The Conversation That Could Change How Women View Menopause

There are certain conversations about women’s health, menopause, and aging that stay with you long after the microphones are turned off. The conversation Dr. Haver had on unPAUSED with Dr. Sharon Malone, physician, educator, advocate, and one of the clearest voices in menopause care today, creates one of those moments.

Dr. Malone has quietly shaped the trajectory of Dr. Haver’s work for years. She was the person who helped her understand the real story behind the Women’s Health Initiative (WHI), the study that reshaped global public opinion on hormone therapy and menopause treatment. Over time, she has become a trusted colleague, a friend, and a North Star for so many trying to correct decades of misinformation and neglect in women’s health.

This conversation was full of wisdom, honesty, and perspective, the kind you only get from someone who has lived many lives both inside and outside medicine. Several themes rose to the surface, forming a roadmap every woman deserves to understand.

Midlife, Reimagined: A Time of Strength and Growth

One of the most powerful ideas Dr. Malone shared, is that midlife is not decline; it is a woman’s most powerful chapter of growth. Women in midlife have never been wiser, more experienced, or better equipped to shape their lives. 

What limits possibility is rarely mindset, it is health. The real tragedy is not that women lose capacity as they age, but that they often lose the medical support, physical stability, and societal encouragement needed to use the depth of wisdom they already possess. 

This is precisely why menopause care matters so profoundly. Sleep, cognition, metabolic health, strength, cardiovascular function, bone density, and mental clarity form the scaffolding for the decades ahead. When women feel strong and clear-headed, they do extraordinary things. 

Midlife is not the ending of anything; it is the beginning of self-directed power.

Why Prevention and Preparation Matter

Biology begins to shift between ages 40 and 50 whether we acknowledge it or not, and Dr. Malone tells her patients a truth that feels almost radical: If you change nothing during this decade, most women will gain weight, lose muscle and bone, and feel the effects of perimenopause long before their periods stop. Not because of failure. Because of normal physiology.

Her message is simple: “Don’t wait for a crisis.”

Know your cardiovascular risk factors, bone density baseline, metabolic markers, family history, and likely perimenopausal symptoms before they arrive. Prevention isn’t glamorous, but it is transformative. It replaces fear with preparedness and replaces reaction with agency.

As Dr. Malone says, “It’s easier to steer a car when you see the road ahead.”

How the WHI Set Menopause Care Back Decades

The Women’s Health Initiative (WHI) was well intentioned, but it was not designed to answer the questions the public thinks it answered. It enrolled women ages 50 to 79 (many already decades past menopause) in order to study cardiovascular outcomes in a shorter timeframe. It excluded women with hot flashes because their symptoms would reveal who was receiving hormone treatment.

It was not a study of newly menopausal women.
It was not a study of symptom management.
And it was never designed to determine whether hormone therapy was safe for healthy women in early menopause.

But when early results were announced at a press conference, all nuance vanished. The media seized on a small increase in breast cancer (less than one additional case per thousand women per year, with no increase in mortality) and turned it into a sweeping indictment. Headlines detonated, women stopped therapy overnight, physicians panicked and residency programs removed menopause training. Global research on hormone therapy halted for years.

Dr. Malone points out that if the women in the WHI had continued therapy, we would now have 30 years of long-term data on cardiovascular health, cognitive aging, frailty, and hormone use. Instead, fear won, and women paid the price.

We are still trying to rebuild the knowledge that was lost in that moment.

Women Shouldn’t Suffer Quietly Through Menopause

Dr. Malone’s perspective on suffering comes from lived experience. She grew up watching what a lack of access, knowledge, and trust can do to a woman’s health. Her mother died at 57 from colon cancer that was diagnosed far too late, in part because preventive care simply wasn’t available.

She has watched the same patterns repeat for decades, especially for Black women, who face higher risks of cardiovascular disease, stroke, dementia, disability, and poor aging outcomes. These disparities are not personal failures, they are the predictable result of systemic neglect, environmental challenges, cultural myths, and a medical system that has long dismissed women’s pain. She calls this dynamic the “suffering Olympics.” Women are conditioned to believe they earn some imaginary medal by enduring years of treatable symptoms in silence.

But the truth is simple: You do not get a prize for suffering. You deserve relief. You deserve access. You deserve to understand your body. None of this is optional.

Second Opinions, Menopause Education and Evidence-Based Options

Dr. Malone’s podcast is called The Second Opinion for a reason. Even today, women are being denied evidence-based treatments by clinicians whose training was shaped by the fear-based aftermath of the WHI.

Women are still being told inaccurate things about hormone therapy, bone health, cardiovascular prevention, sexual wellness, and cognitive aging. Dr. Malone urges women to understand that medical care is a mix of facts, experience, and interpretation. Clinicians disagree, evidence evolves, and you are never wrong for asking questions.

You are allowed to seek clarity, ask “why” and get a second, third or fourth opinion. A clinician secure in their reasoning welcomes that, because the goal is your health, not their ego.

Stepping Into What Comes Next

Dr. Malone’s message is clear: Women over 50 are not done. We are not winding down. We are stepping forward.

Aging is not the enemy and decline is not inevitable. The real threat is the belief that you are supposed to disappear just as you reach the height of your wisdom and clarity.

With good care, good information, and access to treatments that support brain, bone, metabolic, and cardiovascular health, midlife can become the most powerful, productive, and joyful chapter yet. Dr. Malone is living proof of that, and so are millions of women who are no longer willing to apologize for wanting to feel strong, healthy, and fully alive in the second half of life.

This work matters so deeply, not because menopause is a problem to solve, but because women deserve lives that expand, not contract, as they age.

If you want to learn more from Dr. Sharon Malone, you can follow her on Instagram at @smalonemd, listen to her podcast The Second Opinion, and read her New York Times bestselling book Grown Woman Talk.