For nearly 30 years, Dr. Sharon Malone led a prominent and thriving obstetrics and gynecology practice serving hundreds of women across the Washington, DC metro area. Today, as the Chief Medical Director for Alloy, a telehealth venture focused on menopause treatment, Dr. Malone is on a mission to reach even more women (think millions) with information, education — and more importantly access — to medically-approved menopause hormone therapy that can improve their lives.
“…learning is a lifelong process of keeping abreast of change…”
Dr. Malone is pretty direct about the lack of preparedness many doctors – gynecologists included – provide for their patients when it comes to menopause.
“During residency you don’t really get a lot of training on menopause. We are sort of focused on the active parts of obstetrics and gynecology, but when it comes to just the one-on-one experience of what happens to women after they are done having their kids, you kind of fall off a cliff.”
Sadly, this isn’t just anecdotal — there’s actual data to back it up. A 2018 North American Menopause Society survey of medical residency programs (including internal, family medicine and gynecology) found that residents only had “one or two total hours of education about menopause. About 20 percent said they’d had no menopause education, and only about 7 percent said they felt prepared to treat menopausal women.”
As a result, Dr. Malone says that a lot of what she’s learned has been actively gathered throughout her years of practice – particularly the last 15 years, when she stopped practicing obstetrics and dedicated her time to focus on the changing health needs of her patients as they (and she) aged into midlife and beyond.
“I’ve had the good fortune of having been in the same practice for twenty-eight and a half years and over those years, my interests sort of diverged as my patients got older. And as I went through this transition myself, I found that what interests you at 50 is very different than what interests you when you’re 30.”
She was inspired to take a proactive pursuit of menopause education so that she could better serve her patients. This came with the realization that it would require more time to sit and talk with them – beyond just a 15-minute wellness visit – to really know what was going on. She says that in recent years, as both a physician and “a woman of a certain age,” her primary focus has been on better addressing the unique health needs of perimenopausal and post-menopausal women.
Success is when preparation and opportunity meet
As the saying goes, “timing is everything.” For Dr. Malone, COVID posed a time for reflection as she was looking to transition out of her practice. Ultimately, the pandemic shutdown helped clarify what she was going to do with her time, expertise and passion for helping women in mid and later life optimize their health needs.
“Our office was closed for routine visits for three months during COVID and I sort of took a step back and started to think about how I might use my time more wisely. I’d been pretty effective working with women one-on-one. But that’s not a very efficient way to get the word out, you know? In the best of circumstances, I was only talking to about 20 women a day, only half of which were dealing with menopause-related issues.”
It was during this down time that she was contacted by Anne Fulenwider and Monica Molinaar, who were starting a woman’s health company called Alloy. They’d heard her speak candidly and authentically about the need to support women through menopause transition with her good friend, former first lady Michelle Obama, on Mrs. Obama’s podcast last fall. It wasn’t long after, that they reached out to invite her to be a part of what they’re building. After careful deliberation, she accepted.
By transitioning from a private practice to a telehealth platform available nationwide, as Alloy’s Chief Medical Director, Dr. Malone is poised to engage and help a much broader audience. She says that her primary role with Alloy is to ensure that they’re offering trusted and medically-proven solutions, “We’re not going to sell you something that doesn’t work and we’re not going to be dishonest with you about the risks and concerns related to your treatment options. Whatever decision a woman makes is always a personal one, and she should make it based on good information.”
Turning the tide on hormone replacement therapy
In the end, she said yes to Alloy because she was intrigued by the founders’ vision to provide a trusted and accessible avenue for women who are interested in menopause treatment, including hormone replacement therapy (HRT). Leveraging this new platform, Dr. Malone recognizes the unique opportunity she has to address the fear and correct the misinformation that’s out there regarding hormone therapy.
“I think a lot of what drives women at this stage in their life is based on fear and a lack information from your doctor. Every woman deserves to make whatever decision they make about how they want their menopausal lives to be and to have their choices based on facts.”
The release of the Women’s Health Initiative study in 2002 cast a long and dark shadow on the use of HRT as a viable treatment option for women struggling with menopause related symptoms. Twenty years later, with time and more research, more doctors are discussing menopause hormone therapy with their patients and prescribing hormone treatments to help restore the quality of their lives. But just because more doctors are comfortable prescribing it, doesn’t mean women are comfortable taking it. Dr. Malone says that’s why taking time to speak with and educate women about the risks versus benefits, is critical.
“There is misinformation, and I’d say not only with women, but in the medical community. Unfortunately, the headline coming out of the WHI study all those years ago, was that hormone replacement therapy causes breast cancer and is bad for you. And that’s what stuck. Of course, we’ve since come to understand that the findings were much more nuanced.”
Dr. Malone has seen (and experienced firsthand) the benefits that menopause hormone therapy can have for a woman dealing with severe symptoms, like brain fog, hot flashes and fatigue. While she’s a proponent of menopause hormone therapy, she cautions that it’s not a panacea for all women going through menopause transition.
“Hormone replacement is not for everybody. But for symptomatic women who are otherwise healthy, it’s a gamechanger — there can be numerous health benefits.”
She also wants to make sure that she’s reaching Black women with important information on menopause hormone treatments and how they can access them. Due to systemic racism in healthcare, Black women are often misdiagnosed or receive inadequate treatment when it comes to their health; not surprisingly, this extends to menopause.
Dr. Malone says despite data showing otherwise, there’s a misperception within the medical community Black women don’t suffer with menopausal symptoms or develop osteoporosis. As a result, hormone therapy is never discussed with them or made available as a viable treatment option.
“African-American women not only have more severe symptoms, but they have them for longer. And to me, it’s just unconscionable to have women who are out there who are suffering, who at least don’t get the option to decide what they should do, what’s available to them, and how they should treat these symptoms.”
Changing the Landscape of Women’s Healthcare
With her move to telehealth, Dr. Malone knows that the future of healthcare is changing and she believes that individuals should be active and informed partners in their own care plans. A long-time practicing physician herself, she’s sympathetic to the time constraints doctors and nurses are often faced with in their day-to-day interactions with patients.
Even so, she says people should be intentional about scheduling time with their health practitioner to discuss their specific health-related questions and concerns. She advises that if your doctor is not able (or unwilling) to have an intelligent discussion with you, or clearly delineate your treatment options based on your current health status and personal health history, you should find another doctor.
“It really disturbs me when doctors take a paternalistic view. I shouldn’t decide what you can or cannot have. But if I sit there and I talk with you about what your goals are and how you want to feel, then together, we can talk through treatment plans to best address those goals.
But YOU need to decide YOUR course of action because there is not one medication, or procedure, or surgery out there that does not have risks and benefits. And for each individual woman, those risks and benefits are going to fall at a different place on the spectrum.”
Once they’re armed with all of the facts, Dr. Malone says she firmly believes that women can be trusted to make the decisions that are right for them. But she also believes the medical community and those working in the menopause space can do a better job of “getting outside of our bubble” to reach more women – particularly women of color – and drive for better health outcomes in the latter third of life.
“In my years of experience, I’ve seen what works and what doesn’t work. I’d like to be able to share that information with as many women as possible because you shouldn’t have to go through this journey trying to figure it all out for yourself when there are people out here who can help you with that.”
To learn more about Dr. Malone’s work with Alloy click here. You can also follow her on Instagram @smalonemd.