Menopause and cholesterol: Link, management, and prevention


A person’s cholesterol levels can increase during or after menopause, due to reduced levels of the hormone estrogen in the body. Estrogen helps regulate cholesterol levels.

Cholesterol is a waxy, fat-like substance produced in the body. It falls into two categories, depending on the lipoprotein that carries it. There is low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol.

When a person has too much LDL cholesterol, it builds up in the walls of their blood vessels, causing these to narrow. This can cause chest pain or more serious health events, such as a heart attack.

Lipoproteins that are high density bring HDL cholesterol to the liver, which then flushes it from the body. Having high levels of HDL is a sign of good health and a lower risk of heart disease and strokes.

Menopause is a stage of life marked by the end of menstrual periods. It usually begins between the ages of 40 and 58 years.

Menopause is not a health problem, but it can cause symptoms such as hot flashes, vaginal dryness, sleep disturbances, and mood changes.

Shifts in hormone levels cause most of the changes that happen during menopause. A reduction in the hormone estrogen can cause LDL cholesterol levels to rise.

Below, we explore the connection between cholesterol and menopause in more depth and look at the next steps that a person and their doctor may take.

During and after menopause, a person’s cholesterol levels can rise.

A 2018 study confirms that sex hormones such as estrogen provide some protection against heart disease before menopause.

And a 2020 study found that levels of total cholesterol, LDL cholesterol, and triglycerides were much higher in people after menopause, compared with people in the early stages. HDL cholesterol levels were reduced in all the participants.

The liver plays an important part in metabolism by using fatty acids, triglycerides, and cholesterol to meet the body’s metabolic needs.

Estrogen helps regulate the metabolism of lipids in the liver. As a result, the drop in estrogen levels during menopause leads to higher LDL cholesterol and triglyceride levels.

Experiencing this drop in estrogen early may increase certain health risks. According to the Australasian Menopause Society, people who enter menopause early are twice as likely to develop heart disease, compared with similarly aged women who have not yet entered menopause.

High cholesterol usually has no symptoms, and a person may only realize that they have it after experiencing a heart attack or a stroke.

The Centers for Disease Control and Prevention (CDC) recommend having cholesterol levels checked at least every 5 years. During and after menopause, a person might consider having this screening more often.

Anyone with a family member who has high cholesterol should ask a doctor about how frequently they should undergo screening.

Healthcare professionals can check cholesterol levels using a blood test called a lipid profile. A laboratory analyzes the blood sample to measures levels of:

  • total cholesterol
  • LDL cholesterol, which can be harmful
  • HDL cholesterol, which can show good health
  • triglycerides

Here, learn about the signs and risk factors for heart attacks in women.

Some people need medication to reduce their cholesterol levels. Statins are the main type of medication for this purpose. They reduce the body’s production of cholesterol, lowering LDL cholesterol levels. They also increase the liver’s ability to remove LDL cholesterol from the blood.

A healthcare professional may also prescribe hormone replacement therapy (HRT). One 2019 study found that HRT reduced LDL cholesterol levels after menopause.

Diet

Some foods can help reduce cholesterol. Soluble dietary fiber can bind with cholesterol in the digestive system and remove it from the body.

Plant sterols and stanols are cholesterol-like compounds in plant foods, and they can prevent the body from absorbing cholesterol.

To support healthy cholesterol levels, a person might incorporate these foods into their diet:

Learn more about foods that lower cholesterol here.

Around menopause, before it, and at any other time of life, there are many ways to prevent high cholesterol.

Foods rich in saturated fats and trans fats can raise levels of LDL cholesterol in the body. In the lead-up to menopause, especially, a person may wish to reduce their intake of foods containing these fats.

Quitting smoking and being physically active can also lower cholesterol levels. The CDC recommends getting at least 150 minutes of moderate-intensity aerobic activity each week.

In addition, having obesity or overweight raises levels of LDL cholesterol in the body. A way of addressing this, or preventing high cholesterol, is to maintain a moderate weight.

Levels of LDL cholesterol can increase during or after menopause, due to a reduction in the body’s levels of estrogen. This hormone helps the liver regulate cholesterol levels.

Having high cholesterol may cause no symptoms, but it can contribute to serious health problems, such as heart disease, heart attack, and stroke. The CDC recommends that everyone have their cholesterol levels checked every 5 years at least, and a person may wish to have this screening more often during and after menopause.

A person can take several steps to prevent or reduce high cholesterol, such as being physically active, having a healthy diet, and maintaining a moderate weight. Medications, such as HRT and statins, can also help.



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