Why Dr. Sharon Malone Champions Hormone Therapy for Menopause

When it comes to managing menopause, FDA-approved hormone therapy has long been considered one of the most effective options for relieving symptoms. Yet for many, it remains a complicated choice—shaped by personal preference, lingering fear, and decades of misinformation. Dr. Sharon Malone is on a mission to change that.

After more than 30 years as an OB-GYN in Washington, D.C., Dr. Malone stepped away from private practice in 2020—but not from her purpose. She has spent decades listening to women navigate midlife, many of whom have been misled by outdated or incomplete narratives about hormone therapy.

Today, she’s reshaping the conversation. Whether serving as chief medical advisor for Alloy Women’s Health, penning her New York Times bestseller Grown Woman Talk: Your Guide to Getting and Staying Healthy, or appearing in the PBS documentary The M Factor: Shedding the Silence on Menopause, Dr. Malone is using every platform to advocate for informed, empowered care.

HRT and the “Fear Factor”

“Menopause is inevitable. Suffering is not,” says Dr. Sharon Malone.

Still, many women are conditioned to accept discomfort as part of the deal. According to Dr. Malone, that resignation often stems from two things: the lack of medical training around menopause, and a persistent fear of hormone replacement therapy (HRT)—which she calls “the most effective treatment for the symptoms.”

Educating women about the benefits of hormone therapy—and helping them move past their hesitations—is a cornerstone of Dr. Malone’s philosophy. Much of the stigma she’s working to dismantle stems from the Women’s Health Initiative, a study released 22 years ago that Dr. Malone says was flawed in its design. The study’s controversial findings claimed hormone therapy did not reduce the risk of cardiovascular disease and instead increased the risk of breast cancer and Alzheimer’s. But those conclusions, she says, were overstated and overgeneralized—and HRT’s reputation as a viable treatment for women in menopause continues to suffer because of it.

Like many medications, HRT has the potential for adverse effects—but healthcare professionals like Dr. Malone would argue that the benefits far outweigh them. The biggest misconception about HRT revolves around the idea that estrogen causes breast cancer. Dr. Malone quickly points out that even the Women’s Health Initiative findings do not support this. “After over twenty years of follow-up on the women in the study, women who took estrogen-only (those with hysterectomies) had a 23% decrease in the risk of developing breast cancer and a 40% decrease in the risk of dying from it, even if diagnosed. Where is that headline?” she asks.

HRT: Who, Why, and When

While the average age for menopause is 51, some women enter it much earlier—either naturally, through surgery, or as a result of treatments like chemotherapy or radiation. According to Dr. Malone, the right time to consider hormone therapy is when symptoms begin. The earlier the onset of menopause, the greater the benefit of HRT—not just for relief, but for long-term protection. Hormone therapy has been shown to help reduce the risk of cardiovascular disease, osteoporosis, Alzheimer’s, and even diabetes.

That said, HRT isn’t for everyone. Women with a history of breast or uterine cancer, blood clots, stroke, or liver disease may not be ideal candidates. But even these cases aren’t always absolute. “With informed decision-making involving the patient and her doctor, many contraindications that we thought were absolute can be safely managed by using transdermal estrogens rather than oral estrogens,” she says.

Supporting Women of Color

One of Dr. Malone’s most urgent priorities is reaching women who’ve historically been left out of menopause care—especially women of color. Working with Alloy has allowed her to connect with women who struggle to find doctors knowledgeable in midlife health. This lack of access disproportionately affects Black women, who tend to experience more severe and prolonged symptoms yet are less likely to receive treatment—or even be heard.

Dr. Malone believes the key to changing this is education. “Once we have eliminated the fear and misconceptions about menopause and hormone therapy, we can then make the case for why it is especially important for them,” she says.

‘Truly Our Time’

When The M Factor premiered on PBS on October 17—World Menopause Day—Dr. Malone hoped it would offer more than information. She hoped it would offer solidarity.

“We should celebrate menopause because these can be some of the best years of our lives,” she says. “We’ve never been wiser, more experienced, and more capable—if we do not allow poor physical and mental health to rob us of our vitality. Menopause is truly our time.”