July 16, 2024 • 48 mins
Unlock the secrets of navigating perimenopause as we kick off a new season of this show featuring Cardiologist Dr. Jayne Morgan. Get ready to uncover the hidden signs of perimenopause that most women are unaware of, from itchy ears to even heart palpitations, & understand how these symptoms can dramatically influence your life and career.
In this fascinating chat with host Vai Kumar, our guest emphasizes the power of awareness/education in recognizing & managing this natural transition into menopause, ensuring you’re well equipped to handle it proactively.
Our discussion takes a critical look at the link between menopause, heart disease, and racial disparities in healthcare. Learn how hot flashes can serve as a warning sign for cardiovascular risks and why some ethnicities face a higher risk of heart disease due to early menopause and societal pressures.
Dr. Morgan offers vital strategies, from medication and hormone replacement therapy to lifestyle changes like an anti-inflammatory diet, weight resistance exercises, to help mitigate these risks and promote long-term health.
Discover the significance of adequate protein intake, and the transformational role of movement.
We also provide insights into what to ask your healthcare provider, ensuring you’re taking every step to safeguard your health.
Join us for a comprehensive, empowering conversation designed to enhance your well-being &longevity.
LEGAL DISCLAIMER: This episode is for informational purposes only. It is NOT a substitute for individual medical consults with your doctor. Please consult your physician for case by case needs.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Vai Kumar (00:00):
Hey folks, welcome to a new season of podcast, Fresh
Leaf Forever.
After all that focus onsustainability in season three
of the show and after a good six, seven weeks of break, here we
are back with Dr Jayne Morgan, areturning guest on this show.
Hey, Dr Morgan, welcome to thepodcast One more time.
Dr.Jayne Morgan (00:20):
Thank you, I love being here Awesome.
Vai Kumar (00:23):
So today we are here to talk about women's health.
I know you have been aphenomenal spokesperson with
your Stairwell Chronicles,trying to create awareness and
educate the public on all things.
First you started with COVIDand then you transitioned to
your area of expertise,cardiology, and right now you're
(00:44):
focusing, I see, a lot onwomen's health as it relates to
the hormones and the impact oncardiological health.
So that's a great topic tostart this season with, and I'm
delighted.
Dr.Jayne Morgan (00:58):
Yeah, I love it and I'm so happy to come and
talk about it.
You're absolutely right.
I focus a lot as a cardiologiston heart health, but
specifically on women's hearthealth.
Women have been excluded fromclinical trials.
Our symptoms are not wellcharacterized or recognized.
Heart disease still remains thenumber one killer of women, not
(01:18):
breast cancer, even thoughbreast cancer is important.
We need to make certain that weunderstand the importance of
the heart, because that'sactually what is killing us more
than any other disease process.
And then, when we mix inmenopause and perimenopause and
pregnancy complications, wereally start to gather steam,
and so I'm happy to sit here andchat.
Vai Kumar (01:41):
Sure, sure, and one of these days we should, should
get an in person recording to.
Why don't you what viewers withwhat you are doing these days?
Because you are like doing awhole lot for the society, a
whole lot for the medicalcommunity, so why don't you get
us started there?
And then kind of transition tothe impact of hormones on
(02:04):
women's health.
Dr.Jayne Morgan (02:06):
So one of the things that I really like to
talk about are the symptoms ofperimenopause that women may not
even be aware.
Let's just start at thebeginning.
What is perimenopause?
People have heard of menopause,but what's perimenopause?
And perimenopause really areall of those years before you
(02:27):
hit menopause, and menopause isdescribed as you've gone one
year without having a menstrualcycle.
Once you've gone a completeyear and haven't had a menstrual
cycle, then you are officiallyin menopause.
But what's perimenopause?
Perimenopause are those 10 to15 years before that, and why is
that important?
(02:48):
The reason that that isimportant is because it's during
perimenopause when yourestrogen levels start to drop.
Actually, what menopause ischaracterizing is the ovaries
have stopped.
I guess you stopped ovulating.
It's called ovarian failure.
I hate using those words, andthat's another thing that I talk
(03:09):
about often is the languagethat we use around women
cervical incompetence, thesetypes of things.
We don't really want to usethose words.
Vai Kumar (03:18):
Oh, not too strong.
To the point that people startpanicking.
Dr.Jayne Morgan (03:21):
Right, people start panicking right, right,
right, and so this is a part ofthe normal and beautiful not
only aging process of a woman,but another transition in your
life.
Women go through so manybeautiful phases and we should
embrace this phase as well, andI talk a lot about that.
So back to what I was trying tosay perimenopause.
(03:43):
Perimenopause actually startsin your mid-30s and people
aren't aware of that.
You're having regular menstrualcycles or your life is moving
the way it normally has, butunbeknownst to you.
You're starting to get littledecreases in your estrogen
levels, and so how would thatmanifest in your body, where you
may not be aware?
I mean, you may have littlethings like itchy ears, and the
(04:06):
reason your ears are itching isbecause estrogen increases sort
of the elasticity and themoisture of your skin, and you
have skin inside of your ears.
As your estrogen level dropsthat, your skin may start to
become drier, and the firstplace you notice it would be the
skin inside of your ears.
You might have itchy ears.
(04:27):
So think about that.
You never thought about itchyears Like, oh, does this mean
that menopause is coming?
So these are kind of littlesymptoms, you know.
What we think about are hotflashes and night sweats and
insomnia and fatigue and brainfog, but there are a host of
other symptoms, including, as acardiologist, heart palpitations
(04:51):
.
You might start to feel heartpalpitations that could be
alarming and send you to thedoctor for a workup.
So these are all things that Ireally try to make certain that
people have information about,because information is power.
And what do hormones reallymean in our body and how does it
help to make us feel good andmore like ourselves or maybe off
(05:14):
center and not feeling so well?
Vai Kumar (05:18):
So when exactly would one start to feel this
perimenopausal symptoms?
Did you say in the 30s itself?
Dr.Jayne Morgan (05:25):
Yeah, even as early as the 30s, symptoms that
you may not associate withmenopausal symptoms, like itchy
ears, like palpitations, like achange in body odor, if you
start to notice that yourdeodorant just doesn't seem to
work anymore Deodorant you'vealways used and now suddenly it
(05:46):
doesn't seem to work.
Or you're having to wash twoand three times a day and you've
got a drawer full of deodorantsthat you've been sampling at
all the pharmacies and none ofthem seem to work.
Those are some of the symptomsof menopause.
Your estrogen level drops.
All of these things can impactyour body, including
(06:07):
forgetfulness or difficulty inconcentration, which we term as
brain fog, which could haveserious impacts on your career,
your career trajectory, how youperceive others at work, how
they perceive you, how youperceive others at work, how
they perceive you, and you'restruggling.
(06:27):
These could all be symptoms,again, of perimenopause that we
don't think about Brain fog,change in body odor, you keep
switching deodorants, and theseare the kinds of things that you
may not even be aware of, youmay not be thinking about,
you're just living yourday-to-day life, but these are
all signs that you are inperimenopause and these are not
(06:48):
symptoms that we normallydiscuss.
Vai Kumar (06:50):
Okay, what about normal menopause, then, when it
comes to from the standpoint ofage and with you having brought
up itchy feeling in the yearsand that's like skin related,
could you feel any sense ofburning in your skin as well?
Is that, like you know, saysome sporadic ones here and
(07:12):
there?
Dr.Jayne Morgan (07:13):
Vi such a great point.
Yes, you can have burning inthe skin, and we should think
about the skin, because the skinis actually the largest organ
on our bodies, it is our biggestorgan, and so itchy ears might
be the first symptom of dry skin, but ultimately you will start
to see that on your face and inyour hands and in your body with
(07:36):
those fine lines and wrinklesas your skin becomes drier and
drier.
So it's not really so much thatyou get older and you get
wrinkles.
The reason you get wrinkles asyou get older is because your
estrogen levels are dropping.
Now, obviously, men also getwrinkles, and so it is part of
(07:57):
the aging process losing some ofthat elasticity.
And elasticity in the skin isnot all estrogen related.
It's collagen, it's vitamin E,it's a lot of things, but
estrogen is one of those thingsthat does give us some
protection with the skin.
We've got estrogen receptors,though, in every organ of our
body, so we've got estrogenreceptors in the heart.
(08:18):
Estrogen is cardioprotective,it's anti-inflammatory for the
heart, and so the risk of heartdisease for a woman is half that
of a man prior to menopause,but by the time she enters
menopause and those estrogenlevels are at their nadir,
meaning their lowest point.
(08:38):
Her risk, or our risk, of heartdisease is equal to that of a
man, and by the time you reach70, it actually exceeds that of
a man.
That's because we lose theprotection of estrogen on our
hearts.
Estrogen receptors are in thelungs.
They're in the bones.
When you think about anothersubtle symptom in perimenopause,
(08:59):
in your 30s or early 40s, youmight start to have bone pain or
stiffness in your bones orinflammation.
Is that really related toarthritis or getting older, or
is that related to your hormoneschanging, increased bone
resorption that you get?
As the estrogen levels decrease?
(09:19):
When I say bone resorption,your bones can actually become a
little thinner and increaseyour risk of being brittle or
breaking or having fractures.
So these are all things.
Estrogen is not all about theuterus and the ovaries.
We have estrogen receptors inthe heart, in the lungs, in the
bones, in the skin, in the GItract, in the liver, so all over
(09:41):
the body, and so we can haveall kinds of symptoms in all of
these organ systems.
Vai Kumar (09:48):
And from your recent cardiology conference, like
early part of the year, I knowone of your Stable Chronicles
post talked about the varyingresult based on estrogen and the
impact on heart health.
Correct, right?
So, going back to what is anormal menopause, could women
then reason out okay, whateverDr Morgan listed out, I may be
(10:12):
experiencing it at some point orthe other.
So can they feel at peaceknowing that, okay, I'm
transitioning into normalmenopause?
And what age would that be?
And certain women, due to everso many reasons in the world
these days environmental orwhatever, however, our food
supply is what we eat, so on andso forth seem to be
(10:34):
experiencing this at differentage groups, right?
So what exactly would you sayis considered very normal and
what would make someone feellike okay?
Dr.Jayne Morgan (10:49):
this is code red.
I need to go to my physician.
Yeah, I like that code red.
It's all code red.
I'm going to go back and justat the very beginning of what
you commented on.
So I recently went to theAmerican College of Cardiology
conference in April.
It was in Atlanta, and what Viis referring to is that there
was a menopause talk there.
The good news is that there wasa menopause talk there, had not
(11:14):
seen one there before.
The bad news is that it wasrelegated to a side room.
There was barely anybody therein attendance.
But this actually was at a hugecardiology conference and so in
some ways it's starting to makeheadway.
The association betweenmenopause and perimenopause and
heart disease.
(11:34):
That particular talk was veryspecific to the risk of stroke
during perimenopause andmenopause.
Stroke during perimenopause andmenopause and your risk of
stroke increases with theseverity and frequency of your
hot flashes.
And what they found in thatstudy is that the more hot
(11:57):
flashes you have per week, thehigher your risk of stroke,
because the carotid arteriesthat are on either side of your
neck that feed oxygen to thebrain become thicker on the
inside relative to the numberand the amount and frequency of
(12:17):
hot flashes that you have, andso, once again, these symptoms
of menopause are not innocuous.
They're not sort of ha ha ha,look at her, she's hot.
Hot flashes actually are anindicator that you've got an
increased risk of not only heartdisease but also stroke.
(12:38):
So I want to make certain thatwe draw that parallel and that
we understand that it's notreally a laughing matter anymore
.
I mean, you see women sort ofripping off their jackets and
shirts and they're so hot.
These hot flashes actually canhave very serious medical
consequences for women,especially down the road, and so
(13:00):
we're starting to recognizethat we don't have a lot of
clinical trials that areactually focused on women, where
women are enrolled, but we'repushing that as well from the
legislative side, and so all ofthese things are really very
important, and so when we talkabout Code.
Red.
When are we getting to Code Red?
So paramenopause is generallystarts in the mid 30s, so maybe
(13:23):
around 35 to 55.
Menopause is generallysomewhere between 50 and 62,
right, depending on the woman.
And again, menopause is whenyou actually stop having
menstrual cycles.
You're one year out from havingthose menstrual cycles.
What's interesting is when welook at Black women here in the
(13:44):
United States, generally Blackwomen enter menopause about a
year earlier than white women,and there are a number of
reasons for that, includingincreased stress and something I
talk about with weathering,with the racial construct of
America and being a member of aneasily identifiable double
(14:06):
minority so you're easilyidentified as both Black and
female and that dual stress.
But not only might women gointo menopause a year earlier,
black women, that means thatyour risk of heart disease
begins to increase a yearearlier as well, and so it is
(14:27):
not inconsequential.
The effects of weathering, theeffects of a racial society and
how that really impacts yourmorbidity and mortality long
term.
The stress and heart disease,well-being, mental health it is
really all interconnected.
Vai Kumar (14:46):
Then have any remedial measures been discussed
?
I know there's more studiescoming up and stuff like that,
but what then could someone doat this point?
Because I don't want listenersto kind of go into a panic mode
when they hear that oh hey, I'mexperiencing so many heart
(15:06):
flashes, then does that mean,with me hearing, I'm at a
greater risk for stroke.
I should just feel so anxiousright away.
What is it that they can do?
Is like improving estrogenlevels?
Is like hormone therapy asolution, or what is the way to
go?
Dr.Jayne Morgan (15:24):
So let's break that down.
We actually know several things.
As you're going throughperimenopause and entering
menopause, your cholesterollevels begin to increase.
Your blood pressure increases.
You can begin to develop morefat deposits around the
midsection.
We call that visceral fat andthat visceral fat is actually
(15:46):
more dangerous than other typesof fat, because that fat that
sits around the middle alsoencases the organs inside your
body where you don't see, and sothere's several things you can
do to combat that.
Be prescribed an anticholesterolmedication or a statin therapy.
Women are less likely to beprescribed cholesterol
(16:08):
medication and, when prescribed,are less likely to take them.
Take your medications andcontrol your cholesterol.
If your blood pressure isincreasing during perimenopause
those years again a 35 to 55,take medication.
Do not avoid medication.
Take medication and bring yourblood pressure down.
Why do I say that?
(16:28):
Cholesterol is a risk factor forheart disease?
Hypertension is a risk factorfor heart disease.
You can end up getting bothduring perimenopause.
So you want to decrease thoserisk factors.
You've got central fat that'ssitting around the midsection
very hard to get rid of as awoman gets older because of
(16:49):
these drops in estrogen levels.
So it may be time to have adiscussion with your physician
regarding whether or not hormonereplacement therapy is right
for you, meaning an estrogenpatch or an estrogen spray,
something to that degree andthose are conversations that you
have to have based on yourindividual and personal medical
(17:12):
history.
Sleep we know that sleeplessness, insomnia and the lack of a
duration of sleep also increasesyour risk of heart disease, and
this is another symptom ofperimenopause, where you can
have a lot of sleeplessness, soanother risk factor for heart
disease.
So really focus on sleephygiene.
(17:33):
So the point that I'm making ifyou get nothing else out of
this podcast today is that yoursymptoms of perimenopause should
be addressed.
You should not just sufferthrough those symptoms and tough
it out, because those symptomsare actually correlated with
(17:55):
heart disease and stroke.
So make sure you are takingcare of those symptoms.
Those symptoms are a warningsign and an indicator of future
risk.
So when you're developing thosesymptoms, don't think that you
should just suffer through thisand suffer with migraines and
(18:16):
suffer with menstrual cramps anormalization of our culture
that women are to suffer.
But what I'm also saying is, inthis case, suffering actually
(18:37):
can increase your risk of dyingor having a problem later on.
So you absolutely do not wantto suffer.
You want to address your bloodpressure.
You want to address yourcholesterol.
You want to address yoursleeplessness.
You want to address the weightaround your midsection.
We can talk about thatAnti-inflammatory foods, weight
(18:58):
resistant, exercising likePilates and other types of
things where you can increaseyour bone density and begin to
work against that fat that isdepositing around your
midsection.
Vai Kumar (19:13):
Okay, wonderful, you talked about certain populations
being at a risk for heartdisease in general, and also
menopause and heart disease inparticular.
Right, you touched upon theAfrican-American population.
What about, say, the Asianpopulation?
And what about other race, anddo you see any marked
(19:36):
differences?
Dr.Jayne Morgan (19:37):
between groups, and the reason that that is a
better question than youprobably even know is because
these groups are not studied inclinical trials, right?
So we don't have thatinformation.
We do have information on Blackwomen from the Women's Health
Initiative, which is an entirelydebunked study.
(19:57):
I'm not advocating any of thefindings from the Women's Health
Initiative.
However, there were Black womenin the trial and those subgroup
analyses have been veryimportant for us to really
understand the impacts ofestrogen on the body, especially
since most of those women hadhad hysterectomies and that's
(20:18):
another conversation as to whyBlack women are subjected to
hysterectomies in this country.
But what that served in thatparticular trial is it allowed
us to see what estrogen actuallydoes on women, as opposed to
estrogen and progesterone, andso so much work needs to be done
(20:39):
on all cultures.
I talk about this a lot, evenoutside of women's health.
With regard to my most recentstairwell chronicle, that I did
for Juneteenth was really aboutwhite blood cell counts and
what's a normal white blood cellcount?
And all of these normal valueshave been based on people of
(21:02):
European heritage and descent,and we actually find out that
other cultures actually havedifferent normal values, but we
characterize these cultures ashaving abnormal values, because
it's always compared to thenormal value, which is all
people of European heritage, andthen people can be subjected to
unnecessary tests, unnecessarypain, unnecessary expense, and
(21:27):
so I say that to say you hit thenail on the head, vi.
We don't have that informationthat we actually need to have on
all peoples in our globalsociety and not just the white
race and specifically the whitemale sector of our society.
Vai Kumar (21:46):
Okay, you touched upon white blood cell count.
So does it mean having a lowcount is dangerous or does it
mean a high count usually,typically, is significant of
some infection, correct?
Dr.Jayne Morgan (21:58):
Yeah, and so both white, just both high and
low.
I'm using these in quotationmarks because, again, the normal
range is based on people ofEuropean descent.
So what we know is that peopleof African and Middle Eastern
descent tend to have lower whiteblood cell counts, and so,
(22:23):
generally, the lower your whiteblood cell count, the more at
risk you are for infection, andor it can be an indicator that
you've got some other diseaseprocess going on in your bone
marrow, something very serious.
But as it turns out, as we'regetting more and more data, it
may be that these populationsthat have descended from Africa
(22:46):
or the Middle East actually havea lower white blood count for
whatever reason in evolution,and it doesn't mean that
anything is wrong.
It just means that we're beingcompared to a standardization of
a different population.
And so these are all the thingsthat, in medicine, really,
(23:06):
really need to be unraveled,because healthcare does not
serve all populations equitablyin this country for a number of
reasons.
That's just one of them.
I talk about a number of things,if anybody would like to follow
me.
What Vi is talking about is I dosomething called the stairwell
chronicles, and I literally siton the stairs of a house and I
(23:29):
answer one single question aboutmedicine in 60 seconds or less.
I generally do these onWednesdays about a topic really
of my choice, and sometimespeople write in and say hey, I'd
like to know something about X,y and Z and I might create a
Steroid Chronicle.
You can follow me at Dr JaneMorgan D-R-J-A-Y-N-E-M-O-R-G-A-N
(23:51):
on Instagram, but you can alsofind me on all the other
platforms, including LinkedIn.
Do talk about algorithms andformulas that are race-based
within medicine, that canrelegate different people,
including people of AsianAmerican backgrounds, asian
(24:12):
backgrounds as well to lowerlevels of care and concern, and
these are actual formal formulasand calculations that we use
every single day in medicinethat are again based on the
normalcy of the white populationand it doesn't take into
(24:35):
account any other people outsideof that race, and so people who
fall outside of that range thenare considered abnormal, and so
that's how that happens.
Vai Kumar (24:47):
Okay, I just have a question.
When you pointed out thevarying scenarios the impact of
estrogen on cardiological health, hypertension, cholesterol,
whatever it may be right, oreven the occurrence of heart
flashes, the periodicity of it,the frequency Right, and someone
notices that, do you think theyare able to go and address that
(25:09):
with their physician?
Are the physicians equippedenough with the data to answer
it?
Or are they just brushing asidepatients saying, hey, this is
just part of the process,because we talked about women
having to endure this, correct,so we talked about that.
That's part A of that question,and then part B would be then
(25:30):
is the answer to it lies in theindividual taking it on
themselves and focusing more on,say, movement, diet, lifestyle
and those kinds of factors.
Dr.Jayne Morgan (25:42):
Yes, yes, yes and yes.
So doctors are not as wellinformed as they should be,
because this continues to be aburgeoning study and we're
having to unlearn what we weretaught in school from the
Women's Health Initiative andunlearning something is always
(26:07):
more difficult than learning itthe first time and so that is an
uphill battle, and so mostphysicians will not be armed
with the most up-to-dateinformation on women's health,
menopause up-to-date informationon women's health, menopause
(26:27):
and hormone therapy, and you maybe bringing information to them
.
The other thing you shouldthink about is you can look up
physicians and perhaps othertypes of healthcare providers
who are menopause certified,because then they're able to
work in conjunction with you andthey actually have an interest
in it and have studied thesehormones.
Generally, we see that withobstetrician gynecologists, but
(26:50):
I'm working hard to havecardiologists also begin to be a
part of this, because so manyof the long-term effects of
perimenopause and menopause arecardiac related, and
cardiologists really have got toget involved in it.
So, yes, you would need toadvocate for yourself in many
(27:11):
respects A lot of the symptomsthat I talked about earlier in
menopause.
Doctors have no idea what you'retalking about If you come in to
say, hey, I'm 41 years old andmy ears are itching and I kind
of have a bad taste in my mouthand my deodorant doesn't work
anymore.
They are probably going to lookat you cross-eyed.
That means nothing to anyone,right?
(27:31):
We haven't studied thosesymptoms.
Vai Kumar (27:33):
What about OBGYNs?
Do you think, at least rightnow, they are able to answer
these?
Dr.Jayne Morgan (27:39):
or I do not, but, um, I think this whole
world of perimenopause andmenopause and hormone
replacement therapy ispenetrating that specialty
faster, okay, than any of theother specialties okay, yeah,
what about role of movement,diet and lifestyle?
(27:59):
um, all of that is so important.
I mean movement, diet, exercise.
All of that is important injust taking care of yourself
outside of menopause.
When we add perimenopause andmenopause to it, it really
becomes paramount because ananti-inflammatory diet and
(28:20):
generally at a high level ananti-inflammatory diet is a diet
that is high in plant-basedfoods and fruits and even lean,
lean cuts of meat in smallportions, and that protein is
really important.
When I say protein, I mean theprotein sometimes that we get in
meat, but you can get it inbeans and other things.
(28:41):
The protein is so important asa woman ages because we lose
muscle mass and the proteinhelps us maintain that muscle
mass.
But also weight-bearingexercises and you don't
necessarily have to go to thegym and pick up weights and
start doing those weights, butyou can do things.
(29:02):
I teach Pilates.
You can do things where yourbody is being used as the weight
and you are learning resistanceand at the same time, you are
incorporating movement of yourbody.
It is important to move periodand not just Pilates.
I mean just getting up andwalking and being mobile and
making certain that you are notnecessarily staying active but
(29:26):
remaining mobile, because weknow that societies that remain
mobile actually have longerlifespans than those that lead
more sedentary lives, includingsedentary meaning more
industrialized or digitalizedlives that make things easier
for us.
(29:47):
That ease of life actually can,in the long run, take years off
of your life, and we see thatsocieties where movement is a
part of what they have to doevery day to live.
Actually, we're studying thesesocieties because many people
live for many, many long years.
(30:08):
There are many centurions inthese types of societies,
meaning they live to be ahundred or more.
Vai Kumar (30:14):
Oh, that's the blue zone we are talking about, right
, the blue zones.
Dr.Jayne Morgan (30:17):
That is correct .
Vai Kumar (30:19):
Yes In the show earlier, and when you said
movement, I can attest to it.
I think the viewers, listenersof this show know pretty darn
well that I myself wrestled withinflammatory bowel disease, but
I've learned to manage itreally well.
In fact, I am a student of yourPilates program as well, so I'm
(30:41):
proud to share that withlisteners here.
I can personally attest tomovement Every time.
I walk several thousand stepsor I do hiking, I do a
combination of yoga and Pilates.
My bone density and myinflammatory markers have really
even become normal.
(31:01):
Of course, what we eat in thispart of the world, the food
supply, the dietary practices,everything is quite different
and I would just certainlyencourage listeners, viewers, to
make sure that, whatever ispossible, make sure that you
cook fresh food, eat and lead avery healthy lifestyle.
(31:22):
You took us through the role ofmovement and I shared my two
cents on it.
What about the hours of sleep?
I know we all live in adigitized world, hooked to our
phones, and I guess I sound likea broken record, sometimes even
on this very own show, talkingabout hey, people don't be on
your devices all the time.
Dr.Jayne Morgan (31:44):
Yeah, yeah.
So when we talk about sleep,the studies have shown that
people who get six hours or lessof sleep per night have an
increased risk of heart disease.
So six hours seems to be thesweet spot.
Again, more research needs tobe done and we need to really
(32:04):
kind of look specifically atdifferent groups and different
populations specifically atdifferent groups and different
populations.
Vai Kumar (32:11):
Okay, what about mental health, the impact of
mental health, and does estrogenlevels have any impact on
mental health?
And in fact, I also meant toask about varying estrogen
levels and, potentially, peoplegetting blood clots as well.
Dr.Jayne Morgan (32:27):
Estrogen receptors are found in the brain
as well, and so no surprise.
As estrogen levels begin todrop during menopause, you can
start to have changes in yourbrain and the way that you're
thinking and the way that you'reexperiencing life, and it's no
(32:50):
surprise that the most number ofantidepressants are prescribed
to women during this phase oftheir lives.
But the question is are wereally depressed or are we just
in perimenopause?
Do we really needantidepressants or do we need to
think about what's going onwith our hormones and whether
(33:11):
there are other options?
And so just another greatexample of estrogen receptors
being in other places other thanour uterus and our ovaries.
We know that mental health isvery connected to physical
health.
In fact, people with higherlevels of depression and anxiety
also seem to have shorterlifespans as well, sometimes by
(33:37):
as much as 10 years, and somental health drives how you
move when you move, whether youfeel like moving or whether
you're going to sort of adopt asedentary lifestyle, whether
you'll be just sitting at home,whether you will close yourself
off from society All of thosethings you think are just
(33:59):
mentally related.
But it really is now having animpact on your physical health,
and then later it will have animpact on your health overall,
whether or not you start toself-abuse.
So drinking more alcohol orsmoking more, or indulging in
(34:22):
illicit substances and drugabuse, or taking more
prescription andnon-prescription pills All of
these things can be a part ofmental health.
That actually, then willeventually impact your physical
health, including overeating andindulging in all types of foods
(34:43):
that may provide short-termsatisfaction high in sugars
sugar highs but long-term mayhigh in sugars sugar highs but
long-term maybe pushing youtowards diabetes and obesity and
hypertension and highcholesterol.
So mental health is incrediblyimportant.
Vai Kumar (34:59):
And you said a lot of things women are just kind of
told to endure, right?
So in terms of mood swings andthings like that, what about?
The answer Again, is estrogenlevel contributing to how your
mood sways and how you kind ofpresent yourself?
So how can society be much moreforgiving and accept a woman
(35:22):
and embrace her for who she is?
Dr.Jayne Morgan (35:25):
And be more supportive and be more
supportive.
I mean, the word menopauseisn't even a part of any HR
department at any company or anycorporation or any organization
, and so women are just managingit on their own, with fans
under their desk or fans sittingon their desk to blow on them.
And again, we're thinking ofthis as, oh, she's just hot.
(35:50):
But what we should be thinkingof is, oh my gosh, her risk of
heart disease is going to beincreased.
Perhaps we need to have someway of supporting her in this
environment where she issuffering and struggling and
trying to adopt and adapt.
Even someone who's bringingextra shirts to work because
(36:12):
they know they have to wash inthe middle of the day and
freshen up and things are justdifferent for them.
And they're struggling in thissociety and in a work
environment where they may behaving brain fog, challenges
with memory they didn't sleepwell at night.
They don't feel well.
They go to the doctor.
They're told they should justsuffer.
There's nothing wrong with them.
(36:32):
They're having palpitations.
They've been to thecardiologist.
There's nothing wrong withtheir heart.
Eventually am I losing my mindand there's no support for it.
So you are absolutely correctand the support of friends and
your community has really beenshown to actually be more
(36:55):
important than even the supportof a spouse.
That environment and communityand friend support.
And so absolutely talk withyour friends, make sure you have
a community, have sharedexperiences, people shared
experiences, People support you.
And then look for people whoare certified in menopause and
(37:18):
menopause specialty to see ifyou can have a conversation and
start to connect those dots andthen you can take that
information to your physician aswell and begin to have that
conversation with them alsoinformation to your physician as
well and begin to have thatconversation with them also.
Vai Kumar (37:36):
Okay, we'll come to much more of social engagement
in a bit, but again, just torefresh on that question from
before what about estrogenimpact on, say, potential for
blood clots and things like that?
Dr.Jayne Morgan (37:44):
Yes, and so the data from estrogen on blood
clots came from the route ofadministration.
So there are many differentways you can take it.
You can have a spray, you canhave a patch, you can have a
cream.
You're going to have a pill, soit's the pill form that has the
greatest risk of blood clots.
If you're taking it in a pillform which really almost just
(38:08):
isn't done anymore, a pill formwhich really almost just isn't
done anymore, however, it'sstill relatively safe.
But the highest risk of bloodclots comes from the pill form.
Vai Kumar (38:18):
Okay, thank you.
What about, say, tools that onecan empower themselves with?
Would that be when we talkedabout diet and lifestyle?
When you said anti-inflammatoryjust for listeners to have a
very clear picture does thatmean eating more whole grains,
eating more plants and morevegetables and fruits like a
(38:40):
colorful plate?
You talked about the role ofprotein in muscle mass and
everything.
So what would be Dr Morgan'sadvice to someone in terms of,
say, a reasonably good diet andlifestyle practice?
Dr.Jayne Morgan (38:57):
All of the things that you've said.
I mean, you nailed them andthat's not just for
perimenopause and menopause.
This is an adaptation of livinga healthy and whole life, and
so those are the types of foodsthat are anti-inflammatory.
Generally, that is more of aMediterranean and a plant-based
(39:19):
diet.
Why is that important?
We keep talking aboutanti-inflammatory, but I haven't
told you why.
Inflammation, chronicinflammation in the body, is one
of the things that createsheart disease.
It creates the hardening ofthose arteries.
It contributes to that.
People who have chronicinflammation also have a higher
(39:40):
risk of what?
Of cancers, of autoimmunediseases, of arthritis, of GI
diseases, meaning your stomachand your gut.
So we know that chronicinflammation is a causative
factor for disease processes inthe body.
So when we keep talking aboutanti-inflammatory things, that's
(40:02):
why anything that you can dothat can reduce the chronic
inflammation in your body isgoing to be beneficial to you,
because inflammation increasesdisease processes, including all
kinds of things, includingheart disease as well.
When we talk about inflammation, obesity is a driver of
inflammation.
Inflammation is a contributorto obesity, so it's a two way
(40:25):
street.
Obesity, though, is a riskfactor for heart disease.
You can see how everything sortof compounds on itself, and so
it's important to have a healthylifestyle independent of
perimenopause and menopause, butthen, as women enter this phase
in their lives, it becomes animportance of greater paramount.
Vai Kumar (40:45):
Great.
What about?
Even girls these days say, hey,you know what?
I think I'm so bloated duringthe time of the month or
whatever, and everyone wants tobe a size zero.
I mean, we all live in a socialmedia world and everyone is so
image conscious.
There's some good, but thereseems to be so much of pressure.
Society wise for women.
(41:05):
How does a woman fulfill socialobligations but also take care
of herself?
Dr Morgan, and I guess onedoesn't want to feel lonely,
correct?
I think you started touchingthe impact of a community and
yeah, and I think there's commonmisconception or is it really a
misconception that if you getto menopause, you will put on
(41:27):
weight.
So how does anyone combat allof these?
Dr.Jayne Morgan (41:31):
Yeah, loneliness is definitely a risk
factor for decreased lifespan,and so we have to think about
what that is in this societywith all this social media, but
are people actually lonely whenwe talk about risk factors as
well?
As we transition through all ofthese phases in our lives,
(41:56):
community is incredibly,incredibly, incredibly important
, and that connectivity it turnsout.
In the end, humans are verysocial species, and so that
community and that interactionoutside of the digital
interaction turns out to be veryimportant, not only for mental
(42:17):
health, but for your hearthealth as well.
We've already connected mentalhealth to your physical health,
and so taking care of your brain, taking care of your
psychological well-being, isself-love, because that also
takes care of your brain.
Taking care of yourpsychological well-being is
self-love because that alsotakes care of your physical
well-being.
Vai Kumar (42:35):
Okay, perfect.
What about questions?
Just to bring it to a verygranular level, what about
questions?
Every woman should ask theirdoctor for them to know that
they are giving themselves theright kind of self-love, they
are arming themselves with theright kind of protection upfront
(42:56):
, rather than having to say,kind of face the music later.
Dr.Jayne Morgan (43:00):
Yeah, you want to make sure that you get an EKG
at your appointment, notbecause you're sick, not because
you're having chest pain, butevery woman needs to have that
baseline EKG.
So if you ever come in withsymptoms later and we get an EKG
, we have something to compareit to, to what it looks like at
a different time, and oftentimesthat is never ever done.
(43:23):
So request an EKG, not becauseyou're sick, but because you
want a baseline status in yourchart.
Not because you're sick, butbecause you want a baseline
status in your chart.
You want to also talk aboutwhat some of your symptoms are
and whether or not it's time todiscuss hormone therapy, whether
you're interested in it or not,and what are the options are
(43:43):
available to you.
You know, vi, you hit onsomething that is actually very
true and it's actually veryfunny, but it's.
Is it just impossible to get ridof weight as you're going
through perimenopause?
It really is very, very hard.
The physiology of the body isdesigned to hold onto fat and to
(44:05):
hold onto calories right,because we weren't always living
in the types of societies thatwe're living in.
As your estrogen levels drop,that even becomes harder, and
that's why you can often hearwomen say I'm eating the way
I've always eaten and I alwaysexercise and I'm still gaining
(44:26):
weight.
I mean, what does that mean?
And that is part of it, andwomen who are on hormone
replacement therapy actually areway less than women who are not
on hormone replacement therapy.
It's not a reason to take it,but it's something to understand
.
With regard to how estrogenworks in our bodies, and we've
(44:49):
talked a lot about estrogen, butthere's also progesterone and
there's also testosterone thatwe really associate with men,
but women actually have moretestosterone in our bodies than
estrogen and we actually losemore testosterone as well, which
is why we also have difficultyholding onto this muscle mass.
Vai Kumar (45:08):
What about the role of, say, dietary influence, like
soy products and things likethat?
Dr.Jayne Morgan (45:14):
Yeah, we look at soy and estrogen.
So there is no limit really ontaking soy.
There are no studies oncomparing soy to actual estrogen
therapy.
Again, we're going back toclinical trials, so I can only
tell you kind of what we think.
And soy is something positiveto be incorporated into your
(45:35):
diet along with other plants.
Soy in particular tends to bindto the same receptors as
estrogen, but we really need tohave clinical trials and better
research on it.
Vai Kumar (45:46):
Okay, perfect.
I think that's a lot of greatinsights, dr Morgan, on all
things wonderful when it comesto keeping oneself healthy,
keeping oneself empowered,asking the right questions, just
staying on top of it with yourannual physical visits, and so
on and so forth.
I think there were hugeinsights into the impact of
(46:10):
cardiological health and whatone should not ignore, and also
for women to feel at peace,knowing that they are not alone,
feeling some of the symptoms,and I think watching and
listening to a podcast like thisis going to help them feel that
they are not alone, but not toresist or detest themselves from
taking action.
(46:30):
So thank you once again forjoining us and empowering us.
Dr.Jayne Morgan (46:34):
You're welcome.
I'm glad we finally got thisdone again.
Love it.
Vai Kumar (46:37):
Yes, yes, listeners, as always, follow the podcast,
rate the podcast, leave a reviewfrom your podcast app of choice
.
Follow us on YouTube @vaipkumar, that's V-A-I-P-K-U-M-A-R, and
across all podcast sources.
Until next time with yetanother interesting guest and
(46:58):
yet another interesting topic.
It's me Vai, along withwonderful Dr Morgan, saying so
long, so long.
Dr.Jayne Morgan (47:04):
Thanks everybody.
Hey folks, welcome to a new season of podcast, Fresh
Leaf Forever.
After all that focus onsustainability in season three
of the show and after a good six, seven weeks of break, here we
are back with Dr Jayne Morgan, areturning guest on this show.
Hey, Dr Morgan, welcome to thepodcast One more time.
Dr.Jayne Morgan (00:20):
Thank you, I love being here Awesome.
Vai Kumar (00:23):
So today we are here to talk about women's health.
I know you have been aphenomenal spokesperson with
your Stairwell Chronicles,trying to create awareness and
educate the public on all things.
First you started with COVIDand then you transitioned to
your area of expertise,cardiology, and right now you're
(00:44):
focusing, I see, a lot onwomen's health as it relates to
the hormones and the impact oncardiological health.
So that's a great topic tostart this season with, and I'm
delighted.
Dr.Jayne Morgan (00:58):
Yeah, I love it and I'm so happy to come and
talk about it.
You're absolutely right.
I focus a lot as a cardiologiston heart health, but
specifically on women's hearthealth.
Women have been excluded fromclinical trials.
Our symptoms are not wellcharacterized or recognized.
Heart disease still remains thenumber one killer of women, not
(01:18):
breast cancer, even thoughbreast cancer is important.
We need to make certain that weunderstand the importance of
the heart, because that'sactually what is killing us more
than any other disease process.
And then, when we mix inmenopause and perimenopause and
pregnancy complications, wereally start to gather steam,
and so I'm happy to sit here andchat.
Vai Kumar (01:41):
Sure, sure, and one of these days we should, should
get an in person recording to.
Why don't you what viewers withwhat you are doing these days?
Because you are like doing awhole lot for the society, a
whole lot for the medicalcommunity, so why don't you get
us started there?
And then kind of transition tothe impact of hormones on
(02:04):
women's health.
Dr.Jayne Morgan (02:06):
So one of the things that I really like to
talk about are the symptoms ofperimenopause that women may not
even be aware.
Let's just start at thebeginning.
What is perimenopause?
People have heard of menopause,but what's perimenopause?
And perimenopause really areall of those years before you
(02:27):
hit menopause, and menopause isdescribed as you've gone one
year without having a menstrualcycle.
Once you've gone a completeyear and haven't had a menstrual
cycle, then you are officiallyin menopause.
But what's perimenopause?
Perimenopause are those 10 to15 years before that, and why is
that important?
(02:48):
The reason that that isimportant is because it's during
perimenopause when yourestrogen levels start to drop.
Actually, what menopause ischaracterizing is the ovaries
have stopped.
I guess you stopped ovulating.
It's called ovarian failure.
I hate using those words, andthat's another thing that I talk
(03:09):
about often is the languagethat we use around women
cervical incompetence, thesetypes of things.
We don't really want to usethose words.
Vai Kumar (03:18):
Oh, not too strong.
To the point that people startpanicking.
Dr.Jayne Morgan (03:21):
Right, people start panicking right, right,
right, and so this is a part ofthe normal and beautiful not
only aging process of a woman,but another transition in your
life.
Women go through so manybeautiful phases and we should
embrace this phase as well, andI talk a lot about that.
So back to what I was trying tosay perimenopause.
(03:43):
Perimenopause actually startsin your mid-30s and people
aren't aware of that.
You're having regular menstrualcycles or your life is moving
the way it normally has, butunbeknownst to you.
You're starting to get littledecreases in your estrogen
levels, and so how would thatmanifest in your body, where you
may not be aware?
I mean, you may have littlethings like itchy ears, and the
(04:06):
reason your ears are itching isbecause estrogen increases sort
of the elasticity and themoisture of your skin, and you
have skin inside of your ears.
As your estrogen level dropsthat, your skin may start to
become drier, and the firstplace you notice it would be the
skin inside of your ears.
You might have itchy ears.
(04:27):
So think about that.
You never thought about itchyears Like, oh, does this mean
that menopause is coming?
So these are kind of littlesymptoms, you know.
What we think about are hotflashes and night sweats and
insomnia and fatigue and brainfog, but there are a host of
other symptoms, including, as acardiologist, heart palpitations
(04:51):
.
You might start to feel heartpalpitations that could be
alarming and send you to thedoctor for a workup.
So these are all things that Ireally try to make certain that
people have information about,because information is power.
And what do hormones reallymean in our body and how does it
help to make us feel good andmore like ourselves or maybe off
(05:14):
center and not feeling so well?
Vai Kumar (05:18):
So when exactly would one start to feel this
perimenopausal symptoms?
Did you say in the 30s itself?
Dr.Jayne Morgan (05:25):
Yeah, even as early as the 30s, symptoms that
you may not associate withmenopausal symptoms, like itchy
ears, like palpitations, like achange in body odor, if you
start to notice that yourdeodorant just doesn't seem to
work anymore Deodorant you'vealways used and now suddenly it
(05:46):
doesn't seem to work.
Or you're having to wash twoand three times a day and you've
got a drawer full of deodorantsthat you've been sampling at
all the pharmacies and none ofthem seem to work.
Those are some of the symptomsof menopause.
Your estrogen level drops.
All of these things can impactyour body, including
(06:07):
forgetfulness or difficulty inconcentration, which we term as
brain fog, which could haveserious impacts on your career,
your career trajectory, how youperceive others at work, how
they perceive you, how youperceive others at work, how
they perceive you, and you'restruggling.
(06:27):
These could all be symptoms,again, of perimenopause that we
don't think about Brain fog,change in body odor, you keep
switching deodorants, and theseare the kinds of things that you
may not even be aware of, youmay not be thinking about,
you're just living yourday-to-day life, but these are
all signs that you are inperimenopause and these are not
(06:48):
symptoms that we normallydiscuss.
Vai Kumar (06:50):
Okay, what about normal menopause, then, when it
comes to from the standpoint ofage and with you having brought
up itchy feeling in the yearsand that's like skin related,
could you feel any sense ofburning in your skin as well?
Is that, like you know, saysome sporadic ones here and
(07:12):
there?
Dr.Jayne Morgan (07:13):
Vi such a great point.
Yes, you can have burning inthe skin, and we should think
about the skin, because the skinis actually the largest organ
on our bodies, it is our biggestorgan, and so itchy ears might
be the first symptom of dry skin, but ultimately you will start
to see that on your face and inyour hands and in your body with
(07:36):
those fine lines and wrinklesas your skin becomes drier and
drier.
So it's not really so much thatyou get older and you get
wrinkles.
The reason you get wrinkles asyou get older is because your
estrogen levels are dropping.
Now, obviously, men also getwrinkles, and so it is part of
(07:57):
the aging process losing some ofthat elasticity.
And elasticity in the skin isnot all estrogen related.
It's collagen, it's vitamin E,it's a lot of things, but
estrogen is one of those thingsthat does give us some
protection with the skin.
We've got estrogen receptors,though, in every organ of our
body, so we've got estrogenreceptors in the heart.
(08:18):
Estrogen is cardioprotective,it's anti-inflammatory for the
heart, and so the risk of heartdisease for a woman is half that
of a man prior to menopause,but by the time she enters
menopause and those estrogenlevels are at their nadir,
meaning their lowest point.
(08:38):
Her risk, or our risk, of heartdisease is equal to that of a
man, and by the time you reach70, it actually exceeds that of
a man.
That's because we lose theprotection of estrogen on our
hearts.
Estrogen receptors are in thelungs.
They're in the bones.
When you think about anothersubtle symptom in perimenopause,
(08:59):
in your 30s or early 40s, youmight start to have bone pain or
stiffness in your bones orinflammation.
Is that really related toarthritis or getting older, or
is that related to your hormoneschanging, increased bone
resorption that you get?
As the estrogen levels decrease?
(09:19):
When I say bone resorption,your bones can actually become a
little thinner and increaseyour risk of being brittle or
breaking or having fractures.
So these are all things.
Estrogen is not all about theuterus and the ovaries.
We have estrogen receptors inthe heart, in the lungs, in the
bones, in the skin, in the GItract, in the liver, so all over
(09:41):
the body, and so we can haveall kinds of symptoms in all of
these organ systems.
Vai Kumar (09:48):
And from your recent cardiology conference, like
early part of the year, I knowone of your Stable Chronicles
post talked about the varyingresult based on estrogen and the
impact on heart health.
Correct, right?
So, going back to what is anormal menopause, could women
then reason out okay, whateverDr Morgan listed out, I may be
(10:12):
experiencing it at some point orthe other.
So can they feel at peaceknowing that, okay, I'm
transitioning into normalmenopause?
And what age would that be?
And certain women, due to everso many reasons in the world
these days environmental orwhatever, however, our food
supply is what we eat, so on andso forth seem to be
(10:34):
experiencing this at differentage groups, right?
So what exactly would you sayis considered very normal and
what would make someone feellike okay?
Dr.Jayne Morgan (10:49):
this is code red.
I need to go to my physician.
Yeah, I like that code red.
It's all code red.
I'm going to go back and justat the very beginning of what
you commented on.
So I recently went to theAmerican College of Cardiology
conference in April.
It was in Atlanta, and what Viis referring to is that there
was a menopause talk there.
The good news is that there wasa menopause talk there, had not
(11:14):
seen one there before.
The bad news is that it wasrelegated to a side room.
There was barely anybody therein attendance.
But this actually was at a hugecardiology conference and so in
some ways it's starting to makeheadway.
The association betweenmenopause and perimenopause and
heart disease.
(11:34):
That particular talk was veryspecific to the risk of stroke
during perimenopause andmenopause.
Stroke during perimenopause andmenopause and your risk of
stroke increases with theseverity and frequency of your
hot flashes.
And what they found in thatstudy is that the more hot
(11:57):
flashes you have per week, thehigher your risk of stroke,
because the carotid arteriesthat are on either side of your
neck that feed oxygen to thebrain become thicker on the
inside relative to the numberand the amount and frequency of
(12:17):
hot flashes that you have, andso, once again, these symptoms
of menopause are not innocuous.
They're not sort of ha ha ha,look at her, she's hot.
Hot flashes actually are anindicator that you've got an
increased risk of not only heartdisease but also stroke.
(12:38):
So I want to make certain thatwe draw that parallel and that
we understand that it's notreally a laughing matter anymore
.
I mean, you see women sort ofripping off their jackets and
shirts and they're so hot.
These hot flashes actually canhave very serious medical
consequences for women,especially down the road, and so
(13:00):
we're starting to recognizethat we don't have a lot of
clinical trials that areactually focused on women, where
women are enrolled, but we'repushing that as well from the
legislative side, and so all ofthese things are really very
important, and so when we talkabout Code.
Red.
When are we getting to Code Red?
So paramenopause is generallystarts in the mid 30s, so maybe
(13:23):
around 35 to 55.
Menopause is generallysomewhere between 50 and 62,
right, depending on the woman.
And again, menopause is whenyou actually stop having
menstrual cycles.
You're one year out from havingthose menstrual cycles.
What's interesting is when welook at Black women here in the
(13:44):
United States, generally Blackwomen enter menopause about a
year earlier than white women,and there are a number of
reasons for that, includingincreased stress and something I
talk about with weathering,with the racial construct of
America and being a member of aneasily identifiable double
(14:06):
minority so you're easilyidentified as both Black and
female and that dual stress.
But not only might women gointo menopause a year earlier,
black women, that means thatyour risk of heart disease
begins to increase a yearearlier as well, and so it is
(14:27):
not inconsequential.
The effects of weathering, theeffects of a racial society and
how that really impacts yourmorbidity and mortality long
term.
The stress and heart disease,well-being, mental health it is
really all interconnected.
Vai Kumar (14:46):
Then have any remedial measures been discussed
?
I know there's more studiescoming up and stuff like that,
but what then could someone doat this point?
Because I don't want listenersto kind of go into a panic mode
when they hear that oh hey, I'mexperiencing so many heart
(15:06):
flashes, then does that mean,with me hearing, I'm at a
greater risk for stroke.
I should just feel so anxiousright away.
What is it that they can do?
Is like improving estrogenlevels?
Is like hormone therapy asolution, or what is the way to
go?
Dr.Jayne Morgan (15:24):
So let's break that down.
We actually know several things.
As you're going throughperimenopause and entering
menopause, your cholesterollevels begin to increase.
Your blood pressure increases.
You can begin to develop morefat deposits around the
midsection.
We call that visceral fat andthat visceral fat is actually
(15:46):
more dangerous than other typesof fat, because that fat that
sits around the middle alsoencases the organs inside your
body where you don't see, and sothere's several things you can
do to combat that.
Be prescribed an anticholesterolmedication or a statin therapy.
Women are less likely to beprescribed cholesterol
(16:08):
medication and, when prescribed,are less likely to take them.
Take your medications andcontrol your cholesterol.
If your blood pressure isincreasing during perimenopause
those years again a 35 to 55,take medication.
Do not avoid medication.
Take medication and bring yourblood pressure down.
Why do I say that?
(16:28):
Cholesterol is a risk factor forheart disease?
Hypertension is a risk factorfor heart disease.
You can end up getting bothduring perimenopause.
So you want to decrease thoserisk factors.
You've got central fat that'ssitting around the midsection
very hard to get rid of as awoman gets older because of
(16:49):
these drops in estrogen levels.
So it may be time to have adiscussion with your physician
regarding whether or not hormonereplacement therapy is right
for you, meaning an estrogenpatch or an estrogen spray,
something to that degree andthose are conversations that you
have to have based on yourindividual and personal medical
(17:12):
history.
Sleep we know that sleeplessness, insomnia and the lack of a
duration of sleep also increasesyour risk of heart disease, and
this is another symptom ofperimenopause, where you can
have a lot of sleeplessness, soanother risk factor for heart
disease.
So really focus on sleephygiene.
(17:33):
So the point that I'm making ifyou get nothing else out of
this podcast today is that yoursymptoms of perimenopause should
be addressed.
You should not just sufferthrough those symptoms and tough
it out, because those symptomsare actually correlated with
(17:55):
heart disease and stroke.
So make sure you are takingcare of those symptoms.
Those symptoms are a warningsign and an indicator of future
risk.
So when you're developing thosesymptoms, don't think that you
should just suffer through thisand suffer with migraines and
(18:16):
suffer with menstrual cramps anormalization of our culture
that women are to suffer.
But what I'm also saying is, inthis case, suffering actually
(18:37):
can increase your risk of dyingor having a problem later on.
So you absolutely do not wantto suffer.
You want to address your bloodpressure.
You want to address yourcholesterol.
You want to address yoursleeplessness.
You want to address the weightaround your midsection.
We can talk about thatAnti-inflammatory foods, weight
(18:58):
resistant, exercising likePilates and other types of
things where you can increaseyour bone density and begin to
work against that fat that isdepositing around your
midsection.
Vai Kumar (19:13):
Okay, wonderful, you talked about certain populations
being at a risk for heartdisease in general, and also
menopause and heart disease inparticular.
Right, you touched upon theAfrican-American population.
What about, say, the Asianpopulation?
And what about other race, anddo you see any marked
(19:36):
differences?
Dr.Jayne Morgan (19:37):
between groups, and the reason that that is a
better question than youprobably even know is because
these groups are not studied inclinical trials, right?
So we don't have thatinformation.
We do have information on Blackwomen from the Women's Health
Initiative, which is an entirelydebunked study.
(19:57):
I'm not advocating any of thefindings from the Women's Health
Initiative.
However, there were Black womenin the trial and those subgroup
analyses have been veryimportant for us to really
understand the impacts ofestrogen on the body, especially
since most of those women hadhad hysterectomies and that's
(20:18):
another conversation as to whyBlack women are subjected to
hysterectomies in this country.
But what that served in thatparticular trial is it allowed
us to see what estrogen actuallydoes on women, as opposed to
estrogen and progesterone, andso so much work needs to be done
(20:39):
on all cultures.
I talk about this a lot, evenoutside of women's health.
With regard to my most recentstairwell chronicle, that I did
for Juneteenth was really aboutwhite blood cell counts and
what's a normal white blood cellcount?
And all of these normal valueshave been based on people of
(21:02):
European heritage and descent,and we actually find out that
other cultures actually havedifferent normal values, but we
characterize these cultures ashaving abnormal values, because
it's always compared to thenormal value, which is all
people of European heritage, andthen people can be subjected to
unnecessary tests, unnecessarypain, unnecessary expense, and
(21:27):
so I say that to say you hit thenail on the head, vi.
We don't have that informationthat we actually need to have on
all peoples in our globalsociety and not just the white
race and specifically the whitemale sector of our society.
Vai Kumar (21:46):
Okay, you touched upon white blood cell count.
So does it mean having a lowcount is dangerous or does it
mean a high count usually,typically, is significant of
some infection, correct?
Dr.Jayne Morgan (21:58):
Yeah, and so both white, just both high and
low.
I'm using these in quotationmarks because, again, the normal
range is based on people ofEuropean descent.
So what we know is that peopleof African and Middle Eastern
descent tend to have lower whiteblood cell counts, and so,
(22:23):
generally, the lower your whiteblood cell count, the more at
risk you are for infection, andor it can be an indicator that
you've got some other diseaseprocess going on in your bone
marrow, something very serious.
But as it turns out, as we'regetting more and more data, it
may be that these populationsthat have descended from Africa
(22:46):
or the Middle East actually havea lower white blood count for
whatever reason in evolution,and it doesn't mean that
anything is wrong.
It just means that we're beingcompared to a standardization of
a different population.
And so these are all the thingsthat, in medicine, really,
(23:06):
really need to be unraveled,because healthcare does not
serve all populations equitablyin this country for a number of
reasons.
That's just one of them.
I talk about a number of things,if anybody would like to follow
me.
What Vi is talking about is I dosomething called the stairwell
chronicles, and I literally siton the stairs of a house and I
(23:29):
answer one single question aboutmedicine in 60 seconds or less.
I generally do these onWednesdays about a topic really
of my choice, and sometimespeople write in and say hey, I'd
like to know something about X,y and Z and I might create a
Steroid Chronicle.
You can follow me at Dr JaneMorgan D-R-J-A-Y-N-E-M-O-R-G-A-N
(23:51):
on Instagram, but you can alsofind me on all the other
platforms, including LinkedIn.
Do talk about algorithms andformulas that are race-based
within medicine, that canrelegate different people,
including people of AsianAmerican backgrounds, asian
(24:12):
backgrounds as well to lowerlevels of care and concern, and
these are actual formal formulasand calculations that we use
every single day in medicinethat are again based on the
normalcy of the white populationand it doesn't take into
(24:35):
account any other people outsideof that race, and so people who
fall outside of that range thenare considered abnormal, and so
that's how that happens.
Vai Kumar (24:47):
Okay, I just have a question.
When you pointed out thevarying scenarios the impact of
estrogen on cardiological health, hypertension, cholesterol,
whatever it may be right, oreven the occurrence of heart
flashes, the periodicity of it,the frequency Right, and someone
notices that, do you think theyare able to go and address that
(25:09):
with their physician?
Are the physicians equippedenough with the data to answer
it?
Or are they just brushing asidepatients saying, hey, this is
just part of the process,because we talked about women
having to endure this, correct,so we talked about that.
That's part A of that question,and then part B would be then
(25:30):
is the answer to it lies in theindividual taking it on
themselves and focusing more on,say, movement, diet, lifestyle
and those kinds of factors.
Dr.Jayne Morgan (25:42):
Yes, yes, yes and yes.
So doctors are not as wellinformed as they should be,
because this continues to be aburgeoning study and we're
having to unlearn what we weretaught in school from the
Women's Health Initiative andunlearning something is always
(26:07):
more difficult than learning itthe first time and so that is an
uphill battle, and so mostphysicians will not be armed
with the most up-to-dateinformation on women's health,
menopause up-to-date informationon women's health, menopause
(26:27):
and hormone therapy, and you maybe bringing information to them
.
The other thing you shouldthink about is you can look up
physicians and perhaps othertypes of healthcare providers
who are menopause certified,because then they're able to
work in conjunction with you andthey actually have an interest
in it and have studied thesehormones.
Generally, we see that withobstetrician gynecologists, but
(26:50):
I'm working hard to havecardiologists also begin to be a
part of this, because so manyof the long-term effects of
perimenopause and menopause arecardiac related, and
cardiologists really have got toget involved in it.
So, yes, you would need toadvocate for yourself in many
(27:11):
respects A lot of the symptomsthat I talked about earlier in
menopause.
Doctors have no idea what you'retalking about If you come in to
say, hey, I'm 41 years old andmy ears are itching and I kind
of have a bad taste in my mouthand my deodorant doesn't work
anymore.
They are probably going to lookat you cross-eyed.
That means nothing to anyone,right?
(27:31):
We haven't studied thosesymptoms.
Vai Kumar (27:33):
What about OBGYNs?
Do you think, at least rightnow, they are able to answer
these?
Dr.Jayne Morgan (27:39):
or I do not, but, um, I think this whole
world of perimenopause andmenopause and hormone
replacement therapy ispenetrating that specialty
faster, okay, than any of theother specialties okay, yeah,
what about role of movement,diet and lifestyle?
(27:59):
um, all of that is so important.
I mean movement, diet, exercise.
All of that is important injust taking care of yourself
outside of menopause.
When we add perimenopause andmenopause to it, it really
becomes paramount because ananti-inflammatory diet and
(28:20):
generally at a high level ananti-inflammatory diet is a diet
that is high in plant-basedfoods and fruits and even lean,
lean cuts of meat in smallportions, and that protein is
really important.
When I say protein, I mean theprotein sometimes that we get in
meat, but you can get it inbeans and other things.
(28:41):
The protein is so important asa woman ages because we lose
muscle mass and the proteinhelps us maintain that muscle
mass.
But also weight-bearingexercises and you don't
necessarily have to go to thegym and pick up weights and
start doing those weights, butyou can do things.
(29:02):
I teach Pilates.
You can do things where yourbody is being used as the weight
and you are learning resistanceand at the same time, you are
incorporating movement of yourbody.
It is important to move periodand not just Pilates.
I mean just getting up andwalking and being mobile and
making certain that you are notnecessarily staying active but
(29:26):
remaining mobile, because weknow that societies that remain
mobile actually have longerlifespans than those that lead
more sedentary lives, includingsedentary meaning more
industrialized or digitalizedlives that make things easier
for us.
(29:47):
That ease of life actually can,in the long run, take years off
of your life, and we see thatsocieties where movement is a
part of what they have to doevery day to live.
Actually, we're studying thesesocieties because many people
live for many, many long years.
(30:08):
There are many centurions inthese types of societies,
meaning they live to be ahundred or more.
Vai Kumar (30:14):
Oh, that's the blue zone we are talking about, right
, the blue zones.
Dr.Jayne Morgan (30:17):
That is correct .
Vai Kumar (30:19):
Yes In the show earlier, and when you said
movement, I can attest to it.
I think the viewers, listenersof this show know pretty darn
well that I myself wrestled withinflammatory bowel disease, but
I've learned to manage itreally well.
In fact, I am a student of yourPilates program as well, so I'm
(30:41):
proud to share that withlisteners here.
I can personally attest tomovement Every time.
I walk several thousand stepsor I do hiking, I do a
combination of yoga and Pilates.
My bone density and myinflammatory markers have really
even become normal.
(31:01):
Of course, what we eat in thispart of the world, the food
supply, the dietary practices,everything is quite different
and I would just certainlyencourage listeners, viewers, to
make sure that, whatever ispossible, make sure that you
cook fresh food, eat and lead avery healthy lifestyle.
(31:22):
You took us through the role ofmovement and I shared my two
cents on it.
What about the hours of sleep?
I know we all live in adigitized world, hooked to our
phones, and I guess I sound likea broken record, sometimes even
on this very own show, talkingabout hey, people don't be on
your devices all the time.
Dr.Jayne Morgan (31:44):
Yeah, yeah.
So when we talk about sleep,the studies have shown that
people who get six hours or lessof sleep per night have an
increased risk of heart disease.
So six hours seems to be thesweet spot.
Again, more research needs tobe done and we need to really
(32:04):
kind of look specifically atdifferent groups and different
populations specifically atdifferent groups and different
populations.
Vai Kumar (32:11):
Okay, what about mental health, the impact of
mental health, and does estrogenlevels have any impact on
mental health?
And in fact, I also meant toask about varying estrogen
levels and, potentially, peoplegetting blood clots as well.
Dr.Jayne Morgan (32:27):
Estrogen receptors are found in the brain
as well, and so no surprise.
As estrogen levels begin todrop during menopause, you can
start to have changes in yourbrain and the way that you're
thinking and the way that you'reexperiencing life, and it's no
(32:50):
surprise that the most number ofantidepressants are prescribed
to women during this phase oftheir lives.
But the question is are wereally depressed or are we just
in perimenopause?
Do we really needantidepressants or do we need to
think about what's going onwith our hormones and whether
(33:11):
there are other options?
And so just another greatexample of estrogen receptors
being in other places other thanour uterus and our ovaries.
We know that mental health isvery connected to physical
health.
In fact, people with higherlevels of depression and anxiety
also seem to have shorterlifespans as well, sometimes by
(33:37):
as much as 10 years, and somental health drives how you
move when you move, whether youfeel like moving or whether
you're going to sort of adopt asedentary lifestyle, whether
you'll be just sitting at home,whether you will close yourself
off from society All of thosethings you think are just
(33:59):
mentally related.
But it really is now having animpact on your physical health,
and then later it will have animpact on your health overall,
whether or not you start toself-abuse.
So drinking more alcohol orsmoking more, or indulging in
(34:22):
illicit substances and drugabuse, or taking more
prescription andnon-prescription pills All of
these things can be a part ofmental health.
That actually, then willeventually impact your physical
health, including overeating andindulging in all types of foods
(34:43):
that may provide short-termsatisfaction high in sugars
sugar highs but long-term mayhigh in sugars sugar highs but
long-term maybe pushing youtowards diabetes and obesity and
hypertension and highcholesterol.
So mental health is incrediblyimportant.
Vai Kumar (34:59):
And you said a lot of things women are just kind of
told to endure, right?
So in terms of mood swings andthings like that, what about?
The answer Again, is estrogenlevel contributing to how your
mood sways and how you kind ofpresent yourself?
So how can society be much moreforgiving and accept a woman
(35:22):
and embrace her for who she is?
Dr.Jayne Morgan (35:25):
And be more supportive and be more
supportive.
I mean, the word menopauseisn't even a part of any HR
department at any company or anycorporation or any organization
, and so women are just managingit on their own, with fans
under their desk or fans sittingon their desk to blow on them.
And again, we're thinking ofthis as, oh, she's just hot.
(35:50):
But what we should be thinkingof is, oh my gosh, her risk of
heart disease is going to beincreased.
Perhaps we need to have someway of supporting her in this
environment where she issuffering and struggling and
trying to adopt and adapt.
Even someone who's bringingextra shirts to work because
(36:12):
they know they have to wash inthe middle of the day and
freshen up and things are justdifferent for them.
And they're struggling in thissociety and in a work
environment where they may behaving brain fog, challenges
with memory they didn't sleepwell at night.
They don't feel well.
They go to the doctor.
They're told they should justsuffer.
There's nothing wrong with them.
(36:32):
They're having palpitations.
They've been to thecardiologist.
There's nothing wrong withtheir heart.
Eventually am I losing my mindand there's no support for it.
So you are absolutely correctand the support of friends and
your community has really beenshown to actually be more
(36:55):
important than even the supportof a spouse.
That environment and communityand friend support.
And so absolutely talk withyour friends, make sure you have
a community, have sharedexperiences, people shared
experiences, People support you.
And then look for people whoare certified in menopause and
(37:18):
menopause specialty to see ifyou can have a conversation and
start to connect those dots andthen you can take that
information to your physician aswell and begin to have that
conversation with them alsoinformation to your physician as
well and begin to have thatconversation with them also.
Vai Kumar (37:36):
Okay, we'll come to much more of social engagement
in a bit, but again, just torefresh on that question from
before what about estrogenimpact on, say, potential for
blood clots and things like that?
Dr.Jayne Morgan (37:44):
Yes, and so the data from estrogen on blood
clots came from the route ofadministration.
So there are many differentways you can take it.
You can have a spray, you canhave a patch, you can have a
cream.
You're going to have a pill, soit's the pill form that has the
greatest risk of blood clots.
If you're taking it in a pillform which really almost just
(38:08):
isn't done anymore, a pill formwhich really almost just isn't
done anymore, however, it'sstill relatively safe.
But the highest risk of bloodclots comes from the pill form.
Vai Kumar (38:18):
Okay, thank you.
What about, say, tools that onecan empower themselves with?
Would that be when we talkedabout diet and lifestyle?
When you said anti-inflammatoryjust for listeners to have a
very clear picture does thatmean eating more whole grains,
eating more plants and morevegetables and fruits like a
(38:40):
colorful plate?
You talked about the role ofprotein in muscle mass and
everything.
So what would be Dr Morgan'sadvice to someone in terms of,
say, a reasonably good diet andlifestyle practice?
Dr.Jayne Morgan (38:57):
All of the things that you've said.
I mean, you nailed them andthat's not just for
perimenopause and menopause.
This is an adaptation of livinga healthy and whole life, and
so those are the types of foodsthat are anti-inflammatory.
Generally, that is more of aMediterranean and a plant-based
(39:19):
diet.
Why is that important?
We keep talking aboutanti-inflammatory, but I haven't
told you why.
Inflammation, chronicinflammation in the body, is one
of the things that createsheart disease.
It creates the hardening ofthose arteries.
It contributes to that.
People who have chronicinflammation also have a higher
(39:40):
risk of what?
Of cancers, of autoimmunediseases, of arthritis, of GI
diseases, meaning your stomachand your gut.
So we know that chronicinflammation is a causative
factor for disease processes inthe body.
So when we keep talking aboutanti-inflammatory things, that's
(40:02):
why anything that you can dothat can reduce the chronic
inflammation in your body isgoing to be beneficial to you,
because inflammation increasesdisease processes, including all
kinds of things, includingheart disease as well.
When we talk about inflammation, obesity is a driver of
inflammation.
Inflammation is a contributorto obesity, so it's a two way
(40:25):
street.
Obesity, though, is a riskfactor for heart disease.
You can see how everything sortof compounds on itself, and so
it's important to have a healthylifestyle independent of
perimenopause and menopause, butthen, as women enter this phase
in their lives, it becomes animportance of greater paramount.
Vai Kumar (40:45):
Great.
What about?
Even girls these days say, hey,you know what?
I think I'm so bloated duringthe time of the month or
whatever, and everyone wants tobe a size zero.
I mean, we all live in a socialmedia world and everyone is so
image conscious.
There's some good, but thereseems to be so much of pressure.
Society wise for women.
(41:05):
How does a woman fulfill socialobligations but also take care
of herself?
Dr Morgan, and I guess onedoesn't want to feel lonely,
correct?
I think you started touchingthe impact of a community and
yeah, and I think there's commonmisconception or is it really a
misconception that if you getto menopause, you will put on
(41:27):
weight.
So how does anyone combat allof these?
Dr.Jayne Morgan (41:31):
Yeah, loneliness is definitely a risk
factor for decreased lifespan,and so we have to think about
what that is in this societywith all this social media, but
are people actually lonely whenwe talk about risk factors as
well?
As we transition through all ofthese phases in our lives,
(41:56):
community is incredibly,incredibly, incredibly important
, and that connectivity it turnsout.
In the end, humans are verysocial species, and so that
community and that interactionoutside of the digital
interaction turns out to be veryimportant, not only for mental
(42:17):
health, but for your hearthealth as well.
We've already connected mentalhealth to your physical health,
and so taking care of your brain, taking care of your
psychological well-being, isself-love, because that also
takes care of your brain.
Taking care of yourpsychological well-being is
self-love because that alsotakes care of your physical
well-being.
Vai Kumar (42:35):
Okay, perfect.
What about questions?
Just to bring it to a verygranular level, what about
questions?
Every woman should ask theirdoctor for them to know that
they are giving themselves theright kind of self-love, they
are arming themselves with theright kind of protection upfront
(42:56):
, rather than having to say,kind of face the music later.
Dr.Jayne Morgan (43:00):
Yeah, you want to make sure that you get an EKG
at your appointment, notbecause you're sick, not because
you're having chest pain, butevery woman needs to have that
baseline EKG.
So if you ever come in withsymptoms later and we get an EKG
, we have something to compareit to, to what it looks like at
a different time, and oftentimesthat is never ever done.
(43:23):
So request an EKG, not becauseyou're sick, but because you
want a baseline status in yourchart.
Not because you're sick, butbecause you want a baseline
status in your chart.
You want to also talk aboutwhat some of your symptoms are
and whether or not it's time todiscuss hormone therapy, whether
you're interested in it or not,and what are the options are
(43:43):
available to you.
You know, vi, you hit onsomething that is actually very
true and it's actually veryfunny, but it's.
Is it just impossible to get ridof weight as you're going
through perimenopause?
It really is very, very hard.
The physiology of the body isdesigned to hold onto fat and to
(44:05):
hold onto calories right,because we weren't always living
in the types of societies thatwe're living in.
As your estrogen levels drop,that even becomes harder, and
that's why you can often hearwomen say I'm eating the way
I've always eaten and I alwaysexercise and I'm still gaining
(44:26):
weight.
I mean, what does that mean?
And that is part of it, andwomen who are on hormone
replacement therapy actually areway less than women who are not
on hormone replacement therapy.
It's not a reason to take it,but it's something to understand
.
With regard to how estrogenworks in our bodies, and we've
(44:49):
talked a lot about estrogen, butthere's also progesterone and
there's also testosterone thatwe really associate with men,
but women actually have moretestosterone in our bodies than
estrogen and we actually losemore testosterone as well, which
is why we also have difficultyholding onto this muscle mass.
Vai Kumar (45:08):
What about the role of, say, dietary influence, like
soy products and things likethat?
Dr.Jayne Morgan (45:14):
Yeah, we look at soy and estrogen.
So there is no limit really ontaking soy.
There are no studies oncomparing soy to actual estrogen
therapy.
Again, we're going back toclinical trials, so I can only
tell you kind of what we think.
And soy is something positiveto be incorporated into your
(45:35):
diet along with other plants.
Soy in particular tends to bindto the same receptors as
estrogen, but we really need tohave clinical trials and better
research on it.
Vai Kumar (45:46):
Okay, perfect.
I think that's a lot of greatinsights, dr Morgan, on all
things wonderful when it comesto keeping oneself healthy,
keeping oneself empowered,asking the right questions, just
staying on top of it with yourannual physical visits, and so
on and so forth.
I think there were hugeinsights into the impact of
(46:10):
cardiological health and whatone should not ignore, and also
for women to feel at peace,knowing that they are not alone,
feeling some of the symptoms,and I think watching and
listening to a podcast like thisis going to help them feel that
they are not alone, but not toresist or detest themselves from
taking action.
(46:30):
So thank you once again forjoining us and empowering us.
Dr.Jayne Morgan (46:34):
You're welcome.
I'm glad we finally got thisdone again.
Love it.
Vai Kumar (46:37):
Yes, yes, listeners, as always, follow the podcast,
rate the podcast, leave a reviewfrom your podcast app of choice
.
Follow us on YouTube @vaipkumar, that's V-A-I-P-K-U-M-A-R, and
across all podcast sources.
Until next time with yetanother interesting guest and
(46:58):
yet another interesting topic.
It's me Vai, along withwonderful Dr Morgan, saying so
long, so long.
Dr.Jayne Morgan (47:04):
Thanks everybody.
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