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Michelle Obama’s candid talk about her own menopause symptoms — including hot flashes that started in her 30s — has readers asking what perimenopause actually feels like and whether hormone therapy works. Here’s what the former first lady shared and what medical experts say.
What Menopause Symptoms Did Michelle Obama Experience?
On an August 2021 episode of her podcast titled “What Your Mother Never Told You About Health with Dr. Sharon Malone,” Obama traced part of her experience back to fertility treatments. “I have a very healthy baseline, and also, well, I was experiencing hormone shifts because of infertility, having to take shots and all that. I experienced the night sweats, even in my 30s, and when you think of the other symptoms that come along, just hot flashes, I mean, I had a few before I started taking hormones,” she said.
Obama also described a slow change in her body once perimenopause set in. “I never used to weigh myself. I’m not trying to stick to numbers, but when you’re in menopause, you have this slow creep that you just don’t realize,” Obama told People in November 2022. “We’re all in menopause with stretchy [waist] bands and our athleisure wear on, and you look up and you can’t fit the outfits you had last year. I have to be more mindful, not obsessive, but more mindful.”
In addition to the hot flashes and night sweats, Obama said she experienced weight gain.
Michelle Obama Had a Public Hot Flash on Marine One
Obama recalled one of her most vivid hot flashes happening aboard Marine One, the presidential helicopter.
“I remember having one on Marine One. I’m dressed, I need to get out, walk into an event, and, literally, it was like somebody put a furnace in my core and turned it on high, and then everything started melting. And I thought, ‘Well, this is crazy. I can’t, I can’t, I can’t do this,’” she said on the podcast.
Michelle added that her husband, former President Barack Obama, was familiar with the experience because of the number of women working in his administration. “Barack was surrounded by women in his cabinet, many going through menopause, and he could see it, he could see it in somebody, ‘cause sweat would start pouring. And he’s like, ‘Well, what’s going on?’ And it’s like, ‘No, this is just how we live,’” she said. “He didn’t fall apart because he found out there were several women in his staff that were going through menopause. It was just sort of like, ‘Oh, well, turn the air conditioner on.’”
Why Did Michelle Obama Turn to Hormone Replacement Therapy for Menopause Symptoms?
Michelle said she turned to hormone replacement therapy to manage her hot flashes after newer research suggested earlier warnings about hormones were incomplete.
“I’ve had to work with hormones, and that’s new information that we’re learning. Before there were studies that said that hormones were bad. That’s all we heard. Now we’re finding out research is showing that those studies weren’t fully complete and that there are benefits to hormone replacement therapy,” she said.
According to the source material, as estrogen levels drop during menopause, the body’s temperature-control system can become more sensitive, triggering hot flashes. Hormone therapy helps balance hormone levels and reduce the frequency and intensity of those episodes.
Wen Shen, M.D., director of the Women’s Wellness & Healthy Aging Program at Johns Hopkins and a Johns Hopkins gynecologist specializing in perimenopause and menopause, cautioned that it isn’t right for every patient. “Hormone therapy is an option for some women in the early stages of menopause or perimenopause to help relieve moderate to severe symptoms. Hormone therapy can increase the risk of certain health issues, and may not be suitable for everyone. The decision to start using these hormones should be made only after you and your clinician have evaluated your risk versus benefit ratio,” Shen said.
How Common Are Hot Flashes Among Menopause Symptoms?
Hot flashes are one of the most common menopause symptoms, affecting up to 80 percent of women and lasting an average of seven to 10 years, according to The Menopause Society. “They may also contribute to sleep and mood issues that can negatively affect quality of life,” per the outlet notes.
The Mayo Clinic explains the biological trigger this way: “Changing hormone levels before, during and after menopause are the most common causes of hot flashes. It’s not clear how hormonal changes cause hot flashes. But most research suggests that hot flashes happen when lower estrogen levels cause the body’s heat manager, also called the hypothalamus, to respond to slight changes in body temperature. When the hypothalamus thinks the body is too warm, it starts a chain of events in the form of a hot flash to cool down.”
How Is Michelle Obama Managing Menopause Symptoms Now?
Michelle said she now focuses on staying active and reframing her health goals rather than chasing a specific look.
“I think my skin still feels healthy. My hair is still in my head. These are the things that I have to count my blessings for,” she said, adding, “I am still physically active, and my goal now, instead of having ‘Michelle Obama arms,’ I just want to keep moving.”
She has also eased up on intensity. “If I can walk and move, I don’t have to run. I don’t have to beat everyone,” Michelle said. “I’ve had to change the way I see myself in my health space.”
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