IMO with Michelle Obama and Craig Robinson

What Every Woman Should Know About Menopause with Dr. Sharon Malone

October 8, 2025

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  • Dr. Sharon Malone's resilience stems from being the youngest of eight children with a 23-year age span between the oldest and youngest, forcing her to develop humor as a survival skill. 
  • Michelle Obama is releasing a third book titled 'The Look,' which details her fashion evolution as First Lady and will be accompanied by a limited IMO podcast series. 
  • Untreated hot flashes during perimenopause are significant harbingers that increase a woman's risk for disrupted sleep, hypertension, and cardiovascular disease, meaning menopause symptoms should not be endured without treatment. 
  • Current guidelines from major medical societies state that women can take hormone replacement therapy indefinitely unless a contraindication develops, contrary to the common belief that usage should be limited to 10 years. 
  • Hormone therapy is the most effective treatment for menopausal symptoms, and women should start treatment when symptoms begin affecting their quality of life rather than waiting until symptoms are severe. 
  • Healthy lifestyle choices (exercise, diet, community, sleep, reduced alcohol) are the cornerstone of healthy aging, but they are secondary to hormonal treatment for managing menopausal symptoms. 

Segments

Initial Safe Discussion & Location
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(00:00:00)
  • Key Takeaway: The initial discussion about menopause felt safe, informed, and educational for the male participant.
  • Summary: The conversation about menopause was immediately established as a safe space for the male participant. Michelle Obama identified her location as Martha’s Vineyard, specifically in a barn in Chillmark. The segment also included sponsor mentions for Rivian and Alloy Women’s Health.
Michelle Obama’s New Book
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(00:01:59)
  • Key Takeaway: Michelle Obama’s third book, ‘The Look,’ focuses on her fashion evolution and will feature essays and photos, co-written with stylist Meredith Coop.
  • Summary: Michelle Obama announced her third book, ‘The Look,’ which explores her fashion journey, something she avoided discussing as First Lady. The book is structured like a coffee table book with essays and features a foreword by Columbia professor Farah Griffin. A limited IMO series will accompany the book’s November release.
Introducing Dr. Sharon Malone
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(00:04:33)
  • Key Takeaway: Dr. Sharon Malone is a returning guest, a nationally recognized OBGYN, and a New York Times bestselling author of ‘Grown Woman Talk.’
  • Summary: Dr. Sharon Malone is welcomed back to IMO with Michelle Obama and Craig Robinson due to high demand following her previous appearance. She is a nationally recognized OBGYN with over 30 years of experience and hosts the podcast ‘The Second Opinion’ from Higher Ground. Her first book was ‘Grown Woman Talk.’
Dr. Malone’s Childhood and Resilience
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(00:06:55)
  • Key Takeaway: Dr. Malone developed humor as a survival skill due to being the youngest of eight children separated by a 23-year age span.
  • Summary: Growing up as the youngest of eight, Dr. Malone learned to use humor to disarm people and avoid conflict. She moved frequently after her mother died at age 12, forcing her to actively seek community in new schools and churches to combat loneliness. She credits her mother’s resilience, who also lost her mother young, for her own strength.
Path to Becoming a Doctor
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(00:11:57)
  • Key Takeaway: Dr. Malone decided to become a doctor in the third grade after seeing a Black child in her class whose father was a doctor, realizing it was a visible professional path.
  • Summary: The idea of becoming a doctor first occurred to Dr. Malone in the third grade, as her working-class family in segregated Mobile, Alabama, lacked exposure to professionals. Early affirmation from a nun at an integrated Catholic school ensured she never felt intellectually inferior to her white classmates. She notes that smart people in her mother’s generation often lacked the opportunity to demonstrate their intelligence.
Balancing Career and Family Life
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(00:16:28)
  • Key Takeaway: Dr. Malone managed a thriving medical practice while raising three young children during her husband’s demanding career, leading to extreme exhaustion exemplified by her ‘big chop’ haircut.
  • Summary: The segment highlights the difficulty of balancing Dr. Malone’s demanding OBGYN practice with raising three young children while her husband, former Attorney General Eric Holder, had a high-profile career. She experienced intense exhaustion, leading her to cut off her chemically straightened hair (’the big chop’) the day before her 40th birthday. She emphasizes that community and girlfriends were essential for surviving that period.
Women Owning Their Health Baseline
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(00:17:52)
  • Key Takeaway: Women must own their bodies and understand their physical baseline health, as knowing what normal feels like is crucial for recognizing when something is wrong.
  • Summary: Dr. Malone encourages women to prioritize how they feel physically as much as how they look, stressing that effective communication of physical symptoms to a doctor is vital. Her work with Alloy Women’s Health, which began after her first IMO appearance, focuses on making evidence-based menopause care accessible. She notes that 95% of women trying Alloy saw relief in the first two weeks.
Menopause: Beyond Hot Flashes
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(00:43:14)
  • Key Takeaway: Menopause affects every organ system, causing symptoms like irritability, brain fog, and depression, and suffering through it is a choice when effective treatment exists.
  • Summary: There is a normalization of women’s suffering, where symptoms from puberty through menopause are often endured unnecessarily. Menopause impacts the brain, leading to mood swings and anxiety, and untreated hot flashes increase cardiovascular risk due to resulting poor sleep and bad habits. Hormone therapy is the most effective treatment, but fear stemming from a 2002 study has prevented many women from using it.
Perimenopause Underdiagnosis and HRT Duration
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(00:52:31)
  • Key Takeaway: Perimenopause is underdiagnosed because symptoms can persist for years while periods are still occurring, and current guidelines state hormone replacement therapy can be taken indefinitely unless a contraindication arises.
  • Summary: Perimenopause is often missed because women can have symptoms while still having their period, and hormone tests may appear normal during this phase. Women should be treated when symptomatic, even if their period has not stopped. Current guidelines from major medical societies state there is no set time limit for taking hormone therapy, especially for preventing osteoporosis, which accelerates upon stopping treatment.
Supporting Women Through Symptom Changes
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(00:54:42)
  • Key Takeaway: Men should offer grace and actively suggest professional consultation when a woman exhibits uncharacteristic anger or distress, recognizing it may be due to hormonal changes.
  • Summary: Men should offer grace and understand that irritability or rage can be symptoms of hormonal shifts like perimenopause, not just personal reactions. Husbands should ask if their partner is feeling unwell or needs to see a doctor rather than reacting defensively to anger. Early or premature menopause (before 45 or 40, respectively) increases the risk of Alzheimer’s, necessitating hormone therapy to protect the brain.
Hormone Therapy Duration Limits
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(01:05:16)
  • Key Takeaway: Hormone therapy can be taken indefinitely unless contraindications arise.
  • Summary: Current guidelines from ACOG and the Menopause Society permit hormone therapy use forever, provided no contraindications develop. Stopping hormone therapy reverses its protective effects, such as preventing osteoporosis, causing bone density loss to resume within five years. This treatment is comparable to long-term medications like statins or blood pressure medicine.
Contraindications for HRT
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(01:06:37)
  • Key Takeaway: Key contraindications for hormone therapy include active breast or uterine cancer.
  • Summary: The four main contraindications mentioned are active breast cancer, uterine cancer, developing a pulmonary embolus, or undiagnosed vaginal bleeding. Even some of these conditions may be fungible depending on the specific case. If a woman experiences severe menopausal symptoms, she should seek medical advice regarding candidacy for hormone therapy.
Timing and Benefits of HRT
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(01:07:26)
  • Key Takeaway: Starting hormone therapy earlier provides greater benefit and waiting does not earn ‘bonus points’.
  • Summary: Women should not wait until symptoms are severe (like extreme brain fog or 12 months without a period) to seek treatment. Starting hormone therapy when symptoms begin affecting the quality of life is encouraged, as waiting can cause more harm than good. Hormone therapy is cited as the single most effective treatment for menopausal symptoms.
Navigating Menopause Transitions
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(01:08:07)
  • Key Takeaway: Transitions, including menopause, should be embraced as part of continuous evolution, not dreaded.
  • Summary: Listeners are advised to embrace life transitions, viewing them as positive evolution rather than negative events. If symptoms are severe, consulting a doctor for hormonal treatment candidacy is essential, and seeking a second opinion if denied without good reason is recommended. A healthy lifestyle remains the cornerstone supporting overall well-being during this time.
Post-Menopause Outlook and Support
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(01:11:39)
  • Key Takeaway: The post-menopause stage offers significant freedom and can be the best time of life if health is maintained.
  • Summary: The later stages of life, post-menopause, can be a time of great freedom once day-to-day responsibilities lessen. Maintaining health through treatment and lifestyle choices ensures women are well enough to take advantage of this period. Men are encouraged to attend appointments and communicate more actively to support partners through these changes.