#1 Hormone Doctor: The Ultimate Guide to Perimenopause, Fertility, Birth Control, PCOS, & Menopause

I am so excited for the conversation today, because in the last two years,

“I am so proud to tell you that two of our episodes from the Mell Robbins podcast”

have been among the most shared episode of any podcast in the entire world on Apple Podcasts and Spotify, and guess what the topic was, Women's Health. Well, since then, we have been getting non-stop questions from listeners around the world all about how hormones and the reproductive phases of a woman's life impact her health. Now, our team has analyzed thousands of questions from your fellow listeners and there were eight

topics that kept coming up over and over and over again. These are topics that affect women

of all ages. From high school to your 80s and 90s. So today, we're answering all of them,

and you're going to get a masterclass with one of the most trusted medical experts in women's health today. She has been a practicing OB Gen for almost 40 years. And today, she's answering your questions in what is going to be an extraordinary in-depth episode about women's hormonal health. Whether you're 25, 35, 65, hech, 85. This is your guide to understanding what's happening in your body. She's calling out all the misinformation online. This hurting women's health.

You're going to learn what symptoms deserve your attention.

“Two specific questions you need to ask your mom. She will also cover painful periods,”

birth control, fertility, infertility, endometriosis, PCOS, Pyramidopause, HRT, weight changes,

muscle loss, osteoporosis, and so much more. So no matter how old or young you are, this is so relevant for you and the women you love. Because there's one thing that women deserve. You deserve the facts. You deserve the truth. You deserve the treated with respect. Because you get to choose what you're going to do to take care of your health, but I want to make sure that you're informed and that you're getting it from a license and respected medical professional. And that's what we're

doing today. Hey, it's your friend Mel and welcome to the Mel Robbins podcast. I am thrilled that you're here today. I'm so excited about the topic. It's an honor to spend this time together with you. And if you're a new listener or somebody shared this episode with you, I'm so glad that you're here. Because today's episode is the Women's Ormon Health episode for every age. I'm so glad that you're making the time

to listen to this. And if you're not a woman, I'm thrilled that you're here. Because you're listening on behalf of all the women in your life that you care about and love. So thank you. Thank you for listening to this. Because you're about to meet one of the most trusted experts alive today in women's health. Her name, Dr. Sharon Melone. She is a board certified OB/GYN and nationally recognized expert in menopause, perimenopause, reproductive health and women's health equity.

Dr. Melone has been nearly 40 years helping women understand their bodies, advocate for better care, and get the answers they deserve. She graduated from Harvard University, earned her medical degree from Columbia University, completed her residency in OB/GYN at George Washington University. She was also an associate clinical professor at George Washington University for 26 years. She's been in clinical practice in Washington DC for almost 30 years. She's a New York Times

best-selling author, a leader in women's health. And she is more awards and accolades than we have time to list. So please help me welcome Dr. Sharon Melone to the Mel Robbins podcast. Dr. Sharon Melone, welcome to the Mel Robbins podcast. Well, thank you so much for having me. I am so thrilled that you're here. The team is buzzing and we have so many questions from our audience and we're going to go through them one by one. And I think one of the places that I would love to start is I would

love to have you. Speak directly to the person that's here right now and explain a little bit about what might change in their life for the better or their health for the better. If they take

“everything to heart that you're about to share with us. I think the most important thing that women”

should understand is that we are hormonal beings. From the moment we start puberty to the day our period stops forever. And these hormonal changes and and regulations that happen affect every part of our body. And they're not disconnected. Purity is not disconnected from your reproductive

the sooner you know the story, the better you're able to craft a better ending for you. Whether you're 20 something 30 something or 60 something, there will be something in this conversation that will apply to you. Whether you're a mother dealing with a daughter with endometriosis or struggling with infertility or you're a daughter and you're watching your mother age or worry about fractures as she gets older. There are multiple entry points into this conversation and I hope that

we will hit them all. And there will be something that we can all take away from it because we're all grown women. As I'm sitting here in this chair, you are going to share things that I will

likely learn about my body for the first time. And it startles me how much I didn't know about

menopause perimenopause. It startles me as a mom of two daughters in their 20s. How much I don't even know how to explain to them about what's going on in their bodies. Why do you think they're so little education when it comes to women really understanding both the beauty and complexity

“and the very explainable things that are happening? Well, I think that we don't have the conversations.”

I mean, intergenerational league we don't have the conversations. You barely got a period talk. And the period talk is not just about how to put in a tampon or how to use a pad. It is a fundamental change in a girl's body. She is transforming from a girl to a woman and all the things that sort of happen after that. Do we talk about cramps? Do we talk about PMS? No, we don't. Most of us are left to figure it out. And it starts there. We've gotten a little bit better

about having the conversations about birth control and pregnancy. But really when you get into the phase of life, when you need the most advice, you are having that same sort of total body transformation in Perry menopause and menopause. No one warns you. You don't even know what the

“signs and symptoms are. And most women are just caught flatfooted on this. I think it has a lot of”

historical basis for it. And that women are taught that the things that our bodies do are either shameful or disgusting. And so we don't have open conversations. And it starts at the beginning and it goes all the way to the end. Well, what I also love that you just said is that it's this continuum. And it is true. When I think about being 57 or I think about my daughters who are in their mid 20s, it is almost like episode by episode. I'm having problems with my period now. So

now I'll go get help. Or I am having trouble losing weight or sleeping or brain fog. So then I'm

going to go get help. But I've never really kind of thought about it like what's the whole picture

here and how do the dots connect from the very beginning when you get your period all the way

“through till the end of your life. And that's why you're here, Dr. Malone. And so I want to go”

decade by decade. And really have you talk about that sort of continuum medically speaking related to women hormones health. And let's just start with your 20s, okay? One of the things that I've noticed Dr. Malone is there has been a wave of women in their 20s who are going off birth control, who have a lot of fear that birth control is dangerous or that birth control is making them infertile. And they're now using natural methods. And I would love to have you just unpack this for us.

I would love to do that because that drives me absolutely insane when I see these posts and they're saying, oh my god, birth control pills, they're going to give you, you know, you're going to be depressed or you're going to have sexual dysfunction as a result of taking birth control pills. And I would say this to the young women out there, you don't understand birth control pills are probably one of the greatest modern inventions in the history of woman kind. Because it is the first

time that we have reliably, reliably been able to control when and what time we choose to have

our families. And that is something that historically we've never had. So being able to decide

when and where to have your children major innovation. So anything that really sort of chips away at that notion or takes away options for young women about being able to make that decision is problematic for me. And if birth control pills of the only thing they did was control your

or you have heavy period or for women who even have PMS, believe it or not, birth control pills

help even out some of the hormonal fluctuation with PMS. So I don't want to give the impression that birth control pills are for everybody, every medication, it has benefits, it has some risks, the risks are small, particularly for young women. And I don't want them to shy away from the most reliable, accessible birth control option because they're afraid of something or a post that they've seen on social media. And here's the other good news is that now we have other options

if you choose not to do birth control pills, that's fine. We have lots of other contraceptives for young women that are reliable, much more reliable than these natural methods. What are the other methods other than taking a birth control pill that, as a medical doctor,

“you say these are options that you should consider before you look at the quote natural.”

That's, well, one of the things that's really kind of gone by the wayside are diaphragms and condoms, those are considered barrier contraception. Now, either one alone is about 80% effective, but together they're actually quite good. That's probably the least used options in young girls today, but let's not forget the sexually transmitted infection issue where condoms should

always be a part of whatever that regimen is. So regardless of your birth control that you choose.

But we also have something that is really taken whole with young women and that is what we call larks, that's long acting reversible contraception. What is that? Are you dees? Oh, that's what I had. That includes IUDs. You have either a hormone releasing IUD or you can have a copper IUD that has no hormone in it. There's also injectables you can use the depoprevera, which is shot every three months, and then there also the implants that young women can use that. You put them in three years, change

them out. So it takes the user error out of it with the larks. Because again, birth control pills are only as good as the person, the reliability of the person who's taking the pill. But these

“sort of take the user error out of it, and that's why they're a little bit more effective than the pill.”

So yes, we have options. What are the medical benefits Dr. Malone of taking birth control? Like what are the positives? Because I think if you're in your 20s or your 30s, you do not remember a time when this was not something that was accessible to you. And I saw this chart that tracked what happened in society when birth control, safe birth control became a viable medical

option for women to have so that you could control the most important decision that you may or

may not make as a woman, which is when you want to have a family, and I found it incredibly striking. It is a hockey stick. I'm holding up a graph that shows that when birth control was first made widely available, you know, right around 1970, within a decade, there was a statistically significant hockey stick spike in women who were able to enter college, complete college, enter law school, medical school, because they were able to control when they had children. And so I would love

for you, Dr. Malone, to just be very scientific about what are the medical benefits of birth control. And then I want to get into what are the lies that are being spread about this important

“option for women that we need to know. Okay. Well, I think that the positives are birth control”

pills. One, I suppose you have really heavy periods, and there are women who have very heavy debilitating periods, and there's no structural problem. So it's not like it's five boards or something like that that you could fix. It decreases the amount of bleeding that women have every month. So guess what, not only is your life and your ability to do the things, you know, not impacted, but anemia is a problem for women who chronically bleed heavy. So you're able to control

your periods, they're lighter, they're more predictable. That's a big plus. Also, as I said with PMS, some women have really severe PMS, and it happens, you know, because it happens reliably about a week or a few days before their periods. And what's happening in that case when you're in a natural cycle, your estrogen level goes up, it peaks around ovulation, and then if you do not conceive, it starts to go down. And we think the trigger for some of the PMS is not the estrogen

get menstrual migraines. It's the falling hormones. So when you take birth control pills, you can sort of

even out that precipitous decline that you get. So that's very helpful. And it's also first

line for even when they're suspected into metriosis or cramping and some people have very, very painful periods and birth control pills do help with that as well. Do birth control pills cause infertility? No, they do not. You're not accelerating the aging, you're not doing anything deleterious to the ovary itself. Let's just say. You start birth control pills when you're 20. And you take them until you're 35. Because you're not ready to have a baby until you're 35.

Well, your fertility at 35 when you stop taking the pills is not what it was at 20. So if you're having difficulty conceiving at 35, it's not the 15 years of birth control pills that did it to you.

It is the fact that you are 35. And that is something that we have to take into account your

fertility changes decade by decade. But it's not the pills. And sometimes we blame the pills

“for things that really we shouldn't. But let me say I think this is an important point to make”

is that some women do react negatively to birth control pills. I get it. I have two daughters. One, it works fine on the other one, not. I believe her. But we find an alternative for women who do not tolerate birth control pills. And let's be clear. There are about 20 different birth control pills options out there. And you can play around. Sometimes this is not the science of it is the art of it. You may react better to one particular

projection that's in one pill and not to the other. So if you have a little patience,

don't say I took birth control pills once when I was 20. And I had a bad reaction. So I can't take them ever again. That's not true either. It's just knowing that we've evolved. We have different pills. They're lower doses. There are a lot of tweaks we can make along the way that will make

“that option a more viable one for you. I think a lot of young women are worried about falling”

fertility rates. And are opting to go off this safe medication, right? Because they are reading online, or they're being told by an influencer that birth control is responsible for falling fertility rates. And they're opting for, quote, natural birth control with the assumption that doing natural birth control somehow preserves your fertility for whenever it is that you think you're going to get pregnant. Is that what's happening when you use natural birth control that

you're protecting your fertility? You are not. And let me say another thing, I went to Catholic school. This new iteration of natural birth control is really nothing more than modified rhythm method. And having gone to Catholic school, let me tell you rhythm method doesn't work that well. There are a lot of kids in Catholic school and they were trying to follow the victims of the Catholic church and to be able to say, okay, yes, no birth control. And it just is unreliable. And I think that when you

use catch phrases or words like natural, you automatically assume that it's better. And there are a lot of things that are natural. Death and disease are natural, but we don't really want to go

“down that path either, do we? So you have to watch what the agenda is. And I think you have to go a”

little bit deeper into why is there, when we are in a time, when we have the most reliable and varied birth control options available in the history of woman kind, why are we regressing and going back to something that we know for a fact, didn't really work that well to begin with? Well, and as a medical doctor, Dr. Ron, you're stating that it's not reliable. And I guess I'm hovering here because, you know, I really want to respect somebody's decision to do what they

want to do with their body. And if you are using a method, whether it's called rhythm or it's called pull out or it is tracking your cycle or you're using some app that is marketed to you as quote natural birth control, then what that tells me is you don't want to baby right now, exactly. And if you're doing it because you think it's safer than a birth control pill, because you have been told by people that it will ruin your fertility, you have been told a lie.

Is that what you're saying, Dr. Ron? I am saying that. And to give you an idea of like, is it safer? And I think that safer than what, pregnancy is a very complicated and can be a very dangerous time and women's life just from my health point of view. A lot of what comes up

times over not being on birth control pills. Pregnancy increases your risk of blood clotting six times

over what it would be if you were not pregnant. So again, you have to look at it in terms of, you know, relatively birth control pills are way safer and less deleterious to your health than

“being pregnant. And that's why it's so important that you choose the timing. And Mel,”

just like you said earlier, you gave that graph about what happened to women and what professionally and educationally they were able to pursue after birth control. It is a start line for the person that thinks that, okay, I've got a journal. I have an app. I can track my cycle. I can take my

temperature. I've got the smartwatch and the ring. Well, that prevent me from getting pregnant.

No, it won't. The circumstances that it works the best in are people that have extremely regular cycles. So if you say 28 days, I know where I am. My period's coming. I can feel it. I can feel ovulation. And there are people who feel them who say they do that. But what about if your period is 28 days this month, this 31, the next month, or your cycles are very irregular, then all the temperature taking in the world is not going to help you prevent pregnancy.

“Because here's the thing about taking your temperature. Your temperature goes up after you've”

ovulated, not before. So if you had sex yesterday and your temperature goes up today, oops, you know, that's a little too late for that information. So the cycle tracking is helpful in retrospect. You do it, and then you say, okay, three, six months, I see where it is, and when ovulation may happen here, that's when it's helpful. Now we've progressed a little bit. We've got, you know, sticks, you can pee on for ovulation. Those are way more helpful when you are trying to

conceive than when you're trying to prevent pregnancy. And the amount of time that sperm will survive even before you've ovulated, it's like 72 hours. Wait, so if you're practicing the natural method and let's say your partner pulls out, if a little sneaks in there, it's going to live in there for three days. Yeah, up to 72 hours. And so you're, you're like, I'm good. I didn't ovulate today. Well, what about tomorrow or the next day or the next day or the next day? So that's why I said,

it's not as reliable. And I just want women to be able to make good choices. Make choices based on evidence, science, not fear. So Dr. Malone, if someone's listening right now, and they've been using the natural quote method. And they're now thinking, wait a minute, I don't want to get pregnant right now. Wait a minute, the options that have been around for 60 years are medically safe and reliable. Wait a minute, they're not going to impact fertility. What are the top three

things you would recommend to the person who's now thinking, maybe I should consider the I you do, maybe I should take it like what would you think about the timeframe that you, you know, that you're trying to not get pregnant. If you say absolutely, I don't want to have a baby for five years, then I think the larks or the IUDs or the implants are fantastic because again, the margin error is so small because it's not like what forgot to take my pill. But if you say, I don't want

to get pregnant now, but maybe within the year, then it doesn't make sense to get a long acting reversible contraceptive because you can leave them in place for years. That's a situation where maybe a birth control pill may be useful. But again, what are the consequences? This is also

“I think is really important. What are the consequences of you getting pregnant inadvertently?”

If you say, well, I want to get pregnant in a year, but if I got pregnant in six months, it'd be like, oh, well, not what I planned, but it's okay. Versus, I am in the middle of finishing a defending my dissertation or I've got a trip plan to Antarctica. I mean, or I'm living paycheck to paycheck, and I can barely take care of myself. What are the consequences? How would that affect my life if it happened? Not just what would happen if I did? What would happen if I didn't? How

would my life be changed by that? And I think that central question will determine which one you choose

and when? And how quickly could you get pregnant after you stop taking the bill? The first time

you ovulate, which is usually most women who have regular cycles, will get another cycle usually

need to do is ovulate. PCOS has recently been renamed to PMOS and I'm getting so many listener questions about PCOS. Could you explain what this is? I happen to have a daughter that was diagnosed

“with this inner late teens, but there's a lot of misinformation and this is a really important”

thing that impacts a lot of women. I have thoughts on this mill. But PCOS, I'll give you just a little bit of the history of PCOS. PCOS is polycystic ovarian syndrome. Before it was polycystic ovarian syndrome, it was polycystic ovarian disease. So we changed the name from disease to syndrome

because disease makes it very simple. Yeah, it sounds terrible. So that was the first name change. And

then now we've gone from polycystic ovarian syndrome to polyindicron metabolic syndrome. Okay. Ovarian syndrome. PMOS is what it is. Okay, well that's great. We've changed the name. Have we changed the diagnostic criteria for PCOS? No, we haven't. It's the exact same things. How I would make the diagnosis today is the same way I would have made the diagnosis 20 years ago. We just

“changed the name. Dr. Mohan, what are the symptoms that somebody who has PAMOS or PCOS?”

Generally speaking, I think what get people derailed is when you say polycystic ovarian syndrome that means poly just means many. You've got normally in the course of a menstrual cycle, you know, you'll start recruiting eggs. One will take over and you'll ovulate from one egg. Well, with polycystic ovarian syndrome, you don't really ovulate regularly. So they get the signal. Okay. But no one takes over and it's not just one egg that ovulates. So you get this

sort of chronic overproduction of estrogen. You also because you don't ovulate, you also don't

get that second half hormone, which is your progesterone that you kick in the second half. And so

it makes your cycles irregular. Their irregular may be once every three months, it may be once a year. So irregularity of cycles is usually the first point. The second point is that there are also other things going on. A lot of them will find that they have signs of what we say, androgen excess. That just means that your ovaries are also making testosterone. They make more than just estrogen and progesterone. They make testosterone. And so when you don't ovulate,

you get this sort of chronic overproduction of testosterone. And what happens when you get a lot of testosterone? Yeah, acne. Yeah, acne, facial hair. Women will find that they start to get chin hair around the nipples. So there's a sort of a more of a male pattern hair growth. Because you've got that, it can also lead to hair loss. But the endocrine part of it is that we've also

realized that it's not just again, it's never just the ovaries. There are other organ systems that

are affected. And the endocrine part is there's an overproduction of insulin. So there's a degree of insulin resistance because you're not responding to the insulin. So you're overshoot it, and you're making too much insulin. You know, so acne, weight gain, higher levels of insulin,

“irregular cycles. Those criteria are basic the same. And I think that when you get caught up on the”

polycystic part of it, you think you're going to do an ultrasound instead of seeing one follicle, you're going to see 20 little ones. Well, you don't see it. That's not an integral part of making the diagnosis. So we've made a lot of progress in terms of changing the name. But you know where we haven't made a lot of progress. Finding out why it happens and having new treatments for how to deal with it, that's where the attention needs to be focused. So when I say, I have thoughts,

that's like, yeah, great. I'm glad you changed the name, but we need to focus on, okay, now what are we going to do about it? We need more research. It almost sounds like it's a hormone imbalance that is just wreaking havoc on your body, your menstrual cycle, your ovaries, other organs, insulin. So like Manipostas, you know, you're right about, uh, into metriosis in your bestselling book. And I was really surprised to hear that it affects one in 10 women. And it's

also one of the leading causes of painful periods and infertility. Can you explain what endometriosis is and what are the symptoms? Yes, endometriosis is simply that same tissue that lines the

and sluffs every month if you don't conceive during that cycle. That's endometrial tissue,

which is why it's called endometriosis. Well, it belongs in the lining of your uterus, but for reasons that we don't really know why it can migrate or spontaneously generate in places where it doesn't belong. So it can be on your ovaries, it can be the lining of your abdominal cavity, it can be on your bladder, it can be on your bowel, anywhere, but it's just not supposed to be there. We don't know how it got there. There are a lot of theories, but it's there. And so those same hormonal

triggers that you're getting every month to tell the lining of your uterus to grow. And shed is happening. Remember, it's talking to the endometrial implant that's on your bladder

and it's doing the same thing. And chronically, it can lead to scarring. Because remember, when you get

your period, you're sloughing that tissue out. Well, what happens? It has nowhere to go. So it's there and that chronic inflammation really can cause pain, scarring and in the worst cases in fertility. And as I said, a lot of women walk around. I think it is probably more under diagnosed than PCOS. Because when you say one of the signs is painful periods, well, do you know how many women walk around with painful periods and they just figure, well, I'll just take more

motron or I'll do something else. Or I'll just assume that that's normal. Now, the other thing about endometriosis is that it's called really the great masquerader. Because suppose you have it, it's on your bowel and your symptoms may be, oh, I have, you know, really bad diarrhea or bowel issues or sometimes even on your bladder. So it is causing the problems where it lands. If you have really bad endometriosis, the scarring can make sex unbearable for women. So, you know, again,

“you need to have someone to talk to who says, you know, yeah, I kind of see the pattern here,”

but women are often treated individually for their symptoms. So you've got bowel symptoms, you go see a GI doctor. Oh, you have a bladder thing, you go see, you know, or you're all just and not really understanding that it all goes together. And that's why it's a delay in diagnosis for most women. The delay in diagnosis is seven to nine years before they're adequately diagnosed and treated for their endometriosis. Yeah, it's a long time. Women with endometriosis

have had multiple multiple trips to the doctor. It's not like they were not complaining about it. It's just that being able to make the diagnosis. And as physicians, we like objective data. We like to be able to do some lab work and see it or do an ultrasound and see it or a CT. Yeah, and the problem with endometriosis, the reason why a lot of times it's not visualized on a scan, is because the little spots of endometriosis will be so small that they're below the resolution

of whatever you're trying to do to to look at it. So you don't see, you can't see it on a scan, well, then how do you diagnose it? Well, you have the clinical presentation. But sometimes if you're

“really concerned, you need to do a laparoscopy, which is that's where you just take a look,”

go through a scope and look in there and you see it. And that's how you can definitively make the diagnosis. The one thing that the laparoscopy will allow you to do is that if you see it, in addition to being able to treat it medically, if I see endometriosis, I can go in with my laser and I can zap it and correct the things that I see, then do the medical treatment afterward.

That is so helpful. I could listen to you all day. I have so many more questions, but here's what I want

to do. Let's take a quick pause because I want to give our sponsors a chance to share a few words, and I also want to give you a chance to send this episode to your sister, your mom, your best friend, or like me, your daughters. I'm also going to send this to the women that I walk with on Wednesday mornings because this is information we all need and don't go anywhere because after the break, Dr. Malone is going to talk about hot flashes in a way you may have never heard any medical

professional explain them to you. They're trying to tell you something, and she's also going

“to tell you what the one thing is that prevents osteoporosis, and I think it's going to surprise you.”

So stay with me. We'll be right back. Welcome back. It's your friend, Mel Robbins, and today you and I have the honor of learning

your questions in an extraordinary episode all about women's hormonal health at every age.

So Dr. Malone, since you also said that endometriosis is one of the big causes of infertility, let's just talk more about infertility. What do you want women in their 20s and 30s to understand about how fertility changes as you age? Well, your peak fertility years are really in your 20s, probably in your late teens through your 20s. And then when you get into your early 30s, it's a little different, but it's not markedly different, you know, that what's

the difference between 32 and 28, probably not that much. But once you get to about 35, 36,

then we start to see some of the more of the age related fertility decline. Our fertility

is declining, but it's more rapid once you get to your mid 30s to the point where by the time you get to your early 40s, then it's even lower. I mean, you know, the likelihood that you will conceive at 40 is way less than what it would be if you try to conceive at 20. So we have two things. We have number of eggs, and that's more of an issue when you're 50. But when you're in that window of declining fertility, like between 35 and your 40s, there's also another component that we

don't think of that some of its genetic, some of its environmental, and that is your eggs have an expiration date stamped on them. So you don't know when yours is. It is helpful to know

“your family history. That's why I encourage you women. I said, "Please talk to your mother." Ask”

your mother. Mom, did you have trouble conceiving? How old were you when you had your last baby? When did you stop using birth control? That tells you a lot of things. It tells you, you know, knowing your family history about intermedials is about fibroids, about infertility, is important it helps you be proactive going forward. It helps you, perhaps make a decision.

Maybe I won't have my first baby at 37, maybe I'll have it at 34. It's kind of, I say it's data,

and you do with that data what you will. Does freezing your eggs impact the expiration date? No, it does not. Remember I told you your peak fertility years are in your 20s. So if you were going to freeze eggs, if I were just saying theoretically, when, when would I get the best yield from egg freezing and retrieval? It'd be in your 20s. But the flip side of that is, well, what's the likelihood that I would ever come back for those eggs? Because if you're in your

20s, you've got a whole life in front of you, you know, so you meet someone at 30 and you get married and you get pregnant. If you get pregnant on your own or you're ever coming back for those eggs, that you've spent tens of thousand dollars for. So even though the yield is better,

“the likelihood that you will ever need them goes down. God. So I think the sweet spot is somewhere”

probably late 20s early 30s for freezing. But let me be clear about egg freezing. Egg freezing gives you the possibility of pregnancy. It does not guarantee anything. That makes a lot of science. Yeah. What Dr. Malone are surprising reasons for infertility? I think the most surprising and frustrating one is unexplained infertility. Now, we do a whole work up, you know, we've done ultrasound and we look at the lining of the uterus and we know your tubes are open, all of that. And

sometimes every single thing checks off on the list. You're good, you're spouse or your partner's good and you're still not pregnant. That, I think, is probably more frustrating to people than saying, oh, I have fibroids or I had a pile up or my tubes were blocked because everybody likes to have a reason. And I think that's frustrating. I think the other thing about infertility that we don't talk enough about is that it's not just a me problem. It's us problem. And upwards of 50% of

infertility cases sometimes is male factor infertility. 50%. Yeah. Women get blamed, but, you know, it's like

“may not be me, maybe you. And, but again, but their answers even for how did that? That's what,”

you know, IVF is for that's what, what's something called XC. When you have male factor infertility, then that's just interest, site of plasma sperm injection. XC, you see why we say XC? Yes, I do. But all you're doing is now, you're just given that sperm to me. And I know you're not going to get there on your own. So I'll just directly put it into the egg. That's giving it prework out.

couples. So it's not just like, oh, poor me, you know, the more you know, the better choices you're

able to make. And I would also say to young women who are thinking about, you know, where they are in their careers, and should I do it now? Should I do it to years from now? The other important point to make here is that freezing embryos, which is what we do in IVF, where you've already got a known egg and a known sperm, and then we freeze them and come back for them later,

“that's more successful than egg freezing. The procedure is the same. We still have to, you have to”

take all the same medications for IVF that you would for an egg retrieval. You're retrieving eggs. That part of the procedure is the same. The only thing is like, what are you doing after you've retrieved the eggs? Are we fertilizing them now or are we freezing the eggs? And fertilizing them

now with a known partner is always the better option. If you have a known partner. Dr. Roland,

what's the connection between fertility and perimenopause? Oh, well, they go together and it's a age-related thing. Now, here's the connection that I think a lot of people don't understand. Remember, I told you there's a natural age decline in your fertility, right? Associated with age. Well, suppose I tell you, we'll do a little thought experiment here. We say the average is 51 for having gone through menopause. Completed, end of discussion shops closed. Oh, nothing's

happening there, right? No overs. Yep. No no estrogen from those overs. 51. Well, perimenopause that window that long span between your peak reproductive ears and the end of your

reproductive ears. Okay? It can be four to ten years. So if I tell you your menopausal at 50,

all right, then perimenopause can start as early as 40 and then it takes you 10 years to go through that process and there is also diminished ability to conceive because again, now you're 40 something in addition to these hormones are changing. But suppose your menopausal, you've talked your mom and you find out, oh, my mom had an early menopause. She was menopausal at 42. Back it up, four to ten years. That means that for you, you might be perimenopausal in your 30s.

You're early 30s when you think relatively speaking, I should be pretty good on the fertility fund. Yeah. But you don't, you can't predict where you are in that spectrum necessarily.

“So that's why I say it's important to know your family history. So you can say, all right,”

mom, well, I did not know mom that you were menopausal at 40. And that, you know, it's not a one to one, but it is a very important data point if you're the daughter. If you're listening and you have not talked to your mom or your grandmother, she's still here, what are the questions you want every daughter to ask their mother? You want to know all about their medical history, but particularly you want to know about things. Mom, did you have cramps? That's the

sign. Did you have these painful, awful periods that could be indicative of endometriosis? Because we know that daughters of women with endometriosis have a higher incidence of endometriosis. You want to know about whether or not your mom had fibroids. You want to know, because again, that increases your risk of having fibroids at some point in your reproductive life. You want to know what age she was when she conceived was a difficult. And you also want to know

“what was your pregnancy like? Because again, these are very, very important points”

that may affect your history, whether they do or do not, it makes you aware. Such that if any of those things come up for you, you don't wait two or three years to go get that diagnosed. You mentioned that to your doctor, by the way. Oh, yes, my mother had endometriosis. We'll guess what? That's going to help me get to the diagnosis point with you sooner than if you don't know that. So, even just knowing makes you recognize that, okay, this is something I need to pay attention

to, which is really important. If you've gotten a diagnosis of PCOS or PMOS earlier in your life, will that potentially impact your fertility as well? It may, because in PCOS, as I told you, the treatment depends on what your goal. And if you have PCOS and you're trying to get pregnant, you may ovulate irregularly and you don't know when that is. So, you may are going to ovulate three months from now. So, when you're trying to get pregnant, and that's a very different

situation than for someone who has a period once a year, your opportunities for pregnancy are less, you know, for someone who has a monthly cycle, what least you have the opportunity every month.

fertility, but we do have medications that we can induce ovulation with. Dr. Belone, I am learning

so much, and I know as you're listening, you're nodding along, thinking, "I wish I had had this sooner. I am so happy I have this as a resource right now." And I want to take a quick break so that we can have our sponsor share a few words with you. Do not go anywhere, because we're going to return,

“and Dr. Belone is going to explain why you should consider hormone therapy way sooner than you may think.”

It's a stay with me. Welcome back. It's your friend Mel Robbins. And today, you and I are here with Board Certified,

OB, GYN, and WorldRenown Women's Health Expert, Dr. Sharon Malone. And today, she's answering

your questions in this extraordinary episode all about women's hormone health. I'm loving it. I know you and everyone you love is loving it too, so thank you for being here. So, Dr. Melone, let's talk about menopause. What is it really, and Dr. Melone, what do you want women to really know and take seriously when this change starts to happen in your body? What I want women to understand is that menopause is not an event. It is a life stage. You will spend 30 to 40 percent of your life

after you have completed menopause. You will spend more time in menopause than you did in your reproductive years. It is probably if you're lucky enough, and you don't get hit by a car,

“that will be the longest of your reproductive phases that you are in. That's why I don't like the”

term post menopause, because when you say post menopausal and I get it, why we say it that way, but I don't want you to think of it that way, is because that gives the impression that you're

overmenopause. Yes. And you're not. You're never overmenopause. The effects of the lack of estrogen

and hormones in your body will affect you from that point forward. Your bones, your brain, your skin, your hair, all of it. So that's why I don't want people to go. I'm over it. And you know what they mean when they say I'm overmenopause. They're usually they're saying that they're hot flashes one away. And menopause is so much more than a hot flash. I mean, that's the least of the things. But hot flashes are often harbingers of things to come. Wait, hold on a second, because I

harbingers of things to come sound like the orcs are rattling over the mountain. And I do have a question here. Why do I still have hot flashes at 58? I haven't had my period in over two years.

“So if you're still having hot flashes, what is this a signal of things to come Dr. Malone?”

Well, women who have more severe hot flashes and more frequent hot flashes, sometimes it is a marker for impending cardiac issues because what happens to women who have a lot of hot flashes and who has the most hot flashes black women do? They have hot flashes that are more severe. They last longer and they start earlier. So you know, when I told you Perry Minopause is four to ten years if you're an African American woman in this country is closer to ten years. So you are most

symptomatic during Perry Minopause. So all the time, you may be still getting your period. That's the worst. I'm getting my period and hot flashes. But it can happen. And then there's also about 20% of women whose hot flashes will continue into their 60, 70s and beyond. Dr. Malone, don't be telling me this. Really? I'm yes. Why? See, who knows? Why? Do you think there's a connection with stress? Like when I hear the stat that you said about black women having more severe

hot flashes, it started earlier, lasting longer. What came into my mind was the statistic that Dr. Gabor Matesh shared on this episode about autoimmune diseases and the 4X rise of them in the last 20 years. And it was his theory and I know there's a lot of research around this that chronic stress and chronic caregiving and micro traumas and aggression and bias that black women deal with that, you know, I don't have to deal with because I'm not being discriminated against in micro

aggressions every day that that chronic stress creates conditions in your body that impact your immune system. Do you think that that is contributing to these symptoms? I think it is a big factor because I think that the reason why black women tend to experience these symptoms more and this

is toxic to whether you're talking about weight gain, whether you're talking about your cancer risk,

“it accelerates the aging process even for Alzheimer's or dementia. People who have chronic stress,”

all this tend to hiver us and who has higher risk of stress of anything black women. We have twice the risk of dementia than white women. I did not know that until I wrote the book because I was like,

"Wow, I never knew that I never knew that women had twice the risk of Alzheimer's or dementia

than men." So it's clearly something that's happening and it starts somewhere in our midlife. But getting back to the hot flash and the connection to chronic disease, the hot flash is women who have higher incidence of hot flashes. This is what we know. Women who have hot flashes have night sweats. People who have night sweats have disrupted sleep. We know that disrupted sleep is a risk factor for cardiovascular disease. We know that women who have disrupted sleep are more likely

to have hypertension. Women who have disrupted sleep are more likely to develop type 2 diabetes

because it leads to when your sleep is disrupted for months, years on end, chronic fatigue.

If you've got your chronic fatigue, guess what you're not going to do the next day. You're certainly not going to go to the gym. You're not going to get up in the morning like I think I'm

“going to go on a three mile run. So that's why I said a hot flash is often the inciting event”

for a lot of other things and behaviors that will increase your risk for heart disease as you age. I would love to hover just a little longer on the hot flashes and maybe it's selfish because this was something that was chronic for probably seven years for me. I would wake up and the entire

side of my bed. It was almost as if somebody had thrown a bucket of water under me and they've

mitigated things to HRT. What would you say Dr. Malone are the thing like the top three things you want someone to be aware of that you should be checking out to mitigate this. One, I would say this, know that hot flashes are not benign. That's what we've been socialized to believe that suffering, pain, misery, they're just part of womanhood. So we should just grin and bear it and don't worry, close your eyes. It'll be over in a decade or so. That's ridiculous to me. And I do this all the time

because you know now people have these little portable fans that they walk around with. So I had one. I will see a portable fan and I will just walk up to somebody and say, Girl, you know we have something for that. Don't you? We don't we don't have to walk around with a fan. Fix it, do it. I mean, and what do I do? It's hormone therapy. I mean, the most effective treatment FDA approved is hormone or estrogen, particularly for the symptoms of menopause,

vasomotor symptoms or hot flashes. It works. But it's the fear factor that keeps women away from the most effective treatment for the symptoms of menopause. You know what's interesting is it's happening to women in their 20s because there's so much misinformation lies being spread about birth control, which in many cases is low doses of estrogen. Yes. And the same thing is happening to women in our 40s and 50s when it comes to the misinformation and lies related to hormone

replacement therapy, which is not only safe for the vast majority of women, but is shockingly effective.

“Like I remember this when I started hormone replacement therapy, it took about five weeks and”

all of a sudden I thought, oh my god, I feel like myself. What the hell was I doing? Why did I start the sooner? Why didn't I start this sooner? And there's really even more of a medical benefit for starting sooner because the sooner you start and treat those symptoms, the more benefit you get in the long term. What do you mean? I mean, in terms of your cardiovascular risk, in terms of waking, in terms of being able to sleep, all those things, perimenopause does not have a bright

line that defines the way menopause has a bright line that says when you're done. But when to start treatment, when to use hormone therapy in some form or fashion in perimenopause, again, depends on what your treatment goals are and it depends on how bothered you are by your symptoms. And that is what I want women to understand if you're between the ages of 35 and 45, which is usually about the

by your symptoms. Like I wish I had known you like five years ago because when I think about how

revelatory it is to me that I didn't even consider the age range of 35 to 45 and that there's no benefit to waiting until you're suffering and if you just don't feel like yourself, the world is hard enough. And if this is something that can help you feel like yourself again, it's going to make you feel better equipped to handle what's going on in your life instead of like because what ends up happening is you describe any of those symptoms. I can't really sleep like something's wrong,

I'm gaining weight. I don't know what's going on. Oh, here's here's an SSRI. You might be depressed. Right. Here's a sleeping pill. Good night. Versus. This is clearly something going on with hormones because women's entire life. In fact, when we did a poll online, we ever felt like your hormones are affecting your mood energy sleep weight or cycle. 98% yes. See, they could have just asked

“women, we would have told you. You know, I think the reason why women tend to wait, they're probably”

two reasons. One is they don't realize that this is all part of Perry menopause and the menopausal

transition and the second thing is that we have been laboring women have been laboring under the

misconception for a very long time that they can only take hormone therapy for a small amount of time because the direction once was will take the smallest amount for the least amount of time possible. That's not true. You can start getting treated when you're symptomatic. You can take it for as long as you'd like. There is no time limit on how long you can take hormone therapy. Now, bear in mind, there may be some subtle differences in terms of how we prescribe in Perry menopause

and how we prescribe in menopause because you remember sometimes we have different mission. You're Perry menopausal. Remember, I told you your fertility is decreased. It's not gone.

So, do you need birth control or no? The bad PR campaign that's going on about birth control

pills in 20-somethings is also happening about people, it's sort of really disparaging the use of birth control pills in Perry menopause. So, women need to understand that misery should not be your resting place. Lord knows, there's enough of that in the world that you cannot control,

“but for things like this when you're feeling out of control, why wouldn't you fix that?”

I don't get it. I love that you're reminding us that you don't need things to get worse before you can start feeling better and that there are such safe, effective and almost immediate things. I love my patch so much. I will be wearing it on my deathbed. I am not ever spending any time without that sticker on my body because it is made such a difference. In fact, you know, it has been on the headlines that there's a shortage of estrogen patches.

What is going on, Dr. Malone, and what should you do if that's affecting you? Women are breaking up. I know. I mean, I'm delighted because it means that there's more demand for it. And I think what is distressing to me is that you didn't see this coming. I mean, when I tell you, I have personally been out here in this face talking about menopause publicly for over five years. I've been talking about it privately for 35 years. So, the notion that now that women are aware,

that's the only difference that more women are aware. We've knocked down a lot of the misconceptions about breast cancer and all the bad negative press about HRT. Could you not have seen, did can you not read the room here that there was going to be more demand for hormone therapy? Well, you know, again, I think that there's not a lot of attention being paid to women's health, but that's another issue. But the point is, is that the estrogen patch is not your

only option. Systemic estrogen falls into two categories. There is transdermal of which the patches transdermal just means it just goes through the skin. So, if you're out of patches,

“if you want to say, oh, but I really want to stay with the transdermal, you can use a spray,”

you can use a gel. Those are readily available. And even different doses of the patch are available. So, I don't think anyone needs to panic because you can't find a patch. We have options. Then there's also oral. And again, oral hormone therapy gets maligned as if that's something terrible. It's like, you can use oral. Most of the information in the data

data that we have on oral. I really just appreciate that you are explaining this in a way that's

“easy to understand with the level of depth that doesn't make me feel like an idiot for really”

going either. I've never heard it that way or I actually understand it at a deeper level.

And one of the topics that I recently feel like, oh, wait, I never really understood that there's a difference between HRT and what vaginal estrogen might do. And it was after learning about the benefits of vaginal estrogen for UTIs for overall health in your sexual health that I started taking vaginal estrogen as a supplement. I can't believe the difference. And so could you explain Dr. Malone, what the vaginal estrogen supplement is for how it relates to HRT. And

how you want women to think about this, especially as we get older, right? That's an excellent point because, you know, sometimes it gets all mushed in together. But when I'm talking about HRT generally, we're talking about systemic, which means that you are using estrogen and a progesterian of some type. At a level that, again, controls the symptoms, hot flashes, the mood swings, all the brain fog that we typically associate with perimenopause and menopause. So we're taking

estrogen at a level that will take care of those symptoms. Okay. So you can do it early, you can do it transdermally as a patch, but it is going, it says systemic because it is going throughout your body. You've got it. Okay. Topical or vaginal estrogen is used just locally. You put it in your vagina and it and you can use it even on the outside, on the Volvo, on the labor, on the

labor basically because it is addressing the genital urinary syndrome of menopause or GSM.

That's vaginal dryness, painful sex, urinary frequency, urgency and frequent urinary tract infections. You can treat that using local, topical, vaginal estrogen and it will take care of those symptoms, but it basically stays where you put it. Okay. It's not going anywhere. And so you don't, it's not enough in vaginal estrogen. If you have hot flashes and you're using vaginal estrogen, you'll still have hot flashes. You'll still have sleep. Because it's not systemic. It's not your

whole body. No. It's like a pimple patch. You're like putting it here, but it's not in your whole body. You put it where you want it to work. Got it. Okay. And the same is true of like topical estrogen that you use for your face. Remember, one of the things that happens in menopause with estrogen

depletion, you lose 30% of your collagen in your skin in the first five years of menopause.

So what we know is that the skin has estrogen receptors. Your vagina, your vulva has estrogen receptors in it. So you can use it at a level that increases the hydration, collagen formation. And again, we've known this for quite some time, but again, it's not enough to treat your other symptoms.

“So that's why even women who are on systemic hormone therapy may still need to use a little bit”

of extra vaginal estrogen. Wow. Dr. Malone talked to us about the importance of muscle loss and bone health and strength. That is so important because one of the things that happens in menopause is as you start this cycle of bone loss. Because remember, estrogen affects everything. Your skin, your muscles, your bone. So that starts in menopause. That starts really starts in late period menopause and certainly continues through menopause at a more rapid clip once you are

finally done with menopause. You tend to lose muscle, you lose bone, and you gain fat. So that even when you are weight neutral in menopause, you are still changing your body composition. That's why it's like, wait a minute, why do I all of a sudden have this weight around the middle? Why do I have this spare tire? It is because the lack of estrogen causes this sort of redistribution of body fat and muscle. So now, if you go through the next 20 years and you're

losing muscle and you're losing bone. Well, now you're more susceptible to osteoporosis.

“Why is that important? Because then you're more likely to fracture a bone. Be it your spine,”

be it your hip or risk. Your bones are thinner and more fragile. Now, this is where it's a dangerous combo. If you are not careful and mindful of your muscle mass, now you're weaker. So now you've

you do whatever. So when you go down, you go down like a tree and you break things. And that is

really why I think our goals as we age. Yes, we do hormone replacement therapy because hormone replacement therapy of the estrogen component is the only medication that we have that prevents

“osteoporosis. Wait, estrogen is the only thing that we have that can prevent osteoporosis.”

Estrogen in the hormone replacement therapy that you take has an FDA indication for the prevention of osteoporosis. So if you are at risk for osteoporosis. Aren't we all? Well, not everybody. Not everybody's going to break something. I mean, it just depends and see, there's a genetic component that you bring to it. I have, you know, bone density because great bone density because I'm a bigger person than I have, but it's dependent on your exercise level that you have

growing up. How did you how much bone did you form in the first place? Some of this genetic

some of it's from your activity. How much calcium were you a milk drinker as a kid? That's why your mama says drink your milk. Whether or not you've had enough calcium and vitamin D to actually create that bone. And then whether you've been able to maintain it in exercise matters, not just cardiovascular exercise, but that's where the weight training comes in because your bones will respond to whatever load you give it. So the more stress you put on it, the better your muscles are,

the more weight bearing you can do, you tend to preserve more of your bone mass. So that's where you enter menopause. But regardless of where you start, you're going to start to lose it after menopause. And if your bone density is really high, it may take me 35 or 40 years to get to the fracture point. But if you start really low, you're going to get their sooner. If you're already losing bone density, maybe you have a diagnosis or not, maybe you just feel frail or like nervous about it,

“will weight training pause what's happening? Will it help you regrow? Here's the thing about”

most bone loss. Most of it when it happens, you very rarely get back to where you started. So once you're coming in 10 years after the fact, you may be able to sort of slow the train down a little bit. But for the most part, what's lost is lost. You can maintain your bone density. Okay. And estrogen and resistance training, building muscle helps you. Yes, the estrogen. I'll give you an example where I think it will be helpful for women to know. Right now, the current recommendation

for getting a bone density is a recommendation is do it at 65. Why would you do it that late? Isn't that a good question? Why would you wait? Remember, I told you, the most rapid phase of

bone loss happens in the first five years after menopause. By the time you get it at 65,

you've already lost. That's 15 years of bone loss that you're not going to be able to recoup. It makes more sense to me. And what I would advise my patients to do is that once you get to menopause, you don't need to do a bone density when you're 30, you know, but once you get to menopause, say, let's do a snapshot right now and see what my bone density is. It's going to be good, not so good, or maybe it's fantastic. If it's not so good, that doesn't necessarily mean that also doesn't

mean that you're going to fracture. But I would be more aggressive in terms of saying, all right, well, what we can do to prevent you losing further bone is to do hormone therapy at that point. Got it. You see? Yes, I do. And if I wanted to say, oh, I don't know if I want to do it, then I would do it once at menopause. And I'd say, let's do it at 18 months to two years later. And see if you're decline is declining. Then now I can make the case to you that see what's

happening. And then you might want to reconsider at that point. Even if you are in a place where, all right, we blew it. And I now am in osteoporosis or I am losing bone density. How would weight training or building up your muscles? How would that protect you and impact your health

“positively in that case? Your muscles help protect and support your bones. I think we kind of”

think of our bones as once you've grown to adult height and whatever in your bones are just your bones. Your bones are constantly remodeling. They're being broken down and they're building up. And they will build and break down depending upon the stress that you put upon them. So if you're exercising, if you're doing weight-bearing exercise, you will build stronger bone in the earlier phases,

and traveling all the time, it's like I need to be able to put that carry on in that overhead

“compartment here. And that's a matter of just being able to know that I have enough upper body strength”

to be able to lift. I need to know that if I trip that I'm not going to go down like a tree, you have some core strength to be able to sort of prevent you going down like that. I mean, think about that. If you were 20 years old and you tripped on the sidewalk out front, you are very unlikely to break your hip, correct? Because one, you can break a fall, you can do all these things, reaction time, all this stuff is your older not there and your bones are more fragile. So that's

why you need strong bones and strong muscles. Gotta have core strength for maintaining your balance.

Wow, it's so, so good. You're so smart and you have such a incredible way of explaining this

and I hear both the passion and the commitment to women's health and the anger and frustration that you feel on our behalf that the information and the access to these tools has not been as readily available and understood as women around the world deserve it to be and so I appreciate the depth to which you went in each of these topics because I think it can be really confusing. And you know, we do live in a world where there is so much information flooded into the public space

that it is easy to be gaslit. It's easy to have somebody pray on you and your fears and

to have you start to question established medical science to your detriment. Right. And you know,

I guess that brings me to a question I'm curious about. If there was one question, Dr. Malone that you believe every woman could be asking her doctor after listening to this

“episode, what would that important question be? I think you should come into your doctor”

and you should actually ask them two questions. When you are even contemplating having the discussion about hormone therapy and aging, just aging in general, which God willing, we will all do. When you are having a discussion about hormone therapy and whether or not it's right for you, it's not right for everybody, but it's the most effective treatment for most women. The conversation that you really need to have is what are the benefits of taking hormone

replacement therapy and what are the negative things will happen if I don't? I love that. If I don't, because most of us go, what's negative I do? Right. What if I don't? What if I don't?

“What am I? What am I at risk for? And what are the things that will happen if I don't? And I think”

we don't have two sides of that conversation. Well, Dr. Malone, thank you for not only educating us. Thank you for not only being a voice that has been both privately in practice over 40 years and very publicly sharing this information for free and advocating for women. Thank you for writing this remarkable guide, grown woman talk, that gives you the medical and scientific facts that every woman needs to understand and know so you can make informed choices

and understand the ramifications of doing them or not. And thank you for also putting your effort into solving the access problem, because one of the things that I think a lot about is that I know with the global reach of this podcast, that step one is giving somebody access to a world-renowned expert like you in a way that makes you feel empowered, that makes you understand what's happening, that makes you understand the various options that you can

and levers you can pull, that can help you take control of your life, your health. You don't the message that I really want women to have is that you deserve to feel better. You deserve with every tool available to be able to age healthfully and gracefully. That should be the new goal, not all the negativity that's associated with aging. Some of that is going to come, but the reality is that you have way more control over how you navigate this final phase of your life than you

think. That's why I'm grateful that you're here. Dr. Malon, what are your parting words?

experience. So know what that is. Know it's coming. Don't be afraid because I will guarantee you this.

“I'll tell any 47-year-old out there now and I'm 67. I'm having way more fun. It's 67 and I”

was at 47. Really, but you got to feel well enough to be able to do it. Dr. Malon, thank you for giving us the no BS science-backed medical truth that we needed to hear so we can make informed decisions and understand what's going on. I cannot wait to see how this impacts the lives of women and the

people who love them around the world. Thank you. Thank you. Thank you. You are so welcome and thank

you for having me. I really enjoyed this conversation. I did too and I also want to thank you. Thank you for taking the time and making the time to listen to something that will improve your health. I know you want to feel better. I know you want to do better and what you learned today from

“Dr. Malon is going to give you the tools that you need to understand what's happening in your body”

and to make informed decisions so that you can feel better. In case no one else tells you this

today, as your friend, I wanted to tell you that I love you and I believe in you and your ability to create a better life and as Dr. Malon just said, "Holy cow, you can create a better life, but you have to take responsibility for advocating for yourself and getting the support that you deserve." I promise you, if you do that, you will have a better life because you're going to feel a lot better. All righty, I'll see you in the next episode. I'll welcome you in the moment you hit

play. Nothing must have organized person. Because I'm bearing myself and crops here. Thanks, darling. I appreciate it. Okay. Okay. That makes it better. All right, here we go. Everybody, how are we doing? Okay, excellent. I'm so excited, you're here. I'm excited to be here. Oh, you've got sorry Scottsley. I'm like, "Where are you going? It's got. Do you need me to look at you? Do you want us to look at you?" "Dry it up like the Sahara Desert." No, I'm just kidding.

“No, I will not. Now if I put the estrogen lotion on my face, what's going to happen?”

It's not going to turn into a vagina, right? No, I don't. Oh, and one more thing. I know this is not a blooper. This is the legal language. You know what the lawyers write and what I need to read to you. This podcast is presented solely for educational and entertainment purposes. I'm just your friend. I am not a licensed therapist and this podcast is not

intended as a substitute for the advice of a physician, professional coach, psychotherapist or other qualified professional. Got it? Good. I'll see you in the next episode.