Does menopause affect cholesterol levels in women? A cardiologist explains

Cardiovascular disease (CVD) is the leading cause of death in women after the cessation of the menstrual cycle to the extent that more women die from heart disease and stroke than other causes including breast cancer. In spite of the magnitude of the problem, it is frequently underestimated and women are less likely to receive any interventions compared to men. Traditionally, CVD is perceived as a problem for middle-aged men. In fact, it affects just as many women as men – if not more – may be on average a decade later. This delay is attributed to the protective effects of estrogen during pre-menopausal years. Come, let us understand what’s the link between menopause and cholesterol levels.

What is menopause?

Menopause is a stage of life marked by the cessation of menstrual periods. As the oestrogen levels fall significantly following menopause, the protective effect is lost and changes occur that lead to an increased risk of heart disease in the ensuing years.

What is cholesterol?

Cholesterol, a waxy, fat-like substance produced in the body falls into two categories:

Low-Density Lipoprotein (LDL) cholesterol: LDL referred to as bad cholesterol builds up in the walls of blood vessels, causing these to narrow which in turn can lead to chest pain or more serious health events like a heart attack.

High-Density Lipoprotein (HDL) cholesterol: HDL, on the other hand, is termed as good cholesterol and high levels of this are a sign of good health and a lower risk of heart disease and strokes.

Link between menopause and cholesterol

Menopause affects all women and the average age usually varies based on various factors such as genetics, age of menarche, nutrition, and smoking.

Changes related to declining levels of oestrogen may, however commence a number of years before menopause. This deficiency in oestrogen levels can bring about several early, intermediate, and long-term health problems. And while there is widespread awareness of the common early menopausal symptoms such as hot flushes, there is not much appreciation of the important long-term effects of menopause on the cardiovascular system.

The shift in hormone levels during menopause causes most of the changes that happen during this period. The rise in LDL cholesterol levels is attributed to the reduction in the hormone oestrogen.

Studies have further confirmed the fact that sex hormones such as oestrogen offer some protection against heart disease before menopause.

According to a study, levels of total cholesterol, LDL cholesterol, and triglycerides were found to be much higher in people after menopause, compared with people in the early stages.

Treatment and management of cholesterol levels

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

Besides taking appropriate medication to reduce cholesterol levels, a healthy lifestyle has been shown to play a crucial role in the management of the build-up of cholesterol that leads to heart disease.

1. Diet

Some foods are helpful to reduce cholesterol. Certain cholesterol-like compounds such as plant sterols present in plant foods can prevent the body from absorbing cholesterol. To support healthy cholesterol levels, a person can include foods like eggs, shellfish, lean red meats, sardines, fish, and other foods rich in omega-3 fatty acids into their diet.

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

2. Lifestyle

A healthy lifestyle is incomplete without regular exercise. Being physically active can also work to lower cholesterol levels. Experts recommend getting at least 150 minutes of moderate-intensity aerobic activity each week. Quitting smoking is also known to lower cholesterol in smokers.

3. Weight

Lastly, maintaining a healthy weight – being overweight or obese raises levels of LDL cholesterol in the body.

The last word
Women face increased levels of LDL cholesterol during or after menopause, which is attributed to a reduction in the body’s levels of oestrogen during this period.

The hormone oestrogen helps the liver to regulate cholesterol levels. Having high levels of bad cholesterol may not cause any visible symptoms, but can bring about serious health problems such as heart disease, heart attack, and stroke.

It is therefore advised to get cholesterol levels checked at least every five years and more frequently during and after menopause.