As we age, our risk for certain diseases and medical conditions becomes higher. For women, menopause may be an independent risk factor for some of these conditions. Cardiovascular disease, in particular, accelerates in women after menopause. Women who experience menopause before the age of 45 are at an increased risk of cardiovascular disease, while those who go through menopause at an older age have a decreased risk._[1] Research shows that cholesterol levels for women increase at menopause along with other risk factors for heart disease. 

Menopause and Cholesterol Levels

Specifically, there is an increase in LDL cholesterol (the “bad” kind) and a decrease in HDL cholesterol (the “good” kind)._[3-5] The reason why these changes in lipid profiles occur at menopause is still not entirely known. Researchers suspect that there are protective factors in premenopausal women that are lost at the time of menopause._[1] A major change that occurs at menopause is the decline in estrogen levels: estrogen likely helps clear LDL particles from circulation,_[5,6] and thus LDL levels rise when estrogen declines.

Furthermore, metabolic syndrome is much more prevalent after menopause. Metabolic syndrome is the name for a collection of risk factors for cardiovascular disease including obesity, hypertension, and abnormal glucose and lipid metabolism. All of these components are associated with a higher prevalence of coronary artery disease._[2]

Preventing Rising Cholesterol Levels for Women at Menopause

Although you may have never had a problem with cholesterol before, it is important to monitor your cholesterol when you hit menopause. There are many precautions you can take to lower your cholesterol and decrease your risk for heart disease. Here are just a few strategies you may want to try:

1. 1. Eat a healthy diet full of fruits and vegetables. Cut back on sugary foods and carbohydrates, like bread, sodas, and processed foods. Try eating lots of berries, apples, and almonds, which are all cholesterol-lowering foods.
   2. Regular exercise, be it a daily walk, run, or fitness class, lowers cholesterol naturally and boosts the “good” HDL cholesterol.
   3. Supplement with vitamin B3 (niacin). Start with 250 mg daily. Increase slowly, watching for the flushing symptoms that can accompany niacin supplementation, up to 2 g daily. Take only as much as is necessary to achieve healthy cholesterol levels.
   4. Consider talking to your doctor about bioidentical hormone therapy. Many women at menopause have hormonal imbalances that contribute to unpleasant symptoms. Estrogen replacement therapy has been shown to lower LDL cholesterol levels and raise HDL cholesterol levels._[5,6] Bioidentical hormone therapy is safe and effective at naturally managing menopause symptoms and can help you to reduce your cardiovascular disease risk.

This article was originally published in 2014. It has since been updated.

[1] Climacteric. 2014 Jun 27:1-17.

[2] Arq Bras Endocrinol Metabol. 2014 Mar;58(2):91-6.

[3] Biomed Res Int. 2014;2014:457131

[4] Mymensingh Med J. 2013 Oct;22(4):706-11.

[5] J Intern Med. 1997 Mar;241(3):195-203.

[6] Maturitas. 2010 Mar;65(3):237-43.