Podcast Summary:

unPAUSED with Dr. Mary Claire Haver

Episode: Menopause and Heart Disease: What Every Woman Needs to Know with Dr. Jayne Morgan
Date: October 28, 2025
Host: Dr. Mary Claire Haver
Guest: Dr. Jayne Morgan, Research Cardiologist & VP, Medical Affairs at Hello Heart

Main Theme & Purpose

This episode tackles the critical, often-overlooked link between menopause and heart disease. Dr. Mary Claire Haver is joined by Dr. Jayne Morgan, an esteemed cardiologist, to break the silence around female-specific cardiovascular risk, the failures in current training and research paradigms, and how menopause is a uniquely pivotal—and underserved—period for heart health and prevention. Together, they explore why women are so often misdiagnosed or undertreated, how hormonal changes directly influence cardiovascular risk, and the actionable steps women and clinicians can take to reclaim health, agency, and longevity.

Key Discussion Points

1. Dr. Jayne Morgan’s Journey into Medicine and Cardiology

• Inspiration: Grew up surrounded by male physicians, initially wanted to be a nurse due to cultural socialization before realizing she could be a doctor herself ([04:19]).
  • “It’s amazing, the power of words. Literally, someone speaking it to me was the first time I questioned, why don’t I become a doctor?... I couldn’t think of a reason why I couldn’t be a doctor.” (Dr. Morgan, 04:19)
• Choosing Cardiology: Initially considered orthopedic surgery, switched after ICU rotation—chose heart medicine for its cerebral challenge, not the ‘phlegm’ of critical care ([05:10]).

2. Women and Heart Disease: The Leading Killer

• Statistics:

  • Heart disease causes 1 in 3 female deaths yearly.
  • Only 44% of women (as of 2024) recognize this, down from 65% in 2009 ([06:07]).
  • The decline in awareness attributed to successful breast cancer advocacy overshadowing heart health ([06:42]).

• Quote:

  • “The message about the rest of our bodies has been lost... The number one thing that's actually killing us, though, is still there.” (Dr. Morgan, 07:55)

3. Medical Training’s Male Model & Systemic Gaps

• Bubble in Training:

  • Most cardiology research and practice is based on male biology; specialties work in silos ([08:06], [08:47]), leading to poor recognition of female-specific symptoms.
  • Women’s symptoms often labeled “atypical”—code for less aggressive treatment or dismissal.

• Memorable Exchange:

  • “We almost never ruled out a panic disorder in a man... The people who are teaching the courses are the people who are driving the behavior and driving the culture.” (Dr. Morgan, 10:47, 12:05)

• Impact of Language:

  • Terms like “atypical” and “geriatric pregnancy” have psychological effects and shape clinical attitudes ([14:26]-[16:12]).

4. How Heart Attacks Manifest Differently in Women

• Typical (Male) Symptoms:

  • Crushing chest pain, left arm numbness, collapse ([17:07]).

• Common (Female) Symptoms:

  • Fatigue, nausea, jaw pain, gastrointestinal issues—frequently attributed to stress, anxiety, or dismissed as “panic disorder” ([17:07]-[19:17]).

  • Diagnostic delays: Women often sent home or triaged less urgently, even as they’re actively having heart attacks ([21:38]).

  • Striking Statistic:

    • “Women under 55... were seven times more likely than a man to be sent home from the ER while actively having a heart attack.” (Dr. Haver, 21:38)

• Anatomic Basis:

  • Men: Big, sudden blockages in large arteries (“the widowmaker”) ([23:25]).
  • Women: Plaque “studding” or microvascular disease—diffuse, subtler, but equally dangerous ([23:25], [28:46]).

5. Diagnostics: Are Standard Tools Enough?

• Stress tests: Remain useful, but traditional imaging can miss microvascular disease, which is disproportionately common in women ([27:48], [28:47]).
• Lipoprotein(a) (Lp(a)):
  • Underrecognized, likely needs to be checked multiple times in women, especially pre- and post-menopause ([44:59]).
  • “We actually do need to draw it more than once in women. That’s the world according to Dr. Jane Morgan.” (Dr. Morgan, 47:06)

6. Menopause as a Cardiovascular Risk Multiplier

• Symptom Clues:

  • Every perimenopausal symptom—hot flashes, itchy ears, sleep issues—serves as a marker for increased risk ([31:31]-[32:43]).

• Hot Flashes:

  • “Hot flashes are not just like ha ha... what this woman is screaming at you is, my risk of heart disease is increasing, my risk of stroke is increasing.” (Dr. Morgan, 34:02)

• Hormone Fluctuations:

  • Loss of estrogen leads to a dramatic increase in risk, equaling men post-menopause, and eventually surpassing it ([29:45]).

7. Research Failings: Exclusion & Harm

• Lack of Female Inclusion:
  • Women and people of color are routinely excluded from clinical trials; extrapolation from white male data is harmful ([35:53], [38:43]).
• Shocking Finding:

  • Recent research shows beta blockers increase risk of repeat heart attacks, heart failure, and death in women, contrary to accepted male-centric data ([35:53]-[38:43]).

  • Quote:

    • “We’ve got to begin to do research with women in them because we’re killing women in a well-meaning fashion.” (Dr. Morgan, 38:15)

8. Progress: Slow but Real

• Now in the Guidelines:
  • Menopause and pregnancy complications have been added to heart and stroke association guidelines for the first time ([40:38]-[43:02]).
  • Chronic delays between research updates and clinical practice acknowledged.

9. Statins, Lipids, and Menopause

• Statins:
  • Underprescribed to women; menopause clinics seeing cholesterol spikes post-menopause due to falling estrogen.
  • Cardiologists often miss the hormonal context, focusing on weight loss instead ([43:36]).

10. Hormone Therapy and Cardiovascular Prevention

• Women’s Health Initiative Revisit:
  • Original studies failed to analyze important subgroups, especially Black women post-hysterectomy; newer analysis shows estrogen may lower heart and breast cancer risk in this cohort ([48:20]).
• Timing Hypothesis:
  • Hormone therapy most protective when started within 10 years of menopause or before age 60 ([49:51]).

11. Screening, Risk Factors, and Self-Advocacy

• Key modifiable risks: smoking, visceral fat, blood pressure, cholesterol (including ApoB and triglycerides), diabetes, sleep.
• **Start annual screening for cholesterol et al. by age 25 ([67:20]).
• **Women need both a gynecologist and a primary care physician, not just one or the other ([67:29]).

12. Structural and Biological Factors for Women of Color

• Early Menopause in Black Women:
  • Driven by “weathering”—chronic stress from racism, gender bias.
  • Earlier menopause means earlier spike in cardiovascular risk ([63:16]-[65:26]).
• PCOS:
  • Increases long-term heart risk; 80% of risk can be controlled with lifestyle/intervention ([65:58]).

13. Lifestyle, Hypertension, and GLP-1s

• Movement Is Key:

  • Our sedentary “digital era” exacerbates risk; even daily living is less active than in the past ([83:28]).

• High blood pressure:

  • Often missed, especially in perimenopausal women with previously normal BP, even by their own doctors ([73:14]).

• GLP-1s ("Ozempic," etc.):

  • Shown to benefit heart failure and metabolic risk, but likely require lifelong use ([78:45]).

14. What Can Women Do? (Action List)

1. Know the atypical symptoms: Fatigue, nausea, jaw pain, GI upset.
2. Demand appropriate screening: Annual lipids, blood pressure, weight, glucose, Lp(a) from age 25 onward.
3. Track and report perimenopausal symptoms: Early symptoms are cardiovascular risk clues.
4. Consider hormone therapy: Especially if under 60/within 10 years menopausal, unless contraindicated.
5. Lifestyle:
   • Move every day.
   • Limit alcohol, quit smoking.
   • Control blood pressure, cholesterol, diabetes.
   • Aim for >5 hours of continuous sleep.

Notable Quotes & Timestamps

• “The message about the rest of our bodies has been lost... The number one thing that's actually killing us, though, is still there.”
  — Dr. Morgan ([07:55])

• “We almost never ruled out a panic disorder in a man.”
  — Dr. Morgan ([10:47])

• “Hot flashes are not just, ha ha...what this woman is screaming at you is, my risk of heart disease is increasing, my risk of stroke is increasing.”
  — Dr. Morgan ([34:02])

• “We’ve got to begin to do research with women in them because we’re killing women in a well-meaning fashion.”
  — Dr. Morgan ([38:15])

• “The American Heart association has called menopause a critical window for cardiovascular disease prevention, at least on paper. But most midlife women aren’t hearing this from their doctors yet.”
  — Dr. Haver ([62:05])

• “I have decided to unpause societal limitations. I have decided to stop showing up the way society wants me to be... I have decided to stop making people feel comfortable with my presence.”
  — Dr. Morgan ([85:27])

Key Timestamps for Important Segments

• 00:44 – Gender differences in heart failure, mortality, and need for gender-specific research
• 06:07 – Heart disease remains the top killer; women’s declining awareness of risk
• 10:41 – Dismissing women’s symptoms as “atypical” or “panic disorder”
• 21:38 – Women under 55: 7x more likely to be sent home while having a heart attack
• 23:25 – Artery plaque differences: men vs. women
• 28:47 – Microvascular disease and missed diagnosis in women
• 32:43 – Hot flashes as a marker for increased cardiovascular and stroke risk
• 35:53 – Urgent need for sex-specific research; beta blockers harming women
• 40:38 – First inclusion of menopause and pregnancy in cardiology/stroke guidelines
• 49:51 – Timing hypothesis for hormone therapy, vascular calcification
• 67:20 – Importance of early and regular cholesterol screening in women
• 73:14 – Blood pressure and arterial stiffening—the “silent killer,” personal anecdote
• 83:28 – The primacy of movement and lifestyle change for prevention
• 85:27 – Dr. Morgan’s “unpause”—rejecting societal limitation

Tone & Language

Candid, passionate, a blend of clinical expertise and relatable, personal storytelling. Both Dr. Haver and Dr. Morgan mix medical authority with vulnerability and humor, producing a tone that is empowering, occasionally indignant at the status quo, but always pragmatic in focusing on solutions and self-advocacy.

Final Thoughts

This episode is a wake-up call: Menopause marks not merely a reproductive milestone, but a critical fork in a woman’s health trajectory. Heart disease is not "just" a man's issue, and the failure to apply gender-specific research and care is actively harming women. Education—of both patients and providers—plus system change, are urgently needed. Women must recognize and demand a different, more vigilant approach to heart health through every phase of midlife and beyond.

For more:

• Follow Dr. Morgan on social: @DrJaneMorgan (IG, TikTok, YT, FB, LinkedIn)
• Find Dr. Haver: @DoctorMaryClaire and at thepauselife.com

Essential message:
Every woman in midlife should have her cardiovascular risk evaluated, recognize that menopause signals a step-change in risk, and demand more nuanced, informed medical care—starting with herself, and reverberating through the health system.