speaker 2: and I just put fun stuff beautiful. 793 00:47:08,719 --> 00:47:10,880 Speaker 1: We will be sure to include all of that information 794 00:47:10,960 --> 00:47:12,840 Speaker 1: in our show notes. Thank you so much for spending 795 00:47:12,880 --> 00:47:15,319 Speaker 1: some time with us today, Doctor Malone. I appreciate it. 796 00:47:15,760 --> 00:47:20,600 Speaker 2: Thank you for having me, Doctor Joy. 797 00:47:20,840 --> 00:47:22,920 Speaker 1: I'm so glad Doctor Malone was able to join me 798 00:47:22,960 --> 00:47:25,560 Speaker 1: for this conversation. To learn more about her and the 799 00:47:25,600 --> 00:47:27,960 Speaker 1: work she's doing, or to grab a copy of her book, 800 00:47:28,280 --> 00:47:30,080 Speaker 1: you should have visited the show notes at Therapy for 801 00:47:30,160 --> 00:47:33,439 Speaker 1: Blackgirls dot com slash Session three seventy six, and don't 802 00:47:33,440 --> 00:47:35,560 Speaker 1: forget to text two of your girls right now and 803 00:47:35,600 --> 00:47:38,120 Speaker 1: tell them to check out the episode. If you're looking 804 00:47:38,160 --> 00:47:41,200 Speaker 1: for a therapist in your area, visit our therapist directory 805 00:47:41,239 --> 00:47:44,399 Speaker 1: at Therapy for Blackgirls dot com slash directory. And if 806 00:47:44,440 --> 00:47:46,799 Speaker 1: you want to continue digging into this topic or just 807 00:47:46,840 --> 00:47:49,400 Speaker 1: be in community with other sisters, come on over and 808 00:47:49,480 --> 00:47:52,160 Speaker 1: join us in the Sister Circle. It's our cozy corner 809 00:47:52,160 --> 00:47:54,839 Speaker 1: of the Internet designed just for black women. You can 810 00:47:54,920 --> 00:47:58,160 Speaker 1: join us at community dot Therapy for Blackgirls dot com. 811 00:47:58,320 --> 00:48:01,480 Speaker 1: This episode was produced by A. Least Ellis and Zaria Taylor. 812 00:48:01,920 --> 00:48:04,879 Speaker 1: Editing was done by Dennison Bradford. Thank y'all so much 813 00:48:04,920 --> 00:48:07,239 Speaker 1: for joining me again this week. I look forward to 814 00:48:07,280 --> 00:48:10,960 Speaker 1: continuing this conversation with you all real soon. Take good care. 815 00:48:15,320 --> 00:48:15,560 Speaker 3: What's