178: Heart Disease in Women: LDL, Menopause, Statins & Pregnancy with Dr. Abeer Berry

Heart disease is often treated like something women need to start thinking about later in life, but what if some of the earliest clues about your cardiovascular risk appeared decades earlier — during pregnancy?

In this episode of Confessions of a Male Gynecologist, Dr. Shawn Tassone sits down with cardiologist Dr. Abeer Berry for a wide-ranging conversation about women's heart health, menopause, cholesterol, cardiovascular risk, and some of the most persistent heart-health misinformation circulating online.

One of the most important takeaways: a woman's reproductive history is part of her cardiovascular history.

Pregnancy places significant stress on the cardiovascular and metabolic systems. Conditions such as preeclampsia, gestational hypertension, gestational diabetes, and delivering a baby who is small for gestational age can become important pieces of the cardiovascular risk conversation years later.

Then comes another major transition: menopause.

Dr. Tassone and Dr. Berry discuss how changing estrogen levels intersect with blood pressure, cholesterol, metabolism, and cardiovascular risk and why menopause, hormone therapy, and heart health shouldn't automatically be treated as separate conversations.

But the discussion goes much further than hormones. They tackle one of the biggest debates currently happening in the wellness space:

Does LDL cholesterol actually cause atherosclerosis — or is cholesterol being unfairly blamed?

Dr. Berry breaks down LDL cholesterol, inflammation, ApoB, lipoprotein(a), HDL, triglycerides, and why particle size doesn't necessarily tell the story people on social media claim it does. They also discuss statins and the growing amount of misinformation surrounding cholesterol-lowering medications, including claims that statins barely extend life, cause dementia, or are prescribed simply because pharmaceutical companies want to sell more medication.

You'll also hear an important conversation about coronary artery calcium scoring — including why a CAC score of zero doesn't necessarily mean you have zero cardiovascular risk, the difference between calcified and soft plaque, and how calcium scores can influence conversations around treatment.

In This Episode, You Will Learn:

• Why heart disease risk in women is often underestimated
• Pregnancy as a cardiovascular and metabolic "stress test"
• Preeclampsia, gestational hypertension, and future heart health
• Gestational diabetes and long-term cardiovascular risk
• Why reproductive history still matters decades after pregnancy
• Menopause, estrogen, and cardiovascular health
• Hormone replacement therapy in women with cardiovascular risk factors
• Whether LDL cholesterol actually causes atherosclerosis
• LDL-C vs. ApoB and what each measurement tells you
• What lipoprotein(a), or Lp(a), can reveal about inherited cardiovascular risk
• Why extremely high HDL isn't necessarily protective
• Triglycerides and metabolic health
• Statin myths and misinformation on social media
• Why a coronary calcium score of zero doesn't tell the entire story
• Soft plaque vs. calcified plaque
• When lipid-lowering therapy may involve more than statins
• The cardiovascular numbers women should know
• Why high blood pressure can go unnoticed
• Heart attack symptoms in women
• Why women's healthcare needs to look at the whole medical history, not individual systems in isolation

This conversation is about more than cholesterol numbers or whether someone should take a statin. It's about understanding cardiovascular risk across a woman's entire lifetime — from pregnancy through menopause and beyond.

Because sometimes the information that matters at 50 was already beginning to show itself at 30.

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Episode Resources:

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Medical Disclaimer
This podcast and website represent the opinions of Dr. Shawn Tassone and his guests. The content here should not be taken as medical advice and is for informational purposes only. Because each person is so unique, please consult your health care professional for any medical questions.