Menopause and high cholesterol
High cholesterol and menopause, is there a connection?
A 2019 study found post-menopausal women had higher cholesterol levels compared with pre-menopausal women. These higher levels increase the risk of post-menopause heart complications such as heart disease and stroke.
Following blood tests, both Jo and Ann received results that showed high cholesterol levels. Ann had only had a Cholesterol test 6 months previously that showed her cholesterol levels were not on the high-risk scale, she was intrigued to know why it had spiked in such a short period of time.
Jo’s test was for Thyroid, Ann’s was a Menopause test. Up to a month before she took the blood test Ann was still having periods, aged 56. She’s had two periods in four months subsequent to the test, her test confirmed that she had gone through menopause.
Jo is on HRT patches, Ann is not. We wanted to learn more about cholesterol, and to understand in more detail the complexities of it. The good and the bad cholesterol, and how various cholesterol levels all add up to an overall cholesterol level?
And, most of all…
How does menopause impact cholesterol levels?
Firstly, here’s an explanation of the different terms when you receive your cholesterol test results.
Total cholesterol
LDL (low-density lipoprotein cholesterol, or ‘bad’ cholesterol)
HDL (high-density lipoprotein cholesterol, or ‘good’ cholesterol)
Triglycerides (fats (lipid) carried in the blood from food you eat. Excess calories, alcohol, or sugar in your body get converted into triglycerides and stored in fat cells throughout your body.)
What causes high cholesterol?
High cholesterol is when you have too much fatty substance (cholesterol) in your blood. Generally caused by a poor diet of fatty food, not exercising enough, being overweight, smoking, or alcohol.
Is high cholesterol something that is hereditary?
High cholesterol can also run in the family, caused by a condition called familial hypercholesterolaemia. This means you may have a very high cholesterol level, even if you have a healthy lifestyle.
How to interpret your cholesterol test results?
The results are shown in numbers. Firstly, you need to know that these numbers on their own aren’t enough to predict your risk of heart problems, and don’t necessarily determine what you need to do to lower your risk. Instead, they are just one part of a larger equation that looks at your age, your blood pressure, whether you’re on any blood pressure medication, and if you smoke?
This information is used to calculate your risk for serious heart problems.
Below is a general guide to cholesterol levels in healthy adults.
Total cholesterol (TC) - 5mmol/L or below
Non-HDL (all ‘bad’) cholesterol - 4mmol/L or below
LDL (main ‘bad’) cholesterol - 3mmol/L or below
HDL (‘good’) cholesterol - 1mmol/L or above
Cholesterol ratio TC/HDL - 4mmol/L or below
Triglycerides - 2mmol/L or below
Do hormones impact cholesterol levels before menopause and post-menopause?
We asked Medichecks who provide ‘female hormone’ blood testing kits, this question. Their medical advisers informed us; ‘Cholesterol levels are affected by menopause in that some persons the total cholesterol level increases after the menopause (postmenopausal, hypercholesterolaemia) but this is not universal.’
‘Usually, as oestradiol decreases the HDL (good) concentration decreases a little and LDL (bad!) cholesterol increases. These are the usual patterns but there can be a variation on this.’
A 2009 American study followed 1,054 U.S. women in their 40s and early 50s, who were still menstruating when they began the study but had stopped by the time follow-up ended about nine years later. Lead researcher Karen A. Matthews, PhD, of the University of Pittsburgh, and her colleagues tested the women for cholesterol, blood pressure, and other heart disease risk factors such as blood glucose and insulin.
Matthews said, ‘This study shows for the first time that the change in menstruation correlates directly with the change in cholesterol.’
‘As they approach menopause, many, many women show a very striking increase in cholesterol levels, which in turn increases the risk for later heart disease.’
‘The total cholesterol and LDL cholesterol rose substantially one year before and one year after a woman’s last period.’
Matthews said ‘The current study doesn't explain how the increases in cholesterol will affect the rate of heart attacks and mortality down the road, for instance.’
As the SWAN study continues, we hope ten years on that Matthews and her colleagues are closer to identifying the warning signs that show which women are most at risk for heart disease.
Cholesterol and menopause sleep
It appears that menopausal women can’t win in the sleep game either way. Research published in the journal Sleep, found that both too much and too little sleep have a negative impact on lipid levels. Sleeping less than five hours at night raised the risk of high triglycerides and low HDL levels in women. Getting more than eight hours of sleep produced a similar result. Would you believe that men were not as sensitive to oversleeping as women?
Does HRT have any implication for menopause cholesterol changes?
We consulted Medichecks team of doctors who said ‘HRT may increase HDL (good) cholesterol a little in some persons and can also increase triglycerides (especially oral HRT) – again the response to HRT is not universal as some persons may find a very large increase in triglycerides (fats carried in the blood from food) and some people may not show any changes.’
What is the treatment for high cholesterol?
The best way to lower cholesterol levels involves a range of lifestyle adjustments, more exercise and healthy eating. Diets low in saturated fats and trans fats and high in soluble fibres and protein are good for lowering cholesterol build-up.
Reduce saturated fats - fatty meats, cream, and dairy products.
Replace with unsaturated fats - olive oil, avocado, nuts, and salmon.
Regular physical activity of 30 minutes on most days is recommended. This will also help with weight management, which in turn helps with lowering cholesterol and improving your heart health.
Ultimately, a doctor is the best person to talk to figure out the best way to lower bad cholesterol levels. Some may also need to take medicine.