Can menopause cause high cholesterol?

May 1, 2024

Menopause affects each woman differently and can cause a variety of changes in her body. Changes in hormones and metabolism during menopause can affect the fats in a woman’s blood, including cholesterol.¹ Because of this alteration, menopause can cause high cholesterol.

Cholesterol and the menopausal transition

Menopause occurs when a woman hasn’t had a period for 12 months straight.¹ The time leading up to this, when women might experience symptoms such as changes in their menstrual cycles, mood swings and hot flashes, is called the menopausal transition or perimenopause.

Before menopause, when a woman is going through a transition period, the number of mature eggs in her ovaries starts to go down, and ovulation doesn’t happen regularly. Also, the body makes less estrogen and progesterone during this time.

Estrogen

There’s a connection between estrogen and heart health.² Estrogen has different effects on different parts of the body, including the liver. It helps control how the liver handles fats and cholesterol, which are important factors for heart health. It’s believed that the natural cycling of estrogen in the body may protect women against heart disease^7. Studies show that women have a higher risk of heart disease after menopause when estrogen production decreases.

Lower estrogen levels cause most of the symptoms of menopause, including high cholesterol. A rise in total cholesterol levels is due to higher amounts of low-density lipoprotein (LDL), the “bad” cholesterol, and triglycerides, another blood lipid or fat.

Menopause can start anytime from the 30s to the mid-50s or later. The average age is 51.³ It lasts about seven years but can last as long as 14 years.¹ After menopause, women enter postmenopause. Postmenopausal women are even more at risk of developing heart disease. ^1.

What is cholesterol?

Cholesterol is a type of fat called a lipid. It’s needed for your body to function normally. It’s found in every cell and plays an important role in building cell membranes, producing hormones (such as estrogen and testosterone) and helping digestion. Your body naturally produces cholesterol. It also comes from certain foods, particularly those high in saturated and trans fats.

Cholesterol travels through your bloodstream through lipoproteins, classified into several types, including low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Maintaining a healthy balance of cholesterol is necessary for your overall health. High LDL cholesterol levels can increase your risk of heart disease and stroke. On the other hand, high levels of HDL cholesterol lower your risk of developing these conditions.

Menopause, high cholesterol and heart disease

High cholesterol raises your risk of developing heart disease, including atherosclerosis (narrowing of the arteries), heart attack and stroke. With high LDL cholesterol, your risk of heart disease can double.⁴ Heart disease is the leading cause of death for women in the US and can affect women at any age. In 2021, heart disease caused the death of 310,661 women.⁵

Not all women going through menopause develop high cholesterol. A slight increase in cholesterol levels isn’t usually cause for concern if you’re generally healthy and don’t have many heart disease risks. On the other hand, if your cholesterol levels are high or if you have other factors that raise your risk of heart disease (such as family history, high blood pressure, diabetes, being overweight or smoking), then more tests might be necessary.

Cholesterol vs. triglycerides

Triglycerides and cholesterol are different types of lipids that travel through your bloodstream. Your cholesterol levels are determined through a blood test called a lipid profile or lipid panel. This test measures cholesterol and triglycerides. Fasting is required before the test for an accurate triglyceride measurement.

Triglycerides are fats from food. Your body also converts extra calories, sugar and alcohol into triglycerides. Your body then stores them in fat cells and provides your body with energy. Eating more calories than you need can lead to high triglycerides, especially if these calories come from carbohydrates.⁶

Know your numbers

A lipid panel measures:

• Total cholesterol: the total amount of cholesterol circulating in your blood
• HDL l:evel: high-density lipoprotein, the “good” cholesterol, helps remove extra cholesterol from your bloodstream and takes it to your liver, where it’s removed from your body. HDLs help keep your arteries clear of excess cholesterol.
• LDL level: Low-density lipoprotein, the “bad” cholesterol, can cause plaque buildup in your arteries if you have too much
• VLDL level: Very low-density lipoprotein carries triglycerides in your blood and is another “bad” form contributing to plaque buildup.
• Triglycerides: You need some of this fat, but high levels increase your risk for heart disease.
• Non-HDL cholesterol: This term refers to the cholesterol in your blood that isn’t HDL
• Total cholesterol to HDL ratio: You usually want this ratio to be less than five.

Your cholesterol levels indicate the amount of cholesterol in your body. Your total cholesterol should be under 200 for good heart health, with your HDL over 60 and your LDL less than 100. The ranges are identified below:⁷

• Healthy Cholesterol levels^:
• Total cholesterol: under 200
• LDL cholesterol: under 100
• HDL cholesterol: 60+
• Unhealthy Cholesterol levels:
• Total cholesterol: 200 – 239
• LDL cholesterol: 100 – 159
• HDL cholesterol: 50 – 59
• Dangerous Cholesterol levels:
• Total cholesterol: 240+
• LDL cholesterol: 160+
• HDL cholesterol: under 50
• Triglycerides
• Healthy triglyceride levels: under 150
• Unhealthy triglycerides: 150-199
• Dangerous: 200+

If you’re in menopause and have high cholesterol

Metabolic changes in premenopause, menopause and postmenopause are unavoidable. What you used to do to stay healthy might not work anymore. But, as your body changes, you can adapt. If you have high cholesterol, you can take action to lower it. Even moderate lifestyle changes can make a difference. Some tips include:

• Eating a heart-healthy, fiber-rich diet⁸
• Exercising daily
• Maintaining a healthy weight
• Managing stress
• Getting restful sleep
• Not smoking
• Managing any other health conditions you may have
• Taking any medications as prescribed

If lifestyle modifications are not enough, Statins are often prescribed. Statins work by reducing the amount of cholesterol the liver makes and helping the liver remove cholesterol already in the blood.

Recommendations from the U.S. Preventive Services Task Force, the American College of Cardiology, and the American Heart Association outline four primary groups of individuals who may benefit from taking statins:⁹

• People who have one or more factors that increase their chances of heart disease and a 10% or higher risk of having a heart attack within the next decade.
• People who have cardiovascular disease related to hardening of the arteries
• People with very high LDL cholesterol
• People with diabetes

While menopause can cause high cholesterol, there are steps you can take to manage it effectively. We’re here to help. Our team of board-certified physicians, physician assistants and nurse practitioners are committed to your health and well-being. We provide compassionate, personalized care to ensure you receive the support you need. Visit Healthcare Associates of Texas to learn more about what your cholesterol levels mean for your overall health. Then, if your cholesterol numbers are high, we’ll help you get them back to a healthier range.

Sources

1. “What is Menopause?” National Institute on Aging. ND. Last modified September 30, 2021. https://www.nia.nih.gov/health/menopause/what-menopause
2. “Estrogens in the Regulation of Liver Lipid Metabolism.” National Library of Medicine. January 11, 2018. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5763482/
3. “Introduction to Menopause.” John Hopkins Medicine. ND. https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause#:~:text=Although%20the%20average%20age%20of,often%20have%20a%20later%20menopause
4. “Heart Disease and Stroke.” Centers for Disease Control and Prevention. ND. Last modified September 8, 2022. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/heart-disease-stroke.htm#:~:text=High%20LDL%20cholesterol%20can%20double,%2C%20other%20organs%2C%20and%20legs
5. ”Women and Heart Disease.” Centers for Disease Control and Prevention. ND. Last modified January 9, 2024. https://www.cdc.gov/heartdisease/women.htm#:~:text=Heart%20disease%20is%20the%20leading,in%20every%205%20female%20deaths
6. “Triglycerides: Why do They Matter?” Mayo Clinic. ND. Last modified September 3, 2022. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186#:~:text=What%20are%20triglycerides%3F,triglycerides%20for%20energy%20between%20meals
7. “Cholesterol Numbers and What They Mean.” Cleveland Clinic. Last updated July 28, 2022. https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean
8. “Dietary Fiber, Atherosclerosis, and Cardiovascular Disease.” National Library of Medicine. May 11, 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6566984/
9. “Statins: Are these cholesterol-lowering drugs right for you?” Mayo Clinic. ND. Last updated March 2024. https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/statins/art-20045772