Have you ever wondered if the changes you’re noticing in midlife—fatigue, rising cholesterol, changes in blood pressure, or stubborn visceral fat—could be telling you something about your heart?

Heart disease can look very different in women than it does in men, which means symptoms are too often overlooked or dismissed. In this episode, I’m joined by cardiologist Dr. Arash Bereliani to talk about what happens to our cardiovascular health during menopause and what we can do now to protect it.

We’re getting into HRT and heart health, the exercise and nutrition habits that actually matter, supplements, stress and sleep, HRV, and why advocating for yourself could save your life.

In this episode:

[3:11] The biggest myth about women’s heart health—and how decades of research based largely on men still influence the way women are diagnosed and treated

[4:21] Why heart attacks can look so different in women, from nausea and profound fatigue to shortness of breath and jaw pain—and why those symptoms are so easy to dismiss

[6:52] The connection between metabolic health and heart health, and why menopause is a critical time to pay attention to changes in blood sugar, visceral fat, cholesterol, and cardiovascular risk

[10:17] What happens when we lose the cardiovascular protection of estrogen during menopause—and how declining hormones can affect inflammation, cholesterol, and the elasticity of our blood vessels

[13:51] The HRT conversation every midlife woman needs to hear: why timing matters, how oral and transdermal estrogen differ, and what Dr. Bereliani considers when choosing hormone therapy

[17:52] Is HRT cardioprotective? Why Dr. Bereliani doesn’t recommend hormone therapy solely to prevent heart disease—and when he believes the benefits may make sense

[20:10] The four pillars Dr. Bereliani considers essential for cardiovascular health: nutrition, movement, stress reduction, and sleep

[22:28] Why strength training becomes even more important as we age—and the connection between maintaining muscle, insulin sensitivity, metabolic health, bone health, and longevity

[25:38] You don’t have to destroy yourself at the gym to protect your heart: what moderate cardiovascular exercise can look like and why pushing your body too hard may work against you

[27:29] Why the Mediterranean diet continues to stand out for cardiovascular health, plus the importance of fiber, protein, reducing excess carbohydrates, and cutting back on ultra-processed foods

[30:19] The heart-health risk we don’t talk about enough: loneliness and social isolation—and why finding friendship, connection, and community really can be medicine

[32:53] What you need to know before spending money on supplements, including quality and absorption concerns with CoQ10, fish oil, red yeast rice, vitamins, and other commonly used products

[38:23] What your HRV is actually telling you—and why your own trends in exercise, sleep, stress, and recovery matter more than comparing your number to someone else’s

[41:43] Dr. Bereliani’s two take-home messages for women: advocate for yourself when something doesn’t feel right and find a doctor who truly understands preventive cardiovascular care

Links and Resources

Dr. Arash Bereliani, MD, FACC is a board-certified cardiologist and Clinical Associate Professor at UCLA’s Geffen School of Medicine, with 28 years in preventive cardiology. His new book, What About Her Heart? How a Male-Modeled Medical System Is Putting Women's Hearts at Risk, explores how a male-modeled medical system can leave women’s cardiovascular risk misread, especially through perimenopause and beyond.

Website: https://drbereliani.com/

Book: What About Her Heart?: https://www.amazon.com/What-About-Her-Heart-Symptoms-ebook/dp/B0GS42XJ78

Instagram: https://www.instagram.com/drbtheheartdoc/

Connect with me, Sara Poldmae:

• Website: https://risingwomanproject.com
• Instagram: https://www.instagram.com/drsarapoldmae

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