Heart Health & Hormones

In this conversation, Dr. Whitney West discusses the critical aspects of women's health, particularly focusing on heart health and conditions like PCOS. She emphasizes the importance of understanding one's body and the misconceptions surrounding symptoms related to women's health issues. Dr. West advocates for seeking proper treatment and awareness of conditions that affect women's health throughout different life stages, including perimenopause and menopause.

 takeaways

Understanding your body is crucial for heart health.
PCOS is not just a concern during pregnancy.
Misconceptions about women's health symptoms are prevalent.
High stress can impact women's health significantly.
Irregular cycles should not be ignored.
Seek assistance from experienced practitioners for PCOS.
Awareness of heart health is essential for women.
Menopause and perimenopause require special attention.
Education on women's health is often outdated.
Women's health issues are interconnected and complex.

“You’ve been listening to The Integrative Gyn with Dr. Whitney West — because your health deserves more than fifteen minutes.”

The information shared in this podcast is for educational and informational purposes only and is not intended to be medical advice. This podcast does not establish a physician–patient relationship and should not be used as a substitute for individualized medical care. Always consult your own physician or qualified healthcare professional regarding medical decisions or concerns specific to your health.

Transcript

Welcome back to the

Integrative Gyn podcast where women's health gets the time and

attention it deserves. I'm Dr. Whitney West.

February is Heart Health Awareness Month, and today I want to talk about something that almost no one explained to us — how deeply our hormones are connected to our heart health.

Most women I see think heart disease is something men get… or something to worry about much later in life. And that couldn’t be further from the truth.

Heart disease is actually the leading cause of death in women. And what’s even more important — women’s heart disease doesn’t look the same, feel the same, or present the same way it does in men which means the labs can be different

So today we’re going to talk about heart health through a hormone-informed, women-centered lens.

This is not a cardiology lecture.

This is about understanding your body, your risks, and what you can actually do — especially if you have PCOS, irregular cycles, high stress, or you’re navigating perimenopause or menopause.”

One of the biggest problems in women’s heart health is that we’ve been taught the wrong symptoms.

Most people picture crushing chest pain, like an elephant sitting on the chest, left arm pain and the dramatic movie collapse. But that image is largely based on male data.

Women often present differently.

Symptoms can include:
– unusual fatigue
– shortness of breath
– nausea
– jaw, neck, or back pain
– dizziness
– or even anxiety-like symptoms

And I see this all the time-  women are told they’re stressed, overwhelmed, hormonal — and the conversation ends there.

The American Heart Association has been very clear that women are more likely to be underdiagnosed and undertreated for heart disease.

So if you’ve ever felt dismissed, you’re not imagining it.

Listening to your body does not make you dramatic. It makes you informed.”

“Let’s talk about estrogen, because estrogen plays a powerful role in cardiovascular health.

We’re going to go more in depth about estrogen in later episodes but:

Estrogen helps:
– keep blood vessels flexible
– improve cholesterol patterns
– support insulin sensitivity
– regulate inflammation

This is one reason women, before menopause, often have lower cardiovascular risk compared to men.

After menopause, when estrogen declines more consistently, cardiovascular risk increases.

The  Menopause Society discusses this transition extensively and heart health  becomes a major focus after menopause.

This doesn’t mean estrogen is automatically protective or that everyone needs or is a candidate for hormone therapy. It means hormones are deeply connected to vascular health — timing, balance and context matters.”

There has been A LOT of fear around hormone therapy, but organizations like the Menopause society have clarified that hormone therapy can be safe and beneficial for many women-especially when started appropriately and individualized. This is not about everyone needing hormones. Its about informed, personalized care instead of blanket fear.

We'll discuss menopause and hormone therapy in much greater detail in upcoming episodes.

But here’s the nuance: it’s not just menopause that matters.

Hormone imbalance matters too.

If you have PCOS, which comes with irregular or no ovulation (masked as no periods) and imbalance of hormones (specifically estrogen, progesterone and many times testosterone) or you’re in perimenopause where estrogen fluctuates dramatically, that protective effect of estrogen can be disrupted.

Lets discuss PCOS a little in the context of heart health. Polycystic ovarian syndrome (PCOS) is so often misunderstood.

PCOS is not just about fertility or irregular periods. It is a metabolic condition with long-term cardiovascular implications when left untreated or managed. 

this topic is so complex, it deserves a full episode or 2. but in the context of heart health, Women with PCOS have higher rates of:
– insulin resistance
– type 2 diabetes
– hypertension
– dyslipidemia – which is abnormal/ elevated cholesterol

And in women with PCOS, these metabolic changes are Often seen in women of much younger ages- teens and young adults.

And just so we are clear, you can be thin, athletic and still be insulin resistant.

Insulin resistance increases inflammation and affects blood vessel function and increases cardiovascular risk over time.

Organizations like ACOG

and the international PCOS society guidelines recognize this increased cardiometabolic risk and recommend screening across the lifespan — not just when pregnancy is a goal.

So if you were told PCOS only matters when trying to conceive, that’s outdated information. If you think you have PCOS or just irregular or no periods and haven’t been treated for it, please seek assistance from a practitioner experienced in this condition.

“Now let’s talk about stress — because this is where I see so many high-functioning women struggle.

Chronic stress keeps cortisol elevated.

And cortisol affects:
– blood pressure
– blood sugar
– abdominal fat storage
– sleep
– inflammation

Many women are managing careers, and households, caregiving to children, spouses and older parents, holding everything together — and ignoring their own symptoms.

Then they are told to just ‘reduce stress’ which is not helpful.

Stress management is not self-care fluff.

It is cardiovascular care.”

Many are confused or misinformed about their risk of cardiovascular disease, Cholesterol matters, but its not the whole story.

Your menstrual history matters, whether your ovulate and have a regular period matters.

Having PCOS matters. Your blood sugar levels matter.

(whether you have IR/PreDm/DM),

blood pressure matters. And Sleep matters.

ACOG and AHA both emphasize looking at the whole picture, not just one lab value.

So if you’ve been told everything is normal, but you don’t feel well-that deserves deeper conversation and more thorough evaluation. Advocate for yourself.

Now we’ve talked about risk factors and hormone influences--Let’s make this practical.

Because information is only helpful if you know what to do with it.

I don’t believe in extreme diets, or even dieting at all- Everything in moderation. But there are patterns that consistently support heart health — and they align with American Heart Association recommendations and we will touch on them here.

1. Fiber: Aim for 25–30 grams per day

Fiber helps regulate cholesterol and blood sugar.

High-impact sources:
– Lentils
– Black beans
– Chickpeas
– Oats
– Berries
– Chia seeds
– Ground flaxseed
– Avocado

Even small changes like adding half a cup of beans daily or a tablespoon of flaxseed can improve metabolic markers over time.

2. Protein at Every Meal (20–30g per meal) based on 0.8-1g/kg

Protein stabilizes blood sugar, especially important for PCOS and perimenopause (because of metabolic changes that happens with IR/preDM)

Examples:
– Eggs
– Greek yogurt
– Tofu or tempeh
– Salmon
– Sardines
– Chicken
– Lentils
– Protein smoothies

This isn’t about extremes. It’s about stability.

3. Omega-3 Fats (2–3 servings fatty fish weekly)

Examples:

-flax seed, chia seeds

-Walnuts
– Salmon (wild caught)
– Sardines
– Mackerel

Omega-3s support vascular function and reduce inflammation.

4. Reduce Daily Ultra-Processed Foods

Not perfection. Not restriction.

My usual recommendation to my patient is Don’t throw out everything in your pantry. Its not practical and its expensive!

When you run out of one thing, replace it with a healthier option on your next trip to the grocery store.

Just reducing:
– sugary beverages
– highly processed snacks
– refined carbs without protein

can significantly improve insulin sensitivity.

“Now let’s talk movement.

The American Heart Association recommends:

– 150 minutes per week of moderate-intensity aerobic activity
OR
– 75 minutes per week of vigorous activity

That’s about 30 minutes, 5 days a week.

Moderate intensity means brisk walking, cycling, swimming, incline treadmill — you can talk but not sing.

But here’s what women especially need:

Strength training — at least 2 days per week.

This becomes critical in perimenopause and menopause.

Why?

– Improves insulin sensitivity
– Supports bone density
– Helps maintain muscle mass
– Improves metabolic health

You do not need long workouts.

20–30 minutes, twice a week, focused on:
– Squats
– Lunges
– Deadlifts
– Push-ups
– Rows
– Resistance bands

For women with PCOS, resistance training is particularly powerful for improving insulin sensitivity.

And please don’t underestimate sleep.

7–9 hours per night.

Sleep deprivation increases blood pressure, insulin resistance, cortisol, and inflammation.

Sleep is metabolic regulation.

I don’t want you leaving this episode thinking you need to overhaul your life tomorrow.

Instead ask:
What is one thing I could improve this week?

Maybe it’s:
– Adding fiber to breakfast
– Walking 20 minutes after dinner
– Lifting weights twice this week
– Going to bed 30 minutes earlier

These are what I call lifestyle modifications. This is not a diet that you will eventually stop or come off. These changes become a new way of life

Small, consistent changes compound.

I want to end with this because i don't want this episode to feel overwhelming.

You dont need to everything perfectly. You don't need extreme diets or punishing exercise.

Supporting heart health can look like:

moving your body in ways that feel sustainable

eating to support blood sugar, not restrict yourself

prioritizing sleep as hormone regulation

addressing symptoms early instead of waiting years

and working with a practitioner who understands how hormones, metabolism and CV health intersect.

prevention doesnt mean panic- it means paying attention.

Heart health is women’s health.

Hormones are not separate from your heart — they’re deeply connected.

If you have PCOS, irregular cycles, perimenopause symptoms, or a family history of heart disease, a hormone-informed evaluation can be a powerful preventive step.

If this resonated with you, share it with someone who needs to hear it. You can also Submit your questions.

Your symptoms matter.
Your hormones matter.
And your heart matters.”

And here on The Integrative Gyn,

We are Listening, Learning and Healing.