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- [00:00]
Dr. Jane Morgan
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- [00:28]
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- [01:31]
Tamsyn Muir
This is a number one reason women in the US are dying.
- [01:34]
Dr. Jane Morgan
Heart disease is not only the number one killer for Americans, it's the number one killer of women. The first heart attack of a woman is more often fatal than the first heart attack of a man.
- [01:44]
Tamsyn Muir
No one taught them what to look for.
- [01:46]
Dr. Jane Morgan
Jaw pain is actually a very common symptom of heart disease. Women will often mistake it for tooth pain and see a dentist. And guess what? You get to the dentist, they don't find anything wrong with your tooth. But the dentist isn't thinking jaw pain. I need to send this woman to the emergency room.
- [02:03]
Tamsyn Muir
Dr. Jane Morgan is a leading cardiologist and one of the most respected medical voices in the country. She's led groundbreaking research on women's heart health.
- [02:12]
Dr. Jane Morgan
Hot flashes are not ha ha. This is not funny. They are markers of an increased risk of heart disease, an increased risk of stroke.
- [02:22]
Tamsyn Muir
In this episode, she's breaking down exactly what women need to know to protect their heart.
- [02:26]
Dr. Jane Morgan
When we look at foods, we look at things that are more anti inflammatory. I'm a big fan of the Mediterranean.
- [02:33]
Tamsyn Muir
Diet and what they need to avoid.
- [02:35]
Dr. Jane Morgan
Those are the kinds of drinks we want to be very, very careful about, especially those with artificial sugars, because the data has shown.
- [02:45]
Tamsyn Muir
So I have told this story before, but I found out I was in menopause on live television. Well, during the commercial break, I was in the middle of reading a news story, and suddenly my heart started ra. Beating out of my chest. I could feel sweat dripping down my back, my hands shaking, and I couldn't catch my breath. I thought at that moment I was having a heart attack. And I kept going. Later, I found out it was a really intense hot flash and that I was in menopause. Looking back, though, not once did I think to see a cardiologist. And the truth is, most women don't. We don't realize that menopause impacts our heart. We don't get taught how to read the signs, and too often we get dismissed. But today, that all changes. Dr. Jane Morgan is one of the top cardiologists in the country. She has changed the way that I approach. Approach heart health. The truth is, the number one killer of women is heart disease. And that's something we all have to come to terms with, no matter what age you are. It is so, so important for you to hear this episode. Whether it's for you or a woman you love. The next hour will be a roadmap to protecting your heart and advocating for your health. Before we start, though, one tiny favor, please. If you can take just five seconds to subscribe, rate and review this podcast, your support helps us record more life changing interviews like this one. So let's go ahead and get into it. Dr. Morgan, good to see you.
- [04:00]
Dr. Jane Morgan
Oh, Tamsen, so wonderful to be here.
- [04:02]
Tamsyn Muir
I'm excited you came first of all, to our studio.
- [04:04]
Dr. Jane Morgan
Thank you for having me.
- [04:06]
Tamsyn Muir
I really appreciate it. I think I'm hearing myself talk more and more and thinking more and more about heart disease lately because for me, and I think for a lot of women, for years, I thought of it first of all as a guy's disease. My dad had heart disease, his father had heart disease. And not so much as a women's issue. But that is the wrong way to think about this.
- [04:26]
Dr. Jane Morgan
It is the wrong way to think about it because heart disease is not only the. The number one killer of Americans, it's the number one killer of women. And we just don't get that message. You know, women, we are taught socially to conform, be agreeable, suffer, don't make noise, make everyone else's life nice. You know, take care of yourself last. And somehow in the midst of that, we've also not Gotten the message that we have a heart or brain or liver or any of the other organs. Right. So whenever you talk about women's health, people think it's all about reproduction. Right. It's about breasts and pelvic mammograms and Pap smears, which are very, very important. But the fact of the matter is, men have all these other organs as well. Surprise.
- [05:13]
Tamsyn Muir
What drew you to cardiology?
- [05:15]
Dr. Jane Morgan
I grew up, and my best friend lived across the street. Her father's an orthopedic surgeon. And, you know, interestingly, the person who lived on the left of us was a dermatologist. And guy who lived on the right was a family practition. And the guy in front of us was the orthopedic surgeon. So my best friend lived across the street. We would go over there and play, and we would be down in the basement. These are days when you actually played. And on rainy days, we'd go down to the basement and make these blanket houses. And I would always sneak into her dad's office because he had all these medical books with all these gross, weird pictures in them. And I would go and go through the pictures and, you know, and then close them and try to put the book back so he'd never know we were in there. And I think that really started to foster my interest in medicine. Right. Just playing on a rainy day, making blanket houses, sneaking into her dad's office, who's an orthopedic surgeon, to see how many gross pictures I could find.
- [06:05]
Tamsyn Muir
Right, right.
- [06:05]
Dr. Jane Morgan
I later sort of developed an interest in medicine, so went into medical school to become an orthopedic surgeon. Cause that's what I knew about medicine, orthopedic surgeons. And the gross pictures and all the textbooks I'd been secretly looking at. Wasn't reading them, just looking at the pictures. And sometimes I would read a little bit like, oh, didn't know what the words were. It was all Latin. So then I go to medical school, and you sort of. Your world starts to get bigger, and you start to say, oh, there are more doctors than orthopedic surgeons. This is interesting. I remember in medical school, I did a rotation in rheumatology. I had never even heard of rheumatology, the study of arthritis.
- [06:43]
Tamsyn Muir
And I was gonna say, I still don't know what it is.
- [06:45]
Dr. Jane Morgan
It's like rheumatology. What is that? So as long as you were open to your world getting bigger, it just got bigger and bigger and bigger. And eventually I couldn't decide what I wanted to do. So I did internal medicine, which is just basic, right? This is internist, bread and butter medicine. And in doing so, I did a cardiology rotation and just loved it. So this is way late in my career. I'm out of medical school, I'm doing an internal medicine residency, and I come into the world of cardiology and critical care. I liked cardiology better. I liked the EKGs. I liked reading the squiggly lines. And then critical care involved a little pulmonary, your lungs. And I didn't like the sleep sounds of the lungs, the gurgling, the sputum. I was like, oh, no, that's not for me. But the heart don't really like that. The heart was good. It was just blood and blockages and plaques. I could do that. And the EKGs were good. So it's interesting the kinds of things.
- [07:39]
Tamsyn Muir
That turn you off when you look at cardiology. Now, maybe from where you started, was it predominantly men that would come to be treated and women that didn't come until things were so bad? I don't know. When do you get a cardiologist? Not until you have a problem.
- [07:54]
Dr. Jane Morgan
Not only was it predominantly men that came to be treated, predominantly men who were doing the treating, it was all men and me. In fact, I often was ignored in the room. And they would ask when the doctor was coming. This is after I had done a complete physical exam and had completely talked to the family. Everyone was in agreement. And then I would leave. They would say, well, when will the doctor be here? And I would say, oh, my goodness. And I would turn around, take a big breath, and go again. Because I had introduced myself as Dr. J. Morgan, the lab coat does say that. So people were expecting to see a man and probably expecting to see a white man. And so even if I introduce myself as doctor, the lab coat says doctor, I go over the entire history, I do a complete physical exam. They still are waiting for the doctor. So that's how entrenched it is in our system. And so when you talk about did I see women, people not only didn't think of heart disease as a woman's disease, it was run by men, for men, by men. And it was very hard to get that entree. And even for me, when I entered it, I did not see this as a woman's disease because of what I was surrounded with. You have male patients, you have male attending. And so I didn't even see it. I started, as I became deeper and deeper involved in it, started to see more women, and I started to recognize that, oh, women Always come in with these atypical symptoms.
- [09:31]
Tamsyn Muir
Atypical meaning?
- [09:32]
Dr. Jane Morgan
Atypical meaning this is not classic chest pain. This is not shortness of breath. This is not what we think about as a heart attack. She probably is having a panic attack or some anxiety or something else is going on. But just to be sure, we're going to have a cardiologist look at her. But it's not really that serious. We call those atypical symptoms, meaning they've got something like back pain or fatigue or not feeling well. These generalized non specific symptoms. I started to see, wow, the women always have these symptoms. Men never get this diagnosis of atypical. I didn't put it all together, but I had started to notice that early in my career.
- [10:12]
Tamsyn Muir
What are the three main symptoms?
- [10:14]
Dr. Jane Morgan
Yes, men would come in, usually chest pain, shortness of breath or pain on exertion. I feel fine until I walk two flights of stairs or when I got excited in a meeting. I started to have chest pain. We would call those classic, it's called angina, anginal symptoms of chest pain. Women wouldn't generally come in with those kinds of symptoms. But what was interesting is that when men even came in with what we would call atypical symptoms, they generally were not given that diagnosis. They were given more of a benefit of the doubt. They wouldn't write the word atypical in their chart. They wouldn't dictate it. They would say, a man comes in with symptoms that are suspicious of chest pain and, you know, language drives our action or inaction. And so the word atypical was a dismissive term that was relegated more to women. And I noticed when men came in with those exact same symptoms, they were not given the term atypical. They would say, you know, symptoms suggestive of. They would use other terms that also then would drive men towards more aggressive care.
- [11:20]
Tamsyn Muir
Do you think that's why we lose more women to cardiovascular disease?
- [11:24]
Dr. Jane Morgan
It's absolutely one of the reasons. Because there's a delay in care. There's a delay in women recognizing it. Not through any fault of our own. Right. We don't recognize it because the system doesn't teach us to recognize it. The system doesn't really even teach us that our health is of value beyond reproducing children and tending to the family.
- [11:45]
Tamsyn Muir
Can you say that to anybody who is watching or listening right now? What do women need to know?
- [11:51]
Dr. Jane Morgan
Value is beyond reproduction. And even the medical system only values women's health in the terms of the confines of reproduction. And beyond that, we sort of are dismissed.
- [12:05]
Tamsyn Muir
And that's why we have to take charge of our health.
- [12:07]
Dr. Jane Morgan
We have to take charge of our health. It is very difficult. So not only do we delay in symptoms because we don't recognize them, then once you get to the health system, you've got another hurdle because the health system is also minimizing your symptoms as well. And for every five minutes of delay you get to getting to a cath lab, getting your artery open, your risk of death continues to increase. So 37 minutes of a delay, and that's an average, is a huge delay in getting life saving therapies. Yes.
- [12:41]
Tamsyn Muir
So what does that mean? So 37 minutes could be the difference.
- [12:44]
Dr. Jane Morgan
Between life and death? Absolutely. It's the difference between life and death. That's why the first heart attack of a woman is more often fatal than the first heart attack of a man. Because there are these 37 minutes built in. And when you say 37 minutes, remember, that's the average. Some people are out three and four days. Right. Because you're at home and you're trying to do all these other things and you're not feeling well and people are not being supportive of you and they're still asking you to do things and you're still tending to other people and wondering why you're not feeling well. And no one's encouraging you to go to the doctor. People are asking you when's the next thing that they need?
- [13:19]
Tamsyn Muir
What are some of those key symptoms a woman listening should be aware of now to make sure that she doesn't wait 37 minutes.
- [13:26]
Dr. Jane Morgan
If you're feeling nausea, especially if the nausea is chronic or it comes and goes. Nausea's not normal. Ladies don't tolerate nausea. Oh, I'm not feeling well. What do we always say? I think it's something that I ate. I think, you know, my aspirin is bothering me. I think I whatever ran too much. We always make an excuse. Stop making excuse and actually listen to your body. Nausea is one. Jaw pain a big telltale sign. Jaw pain is actually a very common symptom of heart disease. Women will often mistake it for tooth pain and see a dentist. But see the dentist late because it's not an emergency. Maybe don't run straight to the dentist. But at some point you make an appointment to evaluate and guess what, you get to the dentist. They don't find anything wrong with your tooth, but the dentist isn't thinking jaw pain. I need to send this woman to the emergency room. They just do the oral dental assessment and send you out. So Nausea, jaw pain. And then if you are tired, we should not normalize being tired. We normalize that. Why? Because we've got a million things going on. We have 12 plates spinning in the air, another seven balls that are bouncing, and then we're trying to take care of a million people on top of that. And so you have a million reasons for being fatigued. But ladies, do not normalize fatigue. If you are tired, see your doctor. If your energy is low, see your doctor. So I would say those three things, nausea, jaw pain, and fatigue, do not normalize them. Make sure you see someone sooner rather than later.
- [15:07]
Tamsyn Muir
What is jaw pain? Why is jaw pain a thing?
- [15:09]
Dr. Jane Morgan
It's called a referred pain. So it's a pain referred from the heart. So you can think of a little bit like acupuncture, like you might do the acupuncture in your hand for something that's bothering your back. It's a referred pain.
- [15:23]
Tamsyn Muir
Wow, I didn't realize that, I guess. You know, it's funny, I have a friend that I work with and we were walking in the park one day and she's like, I'm just so tired. And my. I don't. I said, maybe, huh? Is Dr. Morgan. That was Saturday, Sunday. I called her. How you doing? I said, I think you should go to the Doctor or the 24 hour, just see what's going on. She went to work the next day and did. She did a telehealth appointment. And the telehealth person realized. The doctor realized that she was in cardiac arrest or distress and sent her there. She was having a heart attack.
- [15:58]
Dr. Jane Morgan
Of course she was. Look at how we delay care. We say, let me just wait. But we don't do that for our children. We don't do that for our spouses. We only do that for ourselves because the system encourages us to do it. And we also don't recognize that the HA is a heart attack, because men don't get described as ha. They get described as crushing chest pain, an elbow, sitting on your chest, shortness of breath. And yet we are much more complex and individual and unique and beautiful creatures. And we need to own that and have more people in medicine on the forefront who look like me, who look like you, who can put the dots together and begin to put women at the center of healthcare instead of over at the edges.
- [16:49]
Tamsyn Muir
And that has to start with research.
- [16:50]
Dr. Jane Morgan
And it has to start with research. It does starts with research, but it also starts with advocacy. It also starts with awareness. Right? And in this big era of social media, we have an opportunity to get the information to people now and for the people to bring it to their doctors.
- [17:06]
Tamsyn Muir
We can work it back on many people there as I can. In midlife, we often chalk things up to stress or hormones. You have published work that has a real connection between menopause and heart risk.
- [17:19]
Dr. Jane Morgan
That's right.
- [17:19]
Tamsyn Muir
Can you talk about that?
- [17:20]
Dr. Jane Morgan
Would love to. So part of what I do is I work in the digital health artificial intelligence space looking at cardiovascular solutions for people remotely, how you can monitor these things yourself. That includes. So my company is called hello Heart. I'm the vice president of medical affairs there. We have a remote cardiovascular system for blood pressure. When we looked at digital health, looking at the system and looking at women in midlife and comparing them to men, and also comparing women at midlife to premenopausal women, it turns out that if you are utilizing artificial intelligence or digital health solutions, women in midlife have an actual better response to lowering their blood pressure than if they were not using digital health solutions. So it's interesting to note that women in particular, women in midlife, are engaged in digital health in their phones, in solutions. And once they make that connection, they will actually follow it and do the coaching and the advice and have much better results than either men or premenopausal women.
- [18:34]
Tamsyn Muir
Digital systems, meaning an app that you're following or tracking.
- [18:38]
Dr. Jane Morgan
Bluetooth enabled app. So in this case, it's a blood pressure monitor that is connected to a Bluetooth enabled app on your phone that not only gives you your real time readings, but gives you your trends over time, gives you information. You can ask questions, it can provide solutions. You can keep your medications in there, you can track your cholesterol. It turns out when midlife women are simply tracking their blood pressure with the app and getting encouragement and feedback and their questions answered in real time, the responsiveness is much better. Much greater decrease in blood pressure. And we know during midlife is when your blood pressure is going up and you're increasing your risk of heart disease, increasing your risk of heart attacks, it turns out that digital solutions are very aptly connected with midlife women. So it just goes to show you all those plate spinnings, all those balls bouncing, we're looking for something that can simplify and integrate into our lives and help us. And once we find it, we connect with it and we get those results. So I was really happy to publish that because I think, you know, this starts to open doors into how are we going to approach women's health. One of the things that I always Say is it can't be the same old thing again. The way we've done it doesn't work. I don't like the people who've been leading it. I don't like the people who've created these guidelines. They haven't included you, they haven't included me. I'm not interested in doing it that way. So from my perspective, digital health and artificial intelligence will actually be driven in the health system by this new paradigm of women's health that we are going to define. And it will be women's health that will put artificial intelligence and digital health on the map, because we are the ones who really need it. And we're not looking for the same old thing. We're going to go in a different direction to get the answers that we.
- [20:34]
Tamsyn Muir
Need and perhaps allow it to expedite the years and decades that we have lost out on, quite frankly.
- [20:41]
Dr. Jane Morgan
Ding, ding, ding.
- [20:42]
Tamsyn Muir
Okay, that's right.
- [20:43]
Dr. Jane Morgan
Accelerating research, you know, these randomized clinical trials. Maybe, maybe not. Maybe we'll go to artificial intelligence modeling and get the answer in six months instead of waiting 12 years, you know, and it may be women's health that will actually be driving this change. So it's super, super exciting. We're the ones in the greatest need, and I think we are more interested in doing it a different and showing the world that this is how it's going to be and then science is going to track alongside behind us. So this is the world that I work in. This is what I'm hoping.
- [21:18]
Tamsyn Muir
I like you in the lead, my friend. I like you in the lead. Hot flashes. And that hot flashes can be a very big indicator of something with your heart. Can you go into that and talk about it? Because I think it's really important that since we come from a place where hot flashes have been the ha ha, right. That's been the thing everyone laughs about. And yes, I understand that it can be humorous sometimes in the right context. The truth of the matter is that that can be a very serious indicator of something else going on in your body.
- [21:47]
Dr. Jane Morgan
Not only can be is a serious indicator. So I was at the American College of Cardiology conference in Atlanta. American College of Cardiology. And they presented some very interesting research. Now, it was not in the main theater. It was sort of on the last day in a back room all the way at the end.
- [22:06]
Tamsyn Muir
Sounds like it's research.
- [22:07]
Dr. Jane Morgan
Find it. That's right where we find women's health and menopause. But the fact of the matter is that that small room was actually had People in it. And I went in and they were presenting a very, very interesting paper. Now, there were not a lot of people in it, but there were people there. I actually did not expect to see people to be, quite frankly. But the research presented was quite interesting. So they presented data on a trial where they enrolled women, and they looked at the number of hot flashes they were having in a week, from one to six. Now, I know people who are listening, like, one to six hot flashes in a week. I have that in a minute. I know, but I'm just telling you the research, right? So the paper was set up one to six hot flashes in a. In a week. Those women who had the most hot flashes in a week, six or more, actually had narrowing of their carotid intimal lining. So what is that? The carotid arteries are the two big arteries on either side of your neck that feed the brain. If those start to narrow right, it decreases the amount of blood that can get to your brain, which means it decreases the amount of oxygen, which means it increases your risk of stroke. So those who had six or more, the women who had the most hot flashes had the most narrowing and the greatest increase of stroke. It successively decreased the fewer hot flashes that you have. And so hot flashes are not. Ha, ha, as you said, this is not funny. They are markers of an increased risk of heart disease and increased risk of stroke. And what we're trying to figure out is, is it the hot flashes that are. Are markers of letting us know, or is it that women who have more hot flashes already have more advanced disease, and therefore, this is what the hot flashes are telling me. Hey, my carotid artery intimal lining, my carotid arteries are narrower than they should be. Either way, it's a telltale sign when you go to your physician's office and you say you're having hot flashes and night sweats and sleeplessness and any number of symptoms of perimenopause. It should not be sort of a pat on the back and there, there, and you'll get through it. Even if you are prescribed, you know, medications to control the symptoms. What needs to happen in that physician's mind, which is not happening, which is why I make a point of publishing scientific data in journals that doctors read, is that you should see that person in front of you as someone who is now at increased risk of heart disease, and you should act accordingly. So if someone says, I have hot flash or a frozen shoulder, or that shouldn't be, let me send you to the orthopedist Let me give you an antidepressant. You can do all of those things, but you should say, aha. This woman is telling me that her risk of heart disease is increasing and she's in the right age group. Let me ask some questions about perimenopause and menopause and begin to actively reduce her risk. Does she need to be on statin therapy to lower her cholesterol? Do I need to talk about weight control? Do I need to really aggressively monitor her blood pressure? Do I need to get her on a home blood pressure monitoring system so we can see what her blood pressure is like in real life, in real time, what we call in the real world and not just in this snapshot of time when you're in the doctor's office who we're starting to recognize, we don't even know what that blood pressure really means. It's just a snapshot in time.
- [25:42]
Tamsyn Muir
It's a moment.
- [25:43]
Dr. Jane Morgan
It's just one moment. We're just taking a moment. And so that's what these symptoms are telling us. And that's the connection, the dot to dot that the health system is still not yet making because we don't have the scientific data being published. Which is why I am making it my life's work to publish data, because that's where doctors are going to start to read it and start to think about it. And then we get it into guidelines. Now, good luck. Kudos to the American Heart Association. They've actually put out some guidelines. And the American Stroke association actually put out some guidelines. So we're starting to think about it. People like you and others who are making a wave, lots of doctors. So we've got these big organizations who now are starting to think about it, starting to at least publish some guidelines. They're not aggressive guidelines because they're looking for data.
- [26:35]
Tamsyn Muir
What are the type of guidelines that example?
- [26:36]
Dr. Jane Morgan
So the guidelines for American Heart Association, American Stroke association are about recognition. Midlife women looking at blood pressure, looking at cholesterol. How aggressive should you be? Is it something to be taken seriously? Is there an increased risk of heart disease? And the American Heart Association, American Stroke association are yes, yes, yes, yes. So that puts it on the doctor's radar. Now, it doesn't tell them what to do or how to treat it or what, but it's just saying, hey, this is out there. We're thinking about it. You should think about it, too. Taking on a DIY job around the house is the ultimate summer project. But if your DIY home security system is a Beware of dog sign when your real pet is Princess, the cat that's safe ish to be actually safe, help protect your home with a DIY system from adt. It's easy to install and gives you virtual assistance from ADT's technical support team. Best of all, you can tell everyone in the neighborhood you set it up yourself. Don't settle for safe ish this summer DIY with ADT. Instead. Visit ADT.com to learn more. AI had the time of my life a I never felt this way before.
- [27:55]
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Dr. Jane Morgan
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- [28:00]
Tamsyn Muir
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Dr. Jane Morgan
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- [28:07]
Dr. Jane Morgan
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- [28:17]
Tamsyn Muir
If someone is listening right now, and I know we have listeners that are perimenopausal, postmenopausal, menopause, what can you do to lower your risk of heart problems or heart issues?
- [28:30]
Additional Sponsor Announcer
Right?
- [28:30]
Dr. Jane Morgan
The first thing you need to do is have a talk with your physician or your healthcare provider, whoever this person is, and just have the conversation. Now. If you have a physician or other healthcare provider who's unwilling to have the conversation or can't have the conversation, then it may be time for you to transition to another doctor. And I, and I, and I say that often, and I say that with kindness. I've had to leave doctors. It doesn't mean that they are not a great physician, that they haven't taken care of you all the way up to this point. But it may mean that now you need something else and you have to now look for that something else and move on to find what you need. It doesn't mean you have to take hormones, doesn't mean you have to ingest them or use patches or do anything. You simply want to have a conversation with someone who understands it, who believes it, who can provide some valid validity to you where you can feel seen. We talk about that, feel heard, and have an intelligent conversation, at least based on the data and information that's available today. As I said, American Heart association and the American Stroke association have published on it in the last year. So there is some reference via which to have these conversations for physicians.
- [29:46]
Tamsyn Muir
Could it be as easy as getting on hormone therapy to help reduce any risk of heart disease? Or do we have that correlation yet?
- [29:53]
Dr. Jane Morgan
Yeah. And can it be that easy? And that's really a big question because we go back to the paper and the Information that was presented at the American College of Cardiology. The question that isn't answered, which may be when we have the next session coming up, is if these women started hormone replacement therapy, do we see a regression or an opening of their carotid artery? So, in other words, do they have fewer symptoms? And now we actually see the plaque going away. Now, very few, there have been very few drugs that we have that actually cause a regression of plaque formation. The plaque can actually decrease. Statins are one of them. So the medications that we often use to treat cholesterol can actually make your plaque smaller, but we don't actually have a lot of them. So that's the question that we need to answer. I think what we think now is that it certainly can keep it from progressing and getting worse, because ultimately what we want to do is decrease your risk of heart disease and stroke.
- [31:00]
Tamsyn Muir
I have a lot of women that are now listening and hearing this information and coming up and asking on the show, I passed this window of I'm past 60 or, oh, gosh, I went into menopause 12 years ago. Is it too late for me to do something now to protect my heart, my bones, my brain when it comes to hormone therapy? What is the answer to them?
- [31:22]
Dr. Jane Morgan
So the old answer, at the age of 60 or 10 years after menopause, we think, oh, you know, the window has closed. You've missed your window of opportunity. But new age thinking is maybe not. And the reason we said that is that the data shows that in the first year of starting hormone therapy, after you're 10 years or more beyond menopause, you do have an increased risk of heart disease, increased risk of effects. Mostly that happens in the first four months. After that, however, your risk drops back down to normal. And so it was thought it's not worth taking that risk. When we take a look at it, that risk is actually quite small. And everyone's history and their physical activity level and physical being is different. However many chronic medical conditions you have, what are you managing? That kind of thing. And so now we say it's an individual conversation that you will have with your physician. All 60 year olds are not equal. All people who are 10 years post menopause are not equal. And so the answer is, maybe have the conversation, but it's no longer no.
- [32:33]
Tamsyn Muir
That's a great answer.
- [32:34]
Dr. Jane Morgan
There you go.
- [32:34]
Tamsyn Muir
That's a great answer. I'm gonna brag on you for a minute.
- [32:37]
Dr. Jane Morgan
Oh, please do.
- [32:38]
Tamsyn Muir
Dr. Jane Morgan is not only an incredible cardiologist publishing research, but also has 17 certifications for Pilates I do, which is gonna bring me into some lifestyle solutions because we talk a lot on this show about strength training and cardio and the best things to eat and the best ways to work out. And I know there's a lot of noise out there, but I want to come to you with this question. There's a big focus on strength training, and I know it's really important right now for protecting your bones and your brain and to make sure we don't fall and we don't slip and we're not frail as we get older. Do we do strength training and skip cardio, or does that go against everything that you stand for?
- [33:20]
Dr. Jane Morgan
Right. We do both. And so I'm going to combine. And I know you're saying, what a. What a cop out.
- [33:26]
Tamsyn Muir
Just tell me I only have to do one every.
- [33:29]
Dr. Jane Morgan
Anybody could have said everything, but here's. I'm going to just give you some context for it, and then, as with everything, you can curate it and individualize it. So, American Heart association, remember, I'm a cardiologist. We follow guidelines. That's why I'm publishing research and data, because doctors follow guidelines. Right. We just, you know, aren't able to say whatever we feel like. We have to be able to have guidelines. So the guidelines from the American Heart association say that we should get 30 minutes of moderate activity exercise for five days a week. We should combine that with some degree of resistance at least two of those days. Now, modifying that somewhat because it can be hedged. If your activity is high intensity, then you can go to three days. If it's moderate intensity, it's kind of hard to remember. What I generally will say is that you need to get at least 30 minutes of movement in. I really prefer the word movement than exercise because people find exercise daunting. They need an outfit, they need clothes, they need a membership. They need to be able to get somewhere. They've got to have a girlfriend or partner who's going to go with them. They don't want to be the only one in the class.
- [34:45]
Tamsyn Muir
You hear every excuse in the book, right?
- [34:48]
Dr. Jane Morgan
So I prefer the word movement. Now, movement has taken away all those things, right? We don't need a cute outfit. It's just moving. So I want you to pick an activity that you like, and when I say activities, not exercise, activity, something that you like or something that you'll be doing that day anyway, and do it for 30 minutes, and then twice a week add some resistance. So, for instance, and at the risk of sounding I'm Just going to say housework. You're going to do housework on a Thursday and you'll be vacuuming and mopping and doing laundry and blah, blah, blah, blah, blah. Try to do that intentionally for those 30 minutes. And then maybe if you want to add some resistance, carry the laundry basket up and down the stairs two or three times. Just have some movement. If you are a gardener, then when you're getting out, crawl around on your knees to each of your different plants and just be in movement for 30 minutes. You can certainly walk and you can play pickleball and you can do all these other things if you want, and canoe and get with your friends. But if the word exercise just drains you, I want you to move away from exercise and say, I'm just gonna move for 30 minutes. Maybe you walk to your mailbox and then walk to your friend's mailbox and walk to your next friend's mailbox and come back and come. Just move for 30 minutes. That is it. You can wear whatever you want.
- [36:07]
Tamsyn Muir
So how many days you can look.
- [36:09]
Dr. Jane Morgan
Yeah, how many days? I know.
- [36:11]
Tamsyn Muir
How many days do we need a move?
- [36:13]
Dr. Jane Morgan
We want you to move for five days a week. Human beings, Homo sapiens, are made to move. Part of the reason that we are breaking down, we have chronic inflammation in our bodies and chronic medical conditions like the hypertension and cholesterol and obesity and kidney disease and diabetes and blah, blah, blah, blah, blah, is because we don't move. Think of yourself, your body, as a car and a beautiful, a beautiful, rare car that's so nice. You keep it garage and you never take it anywhere. And then when you get ready to drive it, it doesn't even start because you haven't used it.
- [36:51]
Tamsyn Muir
A lot of us haven't used parts.
- [36:52]
Dr. Jane Morgan
In order to keep that car running, you gotta use the parts. The parts gotta move. So think of your body as a car. You've got to actually use it. We're made to be in motion and we've stopped moving.
- [37:05]
Tamsyn Muir
For somebody who feels out of breath after mild exercise, how do you know if that is an issue to be aware of or it's deconditioning?
- [37:13]
Dr. Jane Morgan
It is probably an issue to be aware of. And if you are feeling out of breath with mild exercise, you should definitely see your physician. Now, if you're out, you know, running two miles and you haven't run in 10 years, please don't come to the emergency room because you're out of breath, you're out of shape, and so you probably shouldn't have started with the Two mile run, right? Why don't you walk for half a mile for a week and then. So be reasonable people and understand. But if you're just doing mild exercise and your shortness of breath or things that you used to be able to do, let's say you are a high level, maybe marathon participant, and suddenly halfway through, you're running out of energy and you're feeling short of breath. That is abnormal for you. And then you need to see someone. But these are people who are highly trained and they're doing marathons. That's when they need to see someone. For people like me, I don't run marathons. If I decide to get out there and run a marathon and I feel like I'm about to die at the end, that's really my fault. I'm deconditioned. I should hydrate and probably go home and rethink my activities. I'll be there for you.
- [38:23]
Tamsyn Muir
A lot of women talk about heart palpitations during this time. Is. Is that something to be aware of or is that something that comes as a result? I know, I already see your look. If you're listening, you can't see the look she just gave me, but she gave me the look, the Dr. Jane look. If somebody has heart palpitations in perimenopause or menopause, what is that an indication of?
- [38:42]
Dr. Jane Morgan
Okay, so let me tell you my story and for all your listeners, I want you all to remember I am actually a cardiologist. I know tons of cardiologists. This is my world. So at 40, maybe 4, had gone through a divorce, had young children at home, I started having palpitations. Had never heard of anything about palpitations with perimenopause. Think about this, people. I'm an actual cardiologist, started having palpitations. They were coming and going, couldn't get them to go away. I saw a cardiologist, he had a full workup and was told that I have mitral valve prolapse. So mitral valve prolapse means that there's a valve on the left side of my heart that's a little floppy. That's an explanation. I'll tell you what, wink, wink, it means. When you give a woman the diagnosis of mitral valve prolapse, it generally is something that we are saying to each other that she has anxiety. So we generally. Mitral valve prolapse. It's real. But for the rest of your life, when doctors see that on your record, anything that you come in with, they'll say, oh, that's our mitral valve prolapse because it's associated with depression and anxiety and panic attacks. So you can have mitral valve prolapse. And I did. It was mild, one plus. But. But I'm sort of not a panicky person. I'm not really an anxious person. I wasn't really feeling depressed, so I wasn't really buying it. But I recognized, okay, I've got mitral valve prolapse. But the palpitations were still there. Couldn't figure it out. I just decided. I'm a cardiologist, people. I decided I was gonna have to live with it, right? This is how women are.
- [40:30]
Tamsyn Muir
I'll just suffer through it.
- [40:32]
Dr. Jane Morgan
Just suffer through it. I mean, nobody could find. I guess I'm not dying. I don't know. Nobody knows. I wore a Holter monitor, the whole, whole thing. But I had mit valve prolapse. And it's like it's all in your head. That's really what they're saying without saying it. Wink, wink. Then I started to have vertigo. Saw a neurologist, had a big workup for vertigo. They couldn't figure out why I had vertigo. It's actually one of the reasons I was doing Pilates. I started doing down dog, all of these things because they said your Pilates will help the vertigo because it will force you into positions where you will be sicker. And over time your vestibular nerve will reset and you will feel better. I'm not kidding. This is from a neurologist. I'm a part of the system and this is what's happening to me in the system. Then I started having itchy ears. And at first I thought I was coming into money. There was something about. There's like an old wives tale, like, if your ears are itching, you're gonna come into money or something. And I was like, oh, I think I'm gonna come into money. I've got itchy ears. This is kind of weird. And then I. Poor perimenopause, right? Turns out it's not itchy ears, it's itchy palms. So it wasn't itchy ears. So it's like, oh, I must have allergies. I didn't see the doctor. Then I just thought, oh my God, I've got these itchy ears. I was always making those weird sounds with my, with my throat, trying to get my ears, ringing my ears, that kind of thing. I never, ever, ever got a solution. There was no doctor that put it all together. Oh, itchy ears, vertigo, palpitations. That Must be perimenopause. I was still having regular menstrual cycles. Nobody knew. I certainly didn't know. None of my colleagues knew why, because we had never gotten any training in it. I didn't even know itchy ears were part of perimenopause at that time. I did not know at all. All I knew were hot flashes. And then that was just something that people went through. So that's my experience as a part of, of the system coming through the system that is creating doctors. And we don't even know.
- [42:35]
Tamsyn Muir
So if you are listening or watching, you should not feel badly that you don't know what's going on because one doctor after another has told me some other kind, whether it was anxiety or not sleeping or can't remember tools in the or heart palpitations. Is that a sign? What is a heart palpitation? Is there a quick definition for that?
- [42:56]
Dr. Jane Morgan
So heart palpitation is like your, your heart can be beating very fast and we've got estrogen receptors on our heart as we start to lose our estrogen. And you know, I hate to use the word lose because during perimenopause sometimes it's just irregular, it's fluctuating. So it's not, you know, following a regular cycle, our 28 day cycle, it may be fluctuating. And because you don't have binding of estrogen to those estrogen receptors regularly on your heart, you can start to get symptoms like palpitation. But nobody knew anything about it. I've never, I never even heard the word menopause. I was a cardiology fellow. I was a pacemaker fellow. I trained. This was like my.
- [43:38]
Tamsyn Muir
You made me feel better about myself.
- [43:40]
Dr. Jane Morgan
No one has ever used the word menopause in cardiology, like ever, ever, never. You know, that must be something. Maybe in ob gyn, I assume, but I don't know. They were way over on the other side of the hospital. We never interacted. I had no idea what they were doing over there. And we are cardiologists over here. And then I find out you it's.
- [43:58]
Tamsyn Muir
Different place of the body.
- [43:59]
Dr. Jane Morgan
That's right. When I talk to my OBGYN friends, turns out one of whom is my sister, by the way, she's an obgyn. Turns out they're over there not learning anything about menopause either. None of us knew any.
- [44:13]
Tamsyn Muir
If someone has experienced heart palpitations or hot flashes, they should go talk to somebody.
- [44:18]
Dr. Jane Morgan
They should talk to somebody. See your primary care physician. If your primary care physician is unaware or unwilling or unenlightened. Talk to someone else. Find someone. It doesn't mean that someone has to treat you or someone has to fix you, but someone needs to have information such that you can make informed decisions about yourself. These symptoms are not nothing. They are indicators of advancing risk of heart disease and stroke in women as we go through perimenopause. And that's how you must look at these symptoms. You cannot look at them as just an inconvenience or an annoyance or something you have to suffer through. I mean, for me, itchy ears, clearly that wasn't going to stop me in my tracks. It was a mild annoyance. But the fact of the matter is it should have stopped me in my.
- [45:12]
Tamsyn Muir
Tracks and especially vertigo.
- [45:14]
Dr. Jane Morgan
That's right. It should have said to me, oh, my God, my risk of heart disease is increasing. Instead, I'm waiting for a trove of money to drop out of the sky because my ears are itching, you know?
- [45:24]
Tamsyn Muir
So why itchy ears has to do with heart disease?
- [45:27]
Dr. Jane Morgan
Yeah, apparently. But nobody told me. Because itchy ears are related to the perimenopausal changes in skin. With collagen decreasing and your skin begins to thin, the first place that you will notice thinning skin is the inner lining of your ear, where you already have thin skin. So the first symptom that you will have of thinning skin throughout your whole body is your inner ear. It will start to itch because the skin is getting thin.
- [46:01]
Tamsyn Muir
And how does that pertain to heart disease?
- [46:04]
Dr. Jane Morgan
So there's an indicator that your risk of heart disease is increasing. It's a perimenopausal symptom. Symptom of estrogen decreasing. And the first indicator you might get is your ears are itching. That those itching ears should have said to me, again, I want to remind you, I'm a cardiologist. Itching ears should have said to me, oh, my God, Jane, your risk of heart disease is increasing. Instead, nobody knows. And don't forget, I'd already seen a cardiologist with a palpitation. I already been to a neurologist for.
- [46:36]
Tamsyn Muir
Vertigo, you know, you said you went to Pilates.
- [46:38]
Dr. Jane Morgan
That's right. Instead, I went to Pilates to do more downward dogs to force myself into positions that, you know. Luckily, I didn't end up on my head with a cervical fracture and lose dizziness because they thought I needed to reset my vestibular nerve.
- [46:51]
Tamsyn Muir
I know sleep is a big issue during this time. Does sleep impact heart disease risk?
- [46:55]
Dr. Jane Morgan
It does. And again, back to data. Because I like to stick with data. What we have in data is that duration of sleep of less than five hours per night increases your risk of heart disease. Those people who have five hours or less, less than five hours of sleep per night in the study had a higher risk of heart disease than those who got five hours or more of sleep. So in the cardiology world of research and data, where we live, five hours is the cutoff. Now, five hours doesn't even seem like that much, but five hours is the cutoff between whether your risk of heart disease has increased or decreased. What happens during perimenopause? You have sleeplessness, have chronic interruptions of sleep. You may fall asleep and then wake up later, not be able to get back to sleep. Or, you know, you may lay in bed all night and finally not fall asleep till 4 or 5 in the morning when it's time to get up. You know, those kinds of things that all equates to you who are missing the duration, that five hour duration. And if you're not getting that duration, your risk of heart disease is increasing. So sleep is a risk factor for heart disease. And then during perimenopause, sleeplessness occurs along with blood pressure increasing, along with cholesterol increasing. I mean, it's amazing we haven't put all this together before. Along with increasing weight and fat deposition, all of these are risk factors for heart disease. They're happening all at the same time.
- [48:27]
Tamsyn Muir
So perimenopause and menopause, this is a time that you should be thinking about your heart more than anything.
- [48:34]
Dr. Jane Morgan
More than anything.
- [48:35]
Tamsyn Muir
Heart, heart risk, right. Should you get a cardiologist, even if you don't necessarily have a, quote, problem?
- [48:41]
Dr. Jane Morgan
I would say yes. But I'm gonna put a caveat to that. Lots of smart doctors out there. If your primary care physician is engaged, your primary care physician can absolutely manage all of these symptoms. Because ultimately what you want to do is manage those symptoms that you're feeling that are intolerable, that are making it hard for you to live, hard for you to focus, hard for you to get work done. You're uncomfortable, and I say that. And also, remember, you don't have to suffer. So I'm sure some of you are saying, yeah, but I can deal with it. I'm going to throw those into those that you're having to deal with. We don't want you to deal with them. So you can certainly have medications and therapies that can control those symptoms. But we also, on a deeper level, need to have preventive and proactive Therapies for those things that have not yet happened. So we want to prevent heart attacks, we want to prevent strokes. So that means more movement in your day. That means if you're smoking, you gotta quit. That means tighter control of your diabetes. If you haven't been serious about it means weight loss, which is a hard time to lose weight loss when we're gaining weight. So that's another, another subject that means really monitoring your blood pressure because your blood pressure can suddenly increase between your doctor's appointments. It was, it was normal one year and then the next year you go and it's high and you literally have done nothing else. That means controlling your cholesterol and getting treatment for your cholesterol, not allowing it to hang out there. So yes, all of those things, you can have your symptoms treated for comfort, but you also need to proactively and preventively be working to drive your risk back down.
- [50:24]
Tamsyn Muir
Another way to drive your risk down. The correlation between foods that are protective for the heart. I know that we've talked about this before and I was kind of fascinated by some of the ones you said yes and no to. Can you break down the foods that are protective for your heart?
- [50:39]
Dr. Jane Morgan
So when we look at foods, we look, look at things that are more what we call anti inflammatory. I'm a big fan of the Mediterranean diet and I know it does incorporate, it incorporates sort of natural protein because it has a lot of beans and it has a lot of chicken. But for those who are vegans or vegetarians, you know, the kinds of things you need to think about are in a simple way, those types of foods and vegetables that have a lot of animation to them, a lot of color, a lot of zest. They're not bland, they're sort of of interesting. They add some, you know, dynamic to your plate that wouldn't ordinarily be there. Those are the kinds of foods that you should be eating. Beautiful colors. If it has a beautiful color, it's probably something that you need to ingest. It's going to have a lot of antioxidants and vitamins and all kinds of things in it that will be helpful to you. Oftentimes people ask me, should I eat it raw or should I eat it cooked? You know, so there's a whole big, you know, field of study on this. But I would say eat them as you like. The only caveat to that is do not add salt or please minimize the amount of salt. Try to use other seasonings and eat them as much as you can in their natural format. You want to have foods that reduce the inflammation in your body because inflammation is what drives heart disease as well, but also foods that are feeding you you with vitamins and nourishment and not empty calories.
- [52:13]
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Tamsyn Muir
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- [53:32]
Tamsyn Muir
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- [53:34]
Additional Sponsor Announcer
If you've ever walked out of a doctor's office feeling dismissed or brushed aside, you are not alone. I know it personally. In fact, 75% of women seeking care for perimenopause or menopause symptoms are left untreated. I hear it from women every week who say, I was told it's just part of aging. Deal with it. That's why I'm such a supporter of MIDI Health Health. MIDI is the first virtual clinic devoted to women in midlife that's covered by insurance. Their clinicians actually listen and spend time with you, and they offer a full range of solutions, from hormone therapy and weight management to lifestyle coaching and preventative care. This isn't one size fits all medicine. It's care that's uniquely tailored to you. What sets MIDI apart is accessibility. They're the only women's telehealth brand covered by major insurance providers. Providers. So expert care is affordable and available wherever you are. And the relief women feel when someone finally says I hear you and I can help, that's priceless.
- [54:29]
Tamsyn Muir
Ready to feel your best and write your second act script? Visit joinmitty.com today to book your personalized insurance covered virtual visit. That's joinmitty.com MIDI the Care Women deserve Alcohol. A study was released last year that scared everybody. Can you talk about that study? It wasn't vague, but it was scary.
- [54:59]
Dr. Jane Morgan
Well, American Heart association has moved in the last year because of that study to recommend zero alcohol. No alcohol is what's recommended because there is no amount of alcohol that is beneficial to the body. It's all toxic to the body. So the American, the stance of the American Heart association is not don't drink it, it's that we're not recommending it for your heart health because there used.
- [55:29]
Tamsyn Muir
To be a recommendation of a couple of glasses of wine a week of.
- [55:32]
Dr. Jane Morgan
Glasses, especially of red wine. And it's because, you know, red wine contains flavonoids and flavonoids are really powerful antioxidants and anti inflammatory agents that are very good for your body. And it was thought, oh my God, if you drink red wine, you know, you can really improve your heart risk. But it turns out that the toxicity of alcohol is greater than the amount of flavonoids in the red wine. So we say there's actually no amount to drink for heart health. You can certainly drink it for enjoyment, but don't include red wine as a part of your heart health regimen. I'm going to have beets, squash, I'm going to eat some hummus, red wine and I'm going to be there. So red wine can't be a part of it. If you want to have it, you can have it, but it cannot be a part of your heart health regimen.
- [56:23]
Tamsyn Muir
I love that it does have the interesting look you described in the vegetables though. Yes, it does. Coffee or energy drinks, how do you feel about those for the heart?
- [56:31]
Dr. Jane Morgan
So back to data. There's actually interesting data that shows that coffee, especially black coffee, actually might have some beneficial effects on the heart.
- [56:40]
Tamsyn Muir
Well, thank goodness there's some good information, some good news and all this you.
- [56:44]
Dr. Jane Morgan
Might be able to drink up in coffee. Green tea, specifically green tea, the same energy drinks.
- [56:49]
Tamsyn Muir
So coffee and green tea are okay for the heart?
- [56:51]
Dr. Jane Morgan
They seem to be okay for the heart. We'll just continue to follow the research, but yes.
- [56:55]
Tamsyn Muir
Okay.
- [56:56]
Dr. Jane Morgan
Energy drinks, probably a no. They all are not made equal. So some are high in sugar, some are high in. And artificial sugars that are even worse than the natural sugars. So those are the kinds of drinks we want to be very, very careful about, especially those with artificial sugars, because the data has shown when we look at things like the saccharines, like the artificial sugars, there's an increased risk of heart disease, increased risk of stroke, and also an increased risk of cancer. So we are trying to reel in, especially the sodas and all types of drinks where these artificial sugars are just fulminant because it helps you advertise that it has low calories, and it does have low calories, but it also increases your risk.
- [57:57]
Tamsyn Muir
But it has the other side.
- [57:58]
Dr. Jane Morgan
Yes. So it's probably better to just have real sugar. If you're going to have some sugar, have raw sugar.
- [58:04]
Tamsyn Muir
I know when we met, you were on stage, and I was kind of blown away. I was standing on the side of the stage listening to your first. The first speech, the first time I'd ever met you in Brooklyn. And you talked about a lot of different things. And I think it was the first time that I really tuned into how important cardiovascular health is and how to pay attention to it. For black women, the risks are even higher.
- [58:27]
Dr. Jane Morgan
They are.
- [58:28]
Tamsyn Muir
Can you talk about that and how menopause may look different? Different.
- [58:32]
Dr. Jane Morgan
I'm going to Africa in two weeks and I'll be in Liberia. I'm specifically going to be spending time with women and trying to understand their menopause experience. You may say, well, why are you going to Africa to do this? Part of the interesting part of Liberia is that Liberia is a country in Africa that was founded by blacks who were original Africans who came to the United States as slaves, were slaves here, and then repatriated back to Africa and created the country Liberia. So really, as a group of people, they are, I am thinking, the most aligned outside of this country with African Americans because they were African, then they were African American, they went back to Africa. So a very interesting. I'm going to be speaking and meeting with a lot of these women because the experience of menopause is so much harsher. It's so much longer. It's even less discussed, if you can believe it. We do not discuss it in our families. And even more tolerated. And you're expected to tolerate it, but it is long. And, you know, there are a number of things that could be driving it. Nutrition is one of them. I think good nutrition. Is really important. And oftentimes just from the history of slavery, from the history of eating the refuse of foods from the master's table. So things that they didn't want, or things that were parts of the pig they didn't want, or things but that we had to eat to survive. And how we learned to take those and make foods and make them flavorful so we could survive, those are the very things that are killing us now. The techniques that we learned to survive and to make food that was not palatable to slave owners, but had to, but we had to eat it and how you're going to make it such that it's edible, all of those techniques are now were killing us. And so, you know, there's a whole culture to kind of unwind that when we talk about connecting the dots, people often don't even understand that it's the food because they'll say, well, well, collard greens are very nutritious, spinach is very nutritious, the cornmeal is fine. Those things are fine in their raw form, but that's not what you're getting ready to do to them, right? So a whole lot of stuff's getting ready to happen before. And those are the dots that we have to start connecting. Because when you sit down with the plate, the plate looks like, oh, look at all these colors, look at all this stuff. But there are things that have had to be formulated to make them. Like rutabagas are very bitter or very hard, but when you get ready to eat them, they're delicious. That means there's a lot that has.
- [61:34]
Tamsyn Muir
Happened, something's been done to them.
- [61:35]
Dr. Jane Morgan
That's right, that's not healthy. And so we are rampant with high blood pressure and cholesterol and then often as well live in communities where maybe there's not access to green space. We're not moving, we're not walking. And then if you talk about women being, you know, relegated to second class systems in the health system, if you talk about blacks, we often don't even want to go to the health system because we weren't even considered at all as part of the health system. And so there's that distrust that then leads to even poorer health outcomes, which all translates into more severe menopause symptoms, more intense symptoms, more intense, more intense symptoms, longer. It's the foods, it's the activity, it's the epigenetics, meaning how you live and how your ancestors live. And it is the weight, the weight gain that's also coming. That's a culmination of the entire diaspora. And so there's a lot of to unfold there. But yes, symptoms are longer, they're greater duration, they are even more poorly understood. There's even more suffering. I would say almost no one seeks relief from them because it's not expected that the health system is going to take it seriously anyway.
- [62:58]
Tamsyn Muir
And an underrepresentation in research and trials.
- [63:02]
Dr. Jane Morgan
Complete underrepresentation, except in areas where we've been abused and we were overrepresented. And so that's one of the reasons why it's very hard to now to get blacks to participate in trials, because there's just such a distrust. And there's a large trove of medicine that has been developed just on atrocities that were done to black people. I mean, almost the entire world of gynecology was built based on atrocities done to slaves. And so people know that. And, you know, sometimes even when people don't know it, it's hard to explain. It's almost like your body remembers. Like the ancestors whisper to you, you know, why am I hesitant to that? No one's ever actually ever said something, but I had a visceral reaction. It is something that is handed down through the generations through your ancestors, that's kind of whispered in your ear without anybody telling you about it. You automatically kind of withdraw. And then sometimes you learn later, sometimes you do have the information. But it's interesting, you know, I always say, listen to your body. I tell that to women as well. Your body will tell you, your body will tell you. And sometimes there's just that reaction and you can't even explain it. Like, I just got.
- [64:20]
Tamsyn Muir
Maybe you don't even need to, because. Just trust it, right?
- [64:22]
Dr. Jane Morgan
You gotta just trust it.
- [64:23]
Tamsyn Muir
You have to just trust it, right?
- [64:24]
Dr. Jane Morgan
But we're moving now into an era. And I say now, you know, I don't really know even now what's going on in life, real research and science. But when we say we're moving, I mean there is opportunity for principal investigators to be African American, for people to have an opportunity for African Americans and blacks in this country to really step up and participate in clinical trials. Because we've got to have data that's relevant to all populations. The way we do research in this country is we get data on white men. And globally, white men make up only 9% of the entire world's population, if you can believe that, 9% of the entire world's population. But the United States, we make drugs and we make devices for everybody. But the only thing we really know about it is that it works on 9% of the people. Everybody else, we're just extraordinarily.
- [65:16]
Tamsyn Muir
And the rest of us, we sure hope so.
- [65:18]
Dr. Jane Morgan
We sure hope so.
- [65:19]
Tamsyn Muir
We sure hope so.
- [65:20]
Dr. Jane Morgan
And doctors know that. So here's how we practice medicine, especially for women. When women are coming in and we are either, you know, sizing valves for devices or prescribing medication, we often will down adjust doses. Nothing science to it. We can say, oh, she's kind of a smaller lady. And, you know, the trials are done on men. So, you know, what I'm going to give you half a dose. Or what we'll do is we'll prescribe pills that we call scored pills, meaning if you ever gotten a pill, it's got a little line in the middle. Those are called scored. Doctors love scored pills because we can tell our female patients, just break that in half.
- [65:57]
Tamsyn Muir
Half.
- [65:58]
Dr. Jane Morgan
So if we give them the pill and they call back and say, oh, you know, I'm, I'm dizzy or I had too much, then we know, oh, that was probably too hyper, and we say, cut it in half. And it can easily cut it in half. Those are scored pills. That is unscientific science that we practice every single day on women because drugs and trials are done on 9% of the demographic. And then when you talk about blacks and Indians and every other race in the world, world, Asians, we have no idea what we're doing.
- [66:27]
Tamsyn Muir
So what do, what do we do so people don't lose hope? I mean, is there a way to get involved in the research trials? There's a way to find out more about it. If somebody is listening right now and says, hey, okay, I want to get involved in this. Do you recommend that?
- [66:40]
Dr. Jane Morgan
Yeah, absolutely. I recommend everybody get involved in clinical trials because we must have data that is relevant to everyone. So we can stop with this scored pillar therapy, which is what I call. It's common practice. There are a lot of things that are common practice in medicine that technically are voodoo.
- [66:59]
Tamsyn Muir
Oh, gosh.
- [67:00]
Dr. Jane Morgan
Technically we don't really have any science on it, but we know that it's maybe not the best thing for this patient, but it's all that we have. So what can I do to try to, you know, fit a square peg into a round hole, but do that.
- [67:16]
Tamsyn Muir
But it's necessary for women to get better, feel better, handle something. There's not another option in many cases.
- [67:22]
Dr. Jane Morgan
And I'm not saying that we have. Haven't made it feel better. I'm just saying that there are some areas where it's been a little hocus pocus. We need data because pill formulation was based on 9% of people and women are 51% of the population in the United States. So you know that, oh, them, that.
- [67:41]
Tamsyn Muir
Oh, them, oh, those women that.
- [67:44]
Dr. Jane Morgan
You're going to have to figure out something, oh, those for these other people. And doctors will have conversations like, oh, you know, I broke that in half. Do you do that? And another doctor will say, you know what? I have my patients just go to every other day and not break it in half. Another one will say, oh, you know what? I do. But so we all have some way of finagling it with our female patients.
- [68:02]
Tamsyn Muir
What do you want women to walk away with today? And especially understanding heart and cardiovascular disease in midlife?
- [68:08]
Dr. Jane Morgan
You must empower yourself and take charge of your health. Get good information, talk with your physician. If it's not the right physician, move on and do it right away. I had a good friend who told me something her grandmother told me and I always remembered it because this is how women There are seven days in the week. I want you to do it, do something for yourself today. There are seven days in the week and someday isn't one of them.
- [68:40]
Tamsyn Muir
I always say, live your someday today, but that is really good. Dr. Jay Morgan, where can people find you?
- [68:47]
Dr. Jane Morgan
You can find me on Instagram @doctorjanemorgan.d R J A Y N E. I've got a Y in my first name. J A Y N E M O R G A N. I'm on N Instagram. I'm also on LinkedIn where I often, you know, will publish my data@janeMorganMD. But I'm also on Threads and TikTok and YouTube and you can find me in a lot of places, so I hope you follow along. I talk almost always science. I do a lot of media interviews that sometimes are not related to cardiology. They are whatever's in the news at the time. But do a lot of media interviews. But I speak a lot about science and medicine and menopause, digital health, artificial intelligence, clinical trials. I hope I make it entertaining and fun. I do a Stairwell chronicles as well. 60 minutes, 60 seconds. I sit on my stairs and I talk to you about some aspect of medicine in 60 seconds or less. Hopefully you find it entertaining. You can take a little leaf, put it on your tree and continue to kind of grow your whole bush at home and get smarter just because you're following me.
- [69:50]
Tamsyn Muir
You're wonderful. Thank you so much.
- [69:52]
Dr. Jane Morgan
Thanks, Tamsyn. I loved it.
- [69:53]
Tamsyn Muir
Oh, I loved it too. I really hope this conversation with Dr. Morgan left you feeling informed and empowered. Because when it comes to your heart, knowing what to look for and what to ask for is not optional. It's critical. Like she said, if you take one thing from this episode, I hope it's this. Make that cardiologist appointment and don't wait. If this episode made you think differently about your health, please take a second to leave a review. It really, really helps bring you more convers. And if you have a question for a future guest or just want to share your story with me, I would love to hear it. Email us@podcastampsonfadell.com I read every single message and I'll see you next week. Hey everybody, I want you to know today's episode was sponsored by MIDI Health. If you're ready to feel your best and write that second act script, visit joinmitty.com today to book your personalized insurance covered virtual visit. That's joinmitty.com MIDI the care that women deserv.