Mel Robbins interviews Dr Sharon Malone, a US board-certified obstetrician-gynaecologist, for a wide-ranging explainer on women’s reproductive health from contraception through menopause. Malone argues that social media has fuelled fear about hormonal contraception and says birth control pills do not cause infertility; she also urges listeners not to treat cycle-tracking and other “natural” methods as reliable pregnancy prevention, particularly for people with irregular cycles. The discussion covers PCOS (which Malone says has been renamed by some to a broader metabolic label without changing diagnostic criteria), typical symptoms such as irregular periods, androgen excess and insulin resistance, and the limits of current understanding of underlying causes.
Malone outlines endometriosis as uterine-lining-like tissue growing outside the uterus, often missed on imaging and sometimes requiring laparoscopy to diagnose and treat; she says diagnostic delays can stretch for years and that the condition can contribute to infertility and painful sex. On fertility, she describes age-related decline accelerating after the mid-30s and encourages women to ask family members about menopause timing and reproductive history.
On menopause care, Malone characterises menopause as a long life stage affecting multiple systems, not a one-off event. She endorses hormone therapy as the most effective treatment for vasomotor symptoms and disputes the idea that it must be time-limited, while noting treatment should match symptoms and individual risk. She also addresses reported oestrogen patch shortages and alternatives, explains the difference between systemic and local vaginal oestrogen, and stresses resistance training and earlier attention to bone density around menopause.
Sharon Malone says the advice to use hormone therapy for the shortest time is mistaken. She argues people can start treatment when symptoms begin and continue it without a fixed cut-off, while noting prescribing may differ in perimenopause because pregnancy risk is reduced but not eliminated.
Read this moment →Sharon Malone says reported shortages of oestrogen patches reflect rising demand that manufacturers should have anticipated. She advises patients to ask clinicians about transdermal options such as sprays or gels, different patch doses, or oral therapy depending on individual needs.
Read this moment →Board-certified OB-GYN Dr Sharon Malone says frequent or severe hot flashes in menopause can, in some cases, be a marker for future heart problems. She links vasomotor symptoms to disrupted sleep and downstream risks such as hypertension and type 2 diabetes, arguing symptoms should not be dismissed as merely discomfort.
Read this moment →Malone says Black women experience more severe and longer-lasting hot flashes, and argues chronic stress is a major contributing factor to poorer midlife health outcomes. She also claims Black women have twice the risk of dementia compared with white women, framing menopause as part of a wider set of stress-linked health risks.
Read this moment →Malone criticises guidance she describes as recommending first bone-density scans at 65, arguing it misses the period of fastest bone loss after menopause. She suggests a baseline scan at menopause and a repeat 18–24 months later to detect rapid decline and inform decisions on prevention strategies, including hormone therapy and resistance training.
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