Join Dr. McBride every Friday at 3 pm ET for her live Q&As in the app!
For too long, women have been left to navigate menopause in the dark—without facts, without context, and without a roadmap.
In this episode, Dr. McBride is joined by Dr. Sharon Malone—OBGYN, menopause expert, and best-selling author of Grown Woman Talk—to bust myths about hormone therapy, unpack the history of medical misinformation, and talk plainly about what women deserve to know about their bodies.
We cover:
What really happened with the 2002 Women’s Health Initiative study
The truth about hormone therapy and breast cancer risk
Why quality of life is health
How to advocate for yourself in the doctor’s office
And why context, nuance, and individualized care matter more than ever
Key Concepts Discussed
The Cultural Silence Around Menopause is Breaking
A generational shift—Gen X and Millennial women are demanding better information and care.
The internet and social media (Instagram, Substack) have democratized access to menopause conversations.
Women are no longer willing to settle for a diminished quality of life or misinformation about their health.
What was once confined to private doctor’s offices is now in the public discourse.
The 2002 Women's Health Initiative (WHI) Study—What Really Happened
The WHI was designed to explore if HRT reduced cardiovascular disease—not to assess menopause symptoms.
The media misrepresented the study's results, causing widespread fear of HRT, especially linking it to breast cancer.
Crucial context was lost:
The increase in breast cancer risk was less than 1 in 1,000 women per year.
No increase in breast cancer deaths was found.
The WHI included women ages 50-79—skewing results because older women were more vulnerable to risks that don’t apply to younger menopausal women.
Rethinking Hormone Therapy: Benefits, Risks & The Power of Context
Estrogen remains the most effective treatment for menopausal symptoms like hot flashes, night sweats, sleep disruption, and vaginal dryness.
Newer studies show that estrogen-only therapy (in women without a uterus) may decrease breast cancer risk.
The timing of HRT initiation matters:
Starting HRT within 10 years of menopause offers the most benefit and least risk.
Risks of not taking HRT—including osteoporosis, cardiovascular disease, and cognitive decline—are often under-discussed.
Breast cancer risk, while real, must be understood in context alongside these other risks.
Estrogen and Brain Health—What We Know & What We Don't
Estrogen plays a profound role in brain function, mood regulation, memory, and cognition.
Early menopause (before 45) increases dementia risk—HRT is standard care to mitigate that risk.
There’s strong observational evidence (but no definitive RCT) suggesting HRT may help prevent vascular dementia.
Science is evolving—but waiting for absolute certainty means women may unnecessarily suffer.
Quality of Life is Health
Health should not be defined solely as the absence of disease.
Improving sleep, reducing brain fog, alleviating painful sex, and managing mood swings are essential components of wellbeing.
The medical system often centers longevity without addressing how people feel.
There are risks in taking HRT—but there are also significant risks in not taking it, especially for some women.
How to Advocate for Yourself in the Doctor’s Office
Many doctors are still practicing based on outdated information from 2002.
Women need to come prepared to advocate for themselves:
Ask direct questions about HRT.
Know that family history of breast cancer is not an automatic contraindication.
Understand that cardiovascular disease is a far greater threat to women’s health than breast cancer.
Vaginal estrogen is safe and effective for almost every woman at any age—especially for urinary symptoms and vaginal dryness.
Consider virtual care platforms like Alloy Health for evidence-based menopause treatment if access to informed physicians is limited.
Final Takeaway
This conversation is about reframing the narrative around menopause and women’s health. HRT is not for everyone—but informed choice, context, and patient agency should be the standard. Women deserve nuanced, science-backed care that addresses their full humanity—mind, body, and spirit.
Share this post