February 2026
For many women, menopause marks a significant transition — not just in how they feel day to day, but in their long‑term heart health. At Providence Heart Institute, we are helping women better understand these changes and take steps to protect their hearts with personalized care.
Nearly 45% of women ages 20 and older live with some form of heart disease.
According to Lori Tam, M.D., a cardiologist with Providence Heart Institute, menopause is an often‑overlooked factor.
“As women go through menopause, we lose the natural protective effects of our estrogen,” Dr. Tam says. “You lose your natural estrogen, your heart disease risk goes up.”
Hormone replacement therapy: Do's and don't's
Many women seek relief from menopausal symptoms through hormone replacement therapy. While it can be a helpful option for some, Dr. Tam emphasizes that it’s not the right choice for everyone — and that individualized guidance matters.
“For most people, it’s safe, but there’s certainly some groups in which hormone replacement therapy could be more dangerous,” she says.
Some forms of hormone replacement therapy may increase the risk of blood clots, heart attacks, or hormone‑sensitive cancers, making individualized medical guidance essential.
Timing also matters. Some studies suggest that starting hormone replacement therapy earlier — typically before age 60 and within 10 years of menopause — may lower heart‑attack risk.
“It’s important to remember that the timing of initiation of HRT is important,” Dr. Tam says.
Dr. Tam's tips to manage weight and heart health
Weight gain during menopause is another common concern. While hormone replacement therapy doesn’t cause weight loss, it may help redistribute fat in healthier ways. Still, lifestyle choices remain the foundation of heart health.
“At the end of the day, losing weight is about calories in versus calories out,” Dr. Tam says.
'Life's Essential Eight'
To protect your heart health, Dr. Tam recommends American Heart Association’s Life’s Essential Eight. These include:
- Managing blood pressure, blood sugar and cholesterol
- Maintaining a healthy weight
- Exercising regularly
- Getting quality sleep
- Eating a healthy diet
- Avoiding smoking
Most importantly, Dr. Tam encourages women to speak up and stay engaged in their care.
“I think that it’s really important to be proactive, to be aware of your symptoms,” she says. “If you have a strong family history … make sure your doctor is aware, make sure you’re getting the screening tests necessary to really ensure that you can live a heart-healthy life.”
Related
- Hear Dr. Tam's interview with KATU's "AM Northwest."
- Learn more about heart health with Providence Basecamp + Wellness.
- Schedule an appointment with Providence St. Vincent Heart Clinic.
- See a story debunking common myths about women's health and menopause.
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