The SHOW Center

The SHOW Center We provide specialized care to empower, educate, and inspire women to optimize their health.

02/20/2026

Your cholesterol can be “normal”… and you can still have plaque.
Let’s talk about Coronary Artery Calcium (CAC) scoring and what it actually tells us.

A CAC score is a quick, non-contrast CT scan that measures calcified (hard) plaque in the coronary arteries.

✔️ Hard plaque = older, more stable plaque
✔️ A positive score = established coronary artery disease
✔️ A score of zero = no detectable calcified plaque

But here’s the nuance:
A CAC scan does NOT detect soft plaque.

Soft plaque is earlier-stage, fatty, inflamed plaque and sometimes more unstable. It hasn’t calcified yet, so it won’t show up on a calcium score.

So what does this mean?

A zero score is reassuring, especially in midlife women but it does not equal zero risk.

And a positive score?
That changes the prevention conversation.

Now layer in perimenopause and menopause:

As estrogen declines, we often see:
• Rising LDL and ApoB
• Increasing insulin resistance
• More visceral fat
• Higher inflammatory burden

Plaque biology shifts.

This is why CAC is a risk stratification tool not the be-all, end-all.

We still consider:
• ApoB
• Lp(a)
• hs-CRP
• Fasting insulin
• Family history
• Hormone status

Prevention is layered.

If you’re 45+ and wondering about your real heart risk it may be time to look beyond the standard lipid panel.

Prevention is powerful.



02/19/2026

Lp(a) Awareness Part 2: “Why Should Women Care?”

You can eat clean.
You can lift weights.
You can have a “normal” LDL.

And still be at higher risk. Because of Lp(a).
Lipoprotein(a) is a genetically inherited cardiovascular risk marker that:

• Increases clot risk
• Accelerates plaque formation
• Drives inflammation
• Is NOT detected on a standard lipid panel
• Is NOT significantly lowered by diet or exercise
It’s mostly genetic so not a ton you can do to change your genetics.

After menopause, when estrogen declines, cardiovascular protection shifts and elevated Lp(a) becomes even more clinically relevant.

Studies show high Lp(a) is associated with:
• Premature heart attack
• Stroke
• Aortic stenosis
• Increased cardiovascular mortality

Most people are never tested.

You often only need to check it once in your lifetime because it’s genetic and it’s best to check it during menopause.

At The SHOW Center, we include:
ApoB
Lp(a)
hs-CRP
Insulin
Metabolic markers

Because prevention is powerful.
And heart disease is still the #1 killer of women.

Ask your provider:
“Have I ever had my Lp(a) checked?
(a)Awareness

Cholesterol numbers don’t exist in isolation especially in midlife women.Hormonal shifts, insulin resistance, inflammati...
02/18/2026

Cholesterol numbers don’t exist in isolation especially in midlife women.
Hormonal shifts, insulin resistance, inflammation, and metabolic health all influence cardiovascular risk, even when labs fall within a “normal” range.
The goal isn’t fear.
It’s context, trend-tracking, and personalized care.
Your symptoms matter. Your history matters. And your heart deserves nuance.











02/17/2026

Your cholesterol is “normal.”
But is your risk?
This is where many women get false reassurance. Being told your basic lipid panel looks OK does not automatically mean your cardiovascular risk is low especially in midlife. LDL alone doesn’t tell the full story.

Two labs that matter A LOT for women:

🧬 ApoB (Apolipoprotein B)
This tells us how many atherogenic particles are circulating in your blood.
I call it the “stickiness factor.”

The more ApoB particles you have, the more likely cholesterol is to cling to artery walls → plaque → heart attack → stroke.

🧬 Lp(a)
This is largely genetic.
You can look “healthy,” have decent LDL… and still carry significant inherited risk.
And most women have never had it checked.
Add in inflammation markers like high-sensitivity CRP, insulin resistance, and midlife hormone shifts and the picture gets even more nuanced.

Midlife is a metabolic pivot point.
Estrogen declines.
Insulin resistance rises.
Visceral fat increases.
Risk changes.

We cannot afford to rely on a “normal” LDL.

We need deeper data.
Because prevention > reaction.

Ask your clinician:
• What is my ApoB?
• What is my Lp(a)?
• What is my hs-CRP?
• What is my fasting insulin?

Heart disease is the #1 killer of women.

Not breast cancer.
Not osteoporosis.
Heart disease.

Let’s stop underestimating it

Your cholesterol is normal.But your risk might not be.If you’re a midlife woman, a standard lipid panel is NOT the whole...
02/16/2026

Your cholesterol is normal.
But your risk might not be.
If you’re a midlife woman, a standard lipid panel is NOT the whole story.

We need to look beyond total cholesterol and LDL.

We need:
✔️ ApoB
✔️ Lipoprotein(a)
✔️ hs-CRP
✔️ Fasting insulin
✔️ Advanced risk tools

Because heart disease is the #1 killer of women and risk accelerates during perimenopause and menopause.
Hormones shift.
Inflammation rises.
Insulin resistance creeps in.
And most women are told they’re “fine.”

You deserve better than fine.
You deserve data.
You deserve prevention.
You deserve evidence-based care at your fingertips.

Read the full breakdown on Substack. ❤️

02/13/2026

Highlights from ISSWSH

✔️ Top Five Abstract presented from the podium for the first time because research in s*xual medicine matters.
✔️ Deeper discussions on POTS, MCAS, and their impact on s*xual dysfunction an area desperately needing clarity and guidelines.
✔️ And celebrating innovation in pleasure with the launch of a new female vi****or w and .play because science and s*xuality should coexist.

We are just scratching the surface.

The future of s*xual medicine is collaborative, data-driven, and unapologetically inclusive.

POTS MCAS MidlifeHealth

02/12/2026

If we’re not talking about insulin resistance in midlife women, we’re missing the plot.
Estrogen protects the vascular system.
When it declines, insulin sensitivity often declines with it.

That’s when we see:
– Belly weight that feels impossible
– Rising fasting insulin
– Small dense LDL particles
– Inflammation quietly climbing

And all of that feeds heart disease risk.
This is why I don’t treat “weight gain.”
I treat metabolism.
I treat inflammation.
I treat the root cause

Heart Month reminder:
Menopause care = heart disease prevention.

HormoneHealth

Menopause is one of the most under recognized metabolic shifts in a woman’s life.As estrogen declines, insulin resistanc...
02/11/2026

Menopause is one of the most under recognized metabolic shifts in a woman’s life.
As estrogen declines, insulin resistance, inflammation, and lipid changes become more common even in women who’ve “always been healthy.”

This isn’t about blame.
It’s about biology and catching cardiovascular risk early, when we can still change the trajectory.

Heart health is women’s health. Especially in midlife.











02/09/2026

Monday Menopause in a Minute

Menopause isn’t just hot flashes.
It’s a metabolic shift.

As estrogen declines, insulin sensitivity drops, visceral fat increases, and your body becomes more cortisol-reactive. That’s why weight gain feels sudden, blood sugar feels unpredictable, and “doing all the right things” stops working.

This isn’t a willpower problem.
It’s physiology.

Midlife care isn’t cosmetic it’s metabolic prevention.
And hormones, muscle, sleep, and stress all matter.

Science > shame.
Support your metabolism. Support your future.

Address

1301 Shiloh Road NW Bldg 450
Kennesaw, GA
30144

Opening Hours

Monday 9am - 4pm
Tuesday 9am - 4pm
Wednesday 9am - 4pm
Thursday 9am - 4pm
Friday 9am - 12pm

Telephone

+16786733953

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Where SHE is seen

The Sexual Health, Optimization and Wellness (SHOW) Center was founded by Dr. Heather Quaile DNP, WHNP-BC, SANE. The center provides specialized care to empower women to embrace s*xuality in a manner that is integrative, holistic and functional. Heather has focused her entire career specifically helping women dealing with s*xual dysfunction, s*xuality counseling, and holistic, integrative medicine. Heather maintains her philosophy around the golden rule and strives to treat every woman as she would treat her mother, grandmothers, sister, aunts, and friends.

Often women are not “seen or heard”, our mission is to create a center where “She is Seen”. We offer a individualized approach to women’s specific, healthcare concerns. We will maintain an environment that embodies health, wellness, optimization and an understanding of pleasure. We offer evidence-based healthcare that is respectful, empathic, non-judgmental, a place where women are listened to and valued and we meet them where they are on their s*xual health and wellness journey.

Your SHOW provider is board certified in women’s health with specialty training in female s*xual and pelvic dysfunctions, s*xuality counseling, menopausal health, and functional, integrative medicine. Many women’s s*xual concerns have physiological roots and medical professionals are beginning to recognize and understand more treatment options for many of these issues. The SHOW Center collaborates with the area's most respected professionals including urologists, gynecologists, urogynecologists, psychologists, s*x therapists, physical therapists, acupuncturists, health coaches, dieticians, and massage therapists to provide holistic, team-centered, empathic care.