Black Boomer Besties from Brooklyn
Black Boomer Besties from Brooklyn
Hot Flashes and Heart Attacks: The Menopause Conversation Women Aren’t Having
Besties Angella and Leslie bring you another episode in The Year of the Menopause series with the return of Dr Toni Otway, a Board Certified OB/GYN physician. She discusses that cardiovascular disease is the leading cause of death in women, yet the connection between menopause and heart health remains dangerously under-discussed. Dr. Otway explains how dropping estrogen levels during menopause dramatically increase women's heart disease risk.
• Estrogen protects cardiovascular health by keeping blood vessels flexible, reducing inflammation, and helping manage cholesterol
• Women's heart attack symptoms often differ from men's classic chest pain, presenting instead as fatigue, shortness of breath, or indigestion
• CDC reports 6% of women over 20 already show signs of cardiovascular disease
• Pregnancy complications like gestational diabetes and preeclampsia are significant risk factors for future heart disease
• Hormone replacement therapy offers cardiovascular benefits when started early in menopause transition
• Women must advocate for themselves against medical gaslighting and ensure doctors follow appropriate screening guidelines
• Prevention through lifestyle changes remains essential alongside appropriate medication when necessary
Don't forget to schedule your regular health screenings and pay attention to changes in your body – your heart health depends on it.
Resources referenced:
Get Angie’s eBook:
We’re Too Old for This Shit! The Inquisitive Older Woman’s Guide to Joy http://joystrategy.co/ebook
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Hey Ange, hey Les. How's it going? It's going well Good. I'm excited to come on in today.
Speaker 2:That's your natural state?
Speaker 1:Yeah, you're right, my natural state is I'm baseline excited. I want you to come on and be like sad. Like Eeyore, not sad sad but be like.
Speaker 2:Eeyore, I want you to be like. Hmm, I don't know.
Speaker 1:Here we are again. Another episode, another episode. Then they would really say what the heck has gotten into, les. So welcome to another joyous episode of Black Boomer. Besties from Brooklyn.
Speaker 2:I'm Angella and that's Leslie, my best friend of almost 50 years. We are two 60-something-year-old women who have decided, we've committed, to live lives that are more bold and joyful, and we invite you to come along with us. So today we have Dr Tony back. So today we have Dr Tony back. We're going to be it's another episode in our year of the menopause series and we're going to be talking about no, let me make that, let me fix that. They're going to be talking about menopause and cardiovascular health. You're going to talk too. I'm going to be poking at them. I'm going to be like what the hell does that mean? I don't understand this doctor talk. So I'm going to represent the people power to us and they're going to be. Dr Tony's going to be giving us some insight about the connection between menopause and cardiovascular health, which is something that we rarely hear about.
Speaker 1:And before I let Dr Tony in and introduce herself again, what I want to say, ange, is we don't want any barriers between people who are physicians and non-physicians, because one of the things that I stress to my patients and this is something that's newer in the medical arena, but it's no longer the age of where physicians are telling patients what to do we want to continue a dialogue, we want it to be a back and forth and we want really collaboration, because those are the types of behaviors and relationships that foster collaboration compliance, questioning and things like that. So you may be power to the people, but we the people too.
Speaker 2:I get it. I'm just saying before I let this point go. I'm just saying that oftentimes doctors don't they desire that, but you live in a doctor world. You live in a you know, especially when you start you to start kind of I know getting in the weeds I know it's not your desire to to create barriers, but I'm just here in case you slip up, okay and just thank you to you know yeah, we bring to you dr tony outway.
Speaker 1:Hi everybody, thank you for joining and to you, Dr Toni Otway.
Speaker 3:Hi everybody, Thank you for joining and thank you for inviting me back. I'm Toni Otway, I'm board certified OBGYN. I no longer practice OBGYN anymore, but I do work for an insurance company. I'm a utilization reviewer in the state of New Jersey. So, but these kind of discussions are still always dear to my heart and trying to educate the masses on health and how it relates to women especially, and women of color especially too. So Well, good.
Speaker 1:Thank you. Women especially, and women of color especially too. So well, good. So you've decided to, under the umbrella of the year of menopause, specifically talk about the um cardiovascular manifestations or effects, in other words, your heart and your blood vessels, and how that period of menopause affects those organs. Before you do that, let's just remind our listeners what is menopause and why does it matter.
Speaker 3:Okay, so just a reminder, just to go over a few things about menopause. Menopause is that period in your life when your ovaries are no longer functioning. Basically, our ovaries are meant to function to reproduce children release, born with a finite number of eggs to be released over a number of years. Once they've all been exhausted, then you go through this period of time called menopause. So your hormonal changes that help to control this whole function suddenly starts to drop off. Whole function, um, suddenly starts to drop off.
Speaker 3:Um, and there's um perimenopause, which is the time that, uh, the function of your ovaries is starting to slow down, and that's the time when you see changes in your periods, um, and other things that would, uh that go on. And then menopause itself you have, you can truly call yourself menopausal when you've been a whole year without your periods, so, and then you become in the post-menopausal state and I have said before that your estrogen really keeps, makes you, um who you are as a woman. Um, you have over 400 receptors in your body that estrogen affects and it goes all the way from the top of your head to down to your toes and everything in between. So estrogen is a huge factor in your body functioning as a woman, so that's it in a nutshell I have thanks for that.
Speaker 2:That, that was really clear. So it reminded me that my sister-in-law some years ago did not have a period for something like 350 days.
Speaker 1:That's cruel.
Speaker 2:Yes, and then here it comes right and so according to this definition, she was not menopausal. But it seems kind of arbitrary to me, right? Can you talk to that and why? It's kind of how it came to be this kind of rigid in terms of definition, this rigid line between when you are and when you're not?
Speaker 3:Well, I think the way they look at it is that, even though you are and when you're not. Well, I think that the the the way they look at it is that, even though you know when she got that period, it may be that she's she had an egg that was released, so that is still showing you that your ovary still has maybe one or two things left.
Speaker 3:Even though got you, a pregnancy probably wouldn't have come about because your eggs are so much older now, but it's still showing that your body is still producing that level of estrogen that could produce whatever follicles or eggs that are still there. I must stress that if you are coming up to 300 and something days and then all of a sudden you have a period, I would encourage people to go and see their physician, because sometimes in a regular period can also be a sign of other things too.
Speaker 3:So don't just think that just because you, you know you still get in one or two, that it's all, it's normal, it's fine that it's normal, it's fine. Sometimes there are issues that can occur that can have you to still have a bleed that you shouldn't really be having.
Speaker 3:So, if you've gone a period of time and then all of a sudden you get one and it starts coming back full-fledged again. You should really just get it checked out just to be sure that it really truly is nothing other than you know you still going through your changes and those changes can take. You know, it could take a year, it could take a few years. I know people that have been going through those irregular things, um, for a few years and still hasn't stopped, and so everybody's different.
Speaker 2:So well, it's all about getting to know what your body is like.
Speaker 3:That's right that part.
Speaker 2:You know, someone mentioned just before our we started recording that they were having a hot flash.
Speaker 1:So, um, I'm not calling any names and that's boy, but but the one that has the tissues all the time like stuck to her face. I wonder who. But you know, and that also reminds me, let's just you know, I started, I would say, menopause rather late. I was, I think, over 60. Wow, when I, you know, stopped, but I'm sure I was over 60. But what I'm wondering is, and before we get into the cardiovascular part, like the symptoms of hot flashes and stuff, do they last very long? Or is it like when the actual egg release or the bleeding stops, should the discomfort and the sweating and the flesh it stopped? Or is that also a continuum that that can also be a continuum.
Speaker 3:That can also be, I personally never experienced anything. My period just stopped, that was it, and I didn't have any symptoms, nothing and I did I did have one period. I did have one period almost a year to the day of my previous one, and that was it Done. And then it was like so long? Yeah, I never, ever had any issues.
Speaker 1:Wow.
Speaker 3:And then I have people who have had periods. They stopped their periods years ago and they're still having issues, hot flashes. So everybody's different.
Speaker 1:I see.
Speaker 3:Still need more studies to figure out why? But sure and you know, in this day and age, who knows if that's even going to be possible to even study anything anymore. So, um, but yeah, it's, it's uh. It varies. Different people have different, uh, different stories.
Speaker 2:So people have different stories. Yeah Right, different stories.
Speaker 1:Yeah, that's a good way to say it. So you mentioned that menopause has. Well, the body has receptors for estrogen all over the body, talking about the heart and the blood vessels. Tell me about, tell us about some of the things that a person being in menopause what kind of changes might her heart go through?
Speaker 3:Okay, so the issue with cardiovascular disease, and that's what we're going to talk about, and I just wanted to add something because you know I was going to speak about, you know, maybe a woman going to the doctor and saying they have this, that the other symptom, but then, um, I don't know if you know ann burrell, the um chef, on food network she just passed away.
Speaker 3:Yesterday she was 55 years old yes, yes, and now it comes to, they've come to find out they think it might be a. She had a heart attack. So I just want to say that, um, you know, heart disease is actually the leading cause of death in women. Um, it usually occurs later in life than men. Men on average might see heart disease at around 45. We usually see start to see it around 55 and um, cardiovascular disease. The CDC has come out with the percentage that women over 20, there's about 6% of women over the age of 20 that start to show signs of cardiovascular disease. Over 20? Over 20. There's 6% of women that start to show those signs.
Speaker 1:Wow.
Speaker 3:What is cardiovascular disease? Basically, it's primarily the buildup of plaque in the arteries, and it's also called atherosclerosis, it's called peripheral artery disease. It could be called heart muscle valve disease. There's a whole different lot of words to describe it. Basically, it's just this buildup of plaque inside your blood vessels that over time, starts to narrow the blood vessels. And this is the issue it narrows the blood vessels and the flow of blood is decreased.
Speaker 3:So it's not something you can actually see. We know it happens but you can't see how bad it is in you. And usually the first sign of a woman having cardiovascular disease most of the women usually the first outcome is because of a heart attack. So Anne Burrell probably had cardiovascular disease, probably didn't have any of the normal signs or symptoms or didn't do any preventive measures or um, um, and then this is the first sign of us knowing that she had cardiovascular diseases, that she had a heart attack. And this is what happens to women. Um, it's usually the first sign of cardiovascular disease in a lot of women is we have this heart attack. And by saying that we have the worst outcomes when it comes to heart attack, we tend to ignore the atypical signs.
Speaker 1:That's what I was going to say. She may have had signs and said I just ignored it Because I always associate heart disease with men for some reason.
Speaker 2:I'm not sure why that is, but that's my go-to. And the other thing is is this related to cholesterol? And I know that that's what affects the closing of the okay it is related to that.
Speaker 3:So, um yeah, like what was that? What was my thought?
Speaker 1:I think it was interesting that you were saying that she may have had symptoms that may not. She may not, she may not have associated it with being a problem in her heart. But then again we all also know that the medical profession we are taught that, especially in a 55-year-old woman, sometimes these symptoms of heart disease present differently than they would in men.
Speaker 1:Men may come in you know, looking perhaps overweight, like they should have some heart disease, and then you think, well, if you're having chest pain, let me do a workup. A woman may come in. She may not be overweight or obese, she may not have the typical risk factors, or she may have. Oh, I just have some. You know jaw pain that this or there's something going on, or every time. You know just have some. You know jaw pain that this or there's something going on, or every time. You know just a little. You know the symptoms can be very vague and very often it can be missed.
Speaker 3:Exactly.
Speaker 1:And I think that we downplay our symptoms as well. Yeah, because we're busy. Because we're busy, we've got making lunch for the kids.
Speaker 3:Absolutely, yeah, making lunch for the kids? Absolutely. And then we wait longer to seek help, to think that maybe this is something that's wrong with us or because we just kind of poo-poo our symptoms.
Speaker 3:A lot old, associated risk factors are diabetes, smoking, obesity, overweight, physical inactivity, high blood pressure and abnormal lipid levels in your blood, which are the fats, the LDL, the HDL, the cholesterol abnormal. So some of the newer risk factors that they have been finding are also things that may even happen in pregnancy, if you have a pregnancy that has you have gestational diabetes or you have high blood pressure preeclampsia or you have preterm labor, or if you have depression, breast cancer treatment and even early you know early menopause.
Speaker 3:These are all things that can increase your risk, which are things that they never used to think of before. So imagine all these women that are having these issues in pregnancy. These are all risk factors for you to have cardiovascular disease.
Speaker 1:So and then how many physicians 20 years later would ask tell me about your obstetrics history, tell me about your pregnancy. I, you know that was remote. My kids are grown, I don't what do I remember about? When I was, you know, pregnant 20 years ago, was my blood pressure high. I don't know Was I did. I have diabetes.
Speaker 3:I don't remember, you know wow, yeah, so some of the typical symptoms that you know have is the chest pain, which, in women, is not necessary Normally. You know hear men say, oh, they feel like an elephant is sitting on a chest or there's this pressure. It may be different. In women it may be more of, you know, just like a little pain or a little discomfort, uh, whereas with men they, they describe this thing as you know somebody sitting on their chest um, maybe you're short of breath and you probably put that down to maybe I just walk some stairs and stuff, you know, or just walked a little further than normal.
Speaker 3:Um, things like extreme fatigue, I mean, which woman is not I'm?
Speaker 1:always tired.
Speaker 2:This is actually what I was thinking and that's why I was chuckling a little bit, because you've seen those um videos where they put an apparatus on a man at to give him the sensation of period cramps, right, right, and they're like on the floor, like you know, just cannot take it and it's something that most of us just go through.
Speaker 3:Most of us just keep walking, just keep going.
Speaker 2:And so I'm wondering, if women, just by the nature of our physiology, whether we have a high threshold for pain, not only pain but discomfort, right, and that would then put us in this risk factor. And then, of course, after answering that, like, what do we do about it? Then, wow, what do we do about it?
Speaker 3:It's very hard, it's very hard to actually say, but again, I always truly be. You have to really be in tune with your body. You have to really um try not to poo, poo those things that are starting to change within your body, um, and a lot of women will say, well, I'm just going to put it down to menopause or um, you know, but other things too are just, you know, just pain and discomfort. Indigestion is one you know. But other things too are just, you know, just pain and discomfort. Indigestion is one you know. Heartburn is something nausea, vomiting, um, feeling lightheaded, even getting swelling in your legs, and you know, your ankles and your feet could be a sign of heart disease. Um, and which woman doesn't have swollen legs at the end of the?
Speaker 3:day, you know after walking around or whatever. So all these things, yeah, um, you just have to be in tuned with this if these things, if the symptoms don't go away, if they just progressively get worse, if you try and take something that you know you may normally take for maybe the heartburn and it doesn't go away, then you need to see, you need to seek help and then to be in tune with it.
Speaker 1:We need to find time in our busy schedules to seek help, and then you don't want to go to a doctor or whatever if it's nothing you know.
Speaker 2:You don't want to waste your time, you don't want to be embarrassed I have a little something and you know it's right yeah, yeah, it's well, I think it's difficult what probably happens often too is you do go and they say it's nothing right, and then you go back and the next thing that happens oh, it's probably nothing. You know what I mean. So it becomes frustrating cycle.
Speaker 3:Yeah right, yeah, yeah, I mean how many times has a woman been to the emergency room and has been having a heart attack and they've just said, well, it's just indigestion.
Speaker 1:That's yeah sure, because they say we've heard those stories having a heart attack.
Speaker 3:Yeah, maybe you're only 45 years old, you can't possibly be having a heart attack. So yeah, so, um, but yes, but so a plaque itself is is usually a build, is usually made up of cholesterol and fats and other substances, and what estrogen actually does is it starts, it protects you basically in this build-up, so it helps to maintain, um, because our blood vessels and women are smaller, so it helps to maintain, because our blood vessels in women are smaller, so it helps to maintain the flexibility of blood vessels so the blood can pump through easily.
Speaker 3:I see it helps to decrease the production of cholesterol from the liver. It helps to protect you know the diet that you have. It helps to clear you know some of the bad fats and helps to improve the good fats from the liver.
Speaker 1:Wow.
Speaker 3:So this is what estrogen does for you. Good old estrogen, wow Good old estrogen, yes. So again, it helps to relax your blood vessels. It also helps to reduce inflammation within the blood vessels too. Helps to reduce inflammation within the blood vessels too, because the plaque can only adhere to your blood vessel if there's a damage in the blood vessel wall. So if there's any inflammatory things going on, yeah, it can't actually attach.
Speaker 3:So estrogen helps to reduce inflammation also. So, um, you know all these things. This is what estrogen does for you. So this is why you get where you know. Cardiovascular issues really start to skyrocket once you hit menopause. Once you've lost that protection of the estrogen, this is when things start to really ramp up, which is usually around the age of 50 55 in men. It's much younger, it's like 45. Um wow so. So that's how estrogen. You know, estrogen is good so here.
Speaker 1:So, so here's what I'm wondering, though, if I were to go to a doctor? I don't really go to a doctor but, if I, if, if I were to go to, let's say, a cardiologist, a heart doctor, if I'm now 63 years old, should he be speaking to me in a different way than he would have spoken to me if I was 43 years old? He?
Speaker 3:should be Like. Would that screening?
Speaker 1:or conversation be any different.
Speaker 3:It wouldn't be any different. It should be the same. He should actually be speaking to you at 45 or 40 about the things that you need to do to protect your heart. It shouldn't just be when you hit menopause that you are um, you know you're discussing these things. Remember what I said cardiovascular disease cdc has said six percent of women over the age of 20 have started to show signs and they the um.
Speaker 3:You know I was looking at screening tests like blood tests, like for the cholesterol and that, and I was actually shocked to see that you should actually be testing your children when they're starting to turn teenagers 11 and 12 they should be still having a baseline cholesterol really when they're yeah, and then they repeat it every five years, and that's something that should be thought of from childhood. So which kind of shocked me? I didn't know that are these?
Speaker 1:are these new guidelines coming out from the seat?
Speaker 3:well, I know I was going to say coming out from the cdc. Right now there's nonsense coming out from the cdc. There's nothing coming out.
Speaker 1:Yeah, is there yeah, which is a little scary, but, um, I thought that a young person, like like a teenager adolescent, should get tested for cholesterol when they have these familial hypercholesterolemia type issues. You know genetic stuff and what have you. But there are some people saying that everyone should get a baseline. It should be earlier than that, just to see. Yeah, it's not.
Speaker 3:Yeah, because the other risk factors are things like obesity and diabetes too.
Speaker 1:And our weights are going up at younger ages.
Speaker 3:Our weights are going up absolutely. So it's not just genetics anymore, it's hugely about lifestyle. Kids smoke, kids drink, teenagers- do all these things. So these are the things. And they have sedentary lifestyles. They're just sitting in front of the computer playing games. So they're not out there running around anymore, like they used to. So you know, these are all risk factors for having cardiovascular disease. So it's not just about the genetics anymore.
Speaker 1:That's pretty scary.
Speaker 3:It is yes, it is yes it is no-transcript.
Speaker 1:More advocates for their own health and information and I know that sounds cliche and all, but here we're listening to if I'm a 63 or post-menopausal. Now I'm in menopause, you know I need to be going into the doctor and saying like, should I do anything different now? Are there different tests that you should look at for me in addition to the cholesterol or regular EKG? Do you need to take, like, a better look at the heart or at my vessels or things? You know you hear about all of these different kind of studies and what have you like? New blood tests that people take? I know I heard about that. What is that?
Speaker 3:Lipo, lipoprotein A. So you know some of the things you would do on a regular basis when you go for your routine exams. The basic things are really just the blood work, the whole lipid profile. You're measuring your LDL, your HDL. The LDL is the bad, the HDL is the good, cholesterol is bad. Triglycerides are bad too if they're too high. There's always cutoffs for the best things. And the lipoprotein A is a new. It's a type of LDL which is a bad cholesterol that doesn't have as much treatment to reduce it like the other LDLs. So that's the thing with lipoprotein and it really is in 90% of people. It's genetically determined, so you have to be careful if your lipoprotein a is is high because there's not a lot of treatment to get it down. So it's really trying to um, uh mitigate the uh the problems doing other things like his lifestyle changes and stuff like that so so that's a new that's.
Speaker 3:it's not new, but it it's not a lot of people know about it. Um, okay, so I think they do it more when you know you have family history of people with sudden cardiac deaths or heart disease or early cardiac death.
Speaker 1:Yeah, something like that, right.
Speaker 3:Um, I think they look at that more carefully in people with strong family history of cardiovascular disease. So it's not new, but it is something that should be considered if you do have strong family history of cardiovascular disease.
Speaker 1:And that's with or without being menopausal or not. Yes, if you have that strong family history, that might be another component of testing Right.
Speaker 3:Exactly, exactly. So other things. When you start to hit 40, 50, you know you you're going to get based like each EKGs. If you're having some symptoms, they may give you what they call a stress test, which is when they put you on a treadmill to see how your heart reacts to stress.
Speaker 1:basically, yeah, exercise.
Speaker 3:And depending on the other things they look at are inflammatory processes or things like thyroid disease. If you have things like sarcoid lupus, they might look at you a little bit more closely because all of those conditions are stresses, things that stress you also can cause cardiovascular disease or add to the risk factors as part of the risk factors. So, depending on what other chronic diseases you may have, they may start to look at you a little bit more closely. A little younger, um. So uh yeah.
Speaker 2:Okay, I don't know if you're going to be able to answer this, but this, this question, is plaguing me over here. Okay, so the question broadly is how do you know that you have a good doctor?
Speaker 3:Oh God, right, right, I mean how do you know?
Speaker 2:like I know, there's certain things where you really good doctors would say, if a doctor does this run the other way, there are some right. Or if your doctor doesn't do this, run the other way. So I know there's some thing on this, on this, um, on on on the spectrum, where you would say, yes, do this run. So can you find a point?
Speaker 2:on the spectrum, to say in terms of menopause and you know we're speaking to people who have ovaries and who experience these things where you can say, ok, do all your disclaimers that if they don't check you for this or if they say this when you present this way, find another doctor.
Speaker 1:I have a couple of ideas about that. First of all and you and I both know what makes for a good therapist or a counselor, because we've had a lot of experience with that right, yes, and we kind of know some of the things that would be red flags and make us run from them. So, people who listen to you, right, people who are approachable, right, people that you don't have a problem telling the truth to, even if it's embarrassing.
Speaker 2:Right, you know, as an anesthesiologist, a pre, a kind of a bias. It's all of those things, yes.
Speaker 1:I say to my patients if you got to tell the truth to anybody, it should be me. Right, you know, Right. So it's all a matter of like that trust thing, right, I see. But the other thing, that's really big now. I see it on social media, I hear it in the news and unfortunately I hear it from patients Medical gaslighting. When patients go in and say, doc, I've had this pain for a couple of days, it's nothing, you don't really have pain, that's not really a pain, or you know, or so. So you'll get the sense of when someone is listening to you. Even in the era of, we have only 11 minutes to see a patient, we only have a quick time to examine a patient and very often patients feel like we're rushing them or cutting them off, not with me per se, but with other primary care doctors per se, other primary care doctors per se, you know. But I'm saying that that feeling coupled with you have to have some knowledge about some of the guidelines.
Speaker 1:For example, at 45 years old now, people recommend colonoscopies for everybody. If you have a strong family history of GI cancers, then it would be sooner. Is your 46 years old? Is your doctor recommending you get a colonoscopy. You know you should be getting yearly mammograms. That's Dr Otway's realm. Is your doctor recommending you get, or asking you about your mammograms? Are you, you know? So those are the.
Speaker 1:It's like is she missing something? I remember years ago my mom had an internist. Years loved this lady. We made her stop going to this doctor because she would not follow the regular guidelines. Oh, wow, it's like doesn't she care about this? Doesn't she care? When is she going to order this? When is she going to order this? You know, and it was like this lady is not practicing good, recognized good medicine, but mom loved her. So it's a combination of that feeling of being heard and respected and your personhood, and not medical gaslighting, telling you your symptoms are not important, and then also following what you have some sense of being, the national standards and the guidelines and things like that, and somebody that isn't defensive when you speak up and ask questions.
Speaker 3:Yes, exactly.
Speaker 1:What were you going to say, Dr Toni?
Speaker 3:I think that you know back in the day I would say, oh, I hate these people that come in with their Google searches, dr Google. But I think in this day and age, when it's so easy to look up what are the standards these days, I think you have to do a little bit of research for yourself to see is my physician doing this, this, this for?
Speaker 3:me at my age, or you know. I hate to say, but I think you know, I think people have to look up this stuff to be advocates for themselves these days, because and the other thing too, is there's so much, there's so much for one doctor to have to know, you know, especially if you're something like family medicine or internist or not, the specialties, but there's so many different things out there now that they have to understand and learn that they have to understand and learn that sometimes it shouldn't hurt for you to bring in.
Speaker 3:Well, you know, in my condition I see that they have this test out now. I don't think, like you said, a doctor shouldn't be defensive when a patient comes to them and asks them a question about a test that they may not have started them or medication that might be out there now that may work for them better. And I think it's the way of the world now is you have to use to be an advocate for yourself. You have to use what's out there, your resources, to find out information and unfortunately, Google is one of them. So you know the internet is one of them. So I think you have to, because I also think that we are also finding out more and more about the biases that people have against people of color.
Speaker 3:So even more so you know you've got to be an advocate for yourself. You have to question and you have to do your own research, and don't be afraid to do it. Yeah.
Speaker 1:In the time we have left. So let's just say, now we know what to look for or what to think about when we go to our doctors. In terms of the cardiovascular system and we're in menopause, now, let's just say, we do have heart disease. Now we don't know if it's caused from our lack of estrogen by virtue of our being in menopause. We don't know if it's from all the pizza that I love to eat on a regular basis and my sedentary lifestyle is. Would the treatment for menopause related heart changes be any different, let's say, than other treat? You know, high cholesterol from other causes, let's say, or heart disease from other causes.
Speaker 3:Well, I think, when we talk about menopause and heart disease, I think if you are suffering from menopausal symptoms, hormone replacement therapy is one of the best things out there right now and it helps. It really does help with cardiovascular disease as well. And it really does help with cardiovascular disease as well. Placement therapy helps with your weight less weight gain, less male pattern weight gain. It helps to reduce your blood pressure, helps to keep your blood vessels flexible and it helps to keep you know. If you're a diabetic, it helps to keep your fasting glucose down and helps to increase your insulin use. And all these things are good with hormone replacement therapy.
Speaker 3:But the problem is, is the timing? There's this thing out called now the timing hypothesis that estrogen the use of or the replacing of estrogen is more helpful early, when the estrogen receptors are still active and you know the attack on the blood vessels is not as severe. So it's much better, if you're going to start hormone replacement therapy, to start it as close to your menopausal time, as opposed to being like five or 10 years out. Five or 10 years out, you're really not getting the effects of the hormone replacement therapy.
Speaker 3:Um so along with that. It's, it's like anything else. It's lifestyle change. It's uh, exercise. It's uh, changing your diet. It's um, uh's, um, uh smoking. It's decreasing your smoking, decreasing your alcohol intake. Um, eating, well, eating the rainbow. Alcohol, alcohol decrease. I'm finished eating. It's eating the rainbow, um, you know. Low saturated fats, low cholesterol, you know.
Speaker 1:All I hear right now is wah, wah, wah, wah, wah, wah.
Speaker 3:All of that good stuff.
Speaker 1:But yeah.
Speaker 3:And you know, getting your regular checkups, your blood pressure, your cholesterol check, all these kind of things. So really, it's always, always, always about you, always about prevention and trying to change your lifestyle, Lifestyle medications, diet and exercise, and don't be afraid to use the medications that they may want to put you on.
Speaker 1:Yeah, I do see that a lot People say I don't want to start taking medicines I don't like taking it. It's like well, you started getting heart disease.
Speaker 3:Right, you know, and if you're not going to make the lifestyle changes that may reduce you having to take these medications, then you need to take the medications Sure, sure. So.
Speaker 2:Anyone feeling convicted right now?
Speaker 1:Oh my gosh, it's like I'm wondering if that lifestyle modification, can it come in a pill? Oh, I know, you know, I promise.
Speaker 3:I'll take it every day. Yeah, I wish.
Speaker 1:Wow, oh my gosh. This was so wonderful, Dr Tony. A lot of food for thought.
Speaker 3:Yep, a lot Everything is all about prevention, modification and be aware that's all. That's what you need to do.
Speaker 1:And I have a couple of appointments coming up, so I know that my language is going to change a little bit based on just what. You know what we're talking about.
Speaker 2:Right, ok, good Excellent. Oh, thank you. Right Okay, good Excellent. Oh thank you.
Speaker 1:So I know we're going to see you again with some other organ systems and other effects of low estrogen and menopause and all of that. So I'm really looking forward to that.
Speaker 3:Okay, great, thank you so much. Good to have you All right.
Speaker 1:Well, I'll say You're like a regular now. Yeah, yeah, that's wonderful. So this has been another episode of Black Boomer Besties from Brooklyn, brooklyn Bye.
