the report also mentioned the role of gender-affiming hormonal therapy and trans women. [gender-affirming therapy can be crucial to the wellbeing of some trans people, but hormone therapy of any kind can also increase the risk of blood clots, heart attack and stroke.] i’ve actually had experience with that firsthand — about 15 years ago, i was on rotation, and i was treating a trans woman who needed hormone therapy, but also had a risk of blood clots in the family. she had to balance these things. this was part of her identity, but she knew there was a medical risk. we, as physicians, have to help give people the facts, and ultimately it’s their decision. these are two things that were very important to this individual, and only that person can know how important the relative role of these things are. so we provide the facts, and an informed discussion around it.
i think it’s really important to understand that within canada, there are so many different groups of women who can be at increased risk. it’s really important for us to understand that there are societal and political issues that affect women, as well as their genetic predispositions in medicine.
when you’re living in poverty, you may not have access to healthy food, adequate housing, or education, these things make you more susceptible to heart disease and stroke. getty
another example that stood out from the report was the health of new moms. women who had gestational diabetes while pregnant are more likely to develop diabetes later on, and should get their blood sugar checked between six weeks and six months of giving birth, but research has found that they often neglect their own health while caring for their baby.
it’s true. i am a young woman, and i’m a cardiologist, and i enjoy taking care of young woman because i feel that sometimes they get dismissed in the health-care system. people wouldn’t take them seriously. the society of obstetricians and gynaecologists of canada produced a report about health care of pregnant and postpartum women, and found that there’s a significant gap in care when you look at it through an ethnicity lens. there’s been a lot of american research on this, i think in part because of
serena williams having a [postpartum] pulmonary embolism [a blockage of the arteries in the lungs due to a blood clot]. and if serena williams is going to get dismissed, what’s going to happen to the regular person who may not necessarily have the knowledge or awareness to go seeking care? and you’re so busy — women often have the burden of responsibilities with their families.
and it’s so interesting that it rarely changes along the spectrum of life. i have a patient whose husband had dementia. she’s the primary caregiver of her partner with
dementia, and she was having a heart attack, and she did not go into hospital because she had nobody to watch her husband. i also have a patient who was making lunch for her son when she was having a heart attack. she made her son lunch and then went to the emergency room. sometimes women may have these issues, but they have babies at home and are the primary caregiver — they are more likely to prioritize the health needs of other family members over their own. it may just seem like a small thing to get that blood test, but when you have a newborn at home, everything becomes a struggle.
so often when i’m in my office, i do a lot of talking to people about trying to put themselves first. yes, there may be all these people that depend on you, but you’re no use to them if you’re unwell. it’s very challenging, because women are conditioned often to be in these caregiver roles. it’s hard for them to start advocating for themselves and their symptoms when for so long they haven’t been.
maija kappler is a reporter and editor with healthing.
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why heart health is different for women: 'she was having a heart attack, but made her son lunch before going to the emergency room'
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