You may already know that you can reduce your risk of cardiovascular disease by keeping your cholesterol levels in check. But does menopause make this harder to do? And can you take HT if you have high cholesterol? Read on for everything you need to know about menopause and cholesterol.
What is cholesterol and why is it important?
Cholesterol is a type of fat in your body. It has a bad reputation, but your body needs some cholesterol to work properly. In fact, the human brain is about 20% cholesterol!
The issue is that when you have too much cholesterol it can cause problems. It can lead to heart attacks, strokes, and other kinds of cardiovascular disease if it builds up in your blood vessels. This is why your healthcare provider may recommend a cholesterol blood test and medications to lower cholesterol if it is too high.
High cholesterol can be caused by:
- Your genes
- A diet high in foods with unhealthy fats, such as red meat or fried food
- Being overweight
- Not getting enough exercise
- Smoking
- Drinking too much alcohol
Does cholesterol increase with age?
Your cholesterol levels tend to increase with age until you reach the age of 65. Cholesterol levels then tend to stay the same in women and decrease slightly in men.
When should you check your cholesterol?
You should check your cholesterol at least every four to six years, but after age 40, many people should have it checked more often, according to the American Heart Association.
Your healthcare provider will also calculate your 10-year risk of having a heart attack or stroke after age 40. This is called your QRISK score. It takes your risk factors – such as your family history – into account and helps your healthcare provider decide if you should have a cholesterol test more frequently.
Where can you get your cholesterol checked?
Request a cholesterol test from your healthcare provider. You can get it tested at a public screening, but you should always share your results with your healthcare provider so they have the most up-to-date information.
What do your cholesterol results mean?
Cholesterol is measured in mg/dL, which stands for milligrams per 100 milliliters of blood.
You will see a number of different types of cholesterol on your test results, including total cholesterol, LDL, and HDL. HDL is sometimes known as ‘good’ cholesterol because of its role in removing other, more harmful types of cholesterol from the body. LDL is the type of cholesterol that can build up in the blood vessels and cause problems.
Adults should aim for an LDL cholesterol level of 100mg/dL or less. People at high risk of cardiovascular disease should aim for an LDL of 70mg/dL or less.
However, the cholesterol number alone is not the whole picture. Cholesterol is just one part of your overall cardiovascular risk, and needs to be looked at in the context of your general health and your QRISK score.
Bear in mind that your cholesterol reading may become raised for a short time if you are actively losing weight, have recently lost weight, or if you’re pregnant or breastfeeding.
How does menopause affect cholesterol?
High cholesterol is more common after menopause. It is typical to see higher levels of ‘bad’ fats in the blood, known as LDL cholesterol and triglycerides, as well as less ‘good’ fats, known as high-density lipids (HDL).
It is thought that this is partly because estrogen levels fall during this time. Other menopause changes, such as weight gain and lower exercise levels, are also likely to blame.
How can you improve your cholesterol?
Improving your lifestyle and taking medication can help lower your cholesterol levels.
Lifestyle changes that will help include:
- Moving more
- Drinking less alcohol
- Losing some weight if your BMI is over 25
- Eating healthier foods
How to eat to improve your cholesterol
Current advice says that you should get less than 10% of your daily calories from saturated fats, which are mostly found in animal products, including dairy.
To cut down, swap these products with those that are low in saturated fats and/or high in ‘good’ fats, such as:
- Olive oil
- Fish
- Nuts
- Seeds
- Wholegrain products
- Fruits
- Vegetables – including the trusty avocado!
What medication can help?
Your healthcare provider may recommend medication to reduce your cholesterol if you are at high risk of cardiovascular disease. There are various options, but they will usually prescribe statins. This group of medicines includes atorvastatin, simvastatin, pravastatin, and rosuvastatin.
Statins have revolutionized cardiovascular medicine over the past few decades and work very well to both reduce your cholesterol and stabilize plaques of cholesterol buildup in the blood vessels. While statins aren’t suitable for everyone, they may be a useful addition.
Hormone therapy (HT) has also been shown to reduce cholesterol levels, but it is not prescribed for this reason alone. Of course, lower cholesterol might be a welcome side effect if you’re using HT for menopause relief!
Can you take hormone therapy (HT) with high cholesterol?
The answer is different for everyone, but HT may still be the best treatment for menopause symptoms for people with high cholesterol. It is also safe to take HT at the same time as cholesterol medication, including statins.
Your healthcare provider will help you weigh up the pros and cons of taking HT when deciding on the right menopause treatment for you. If you are at higher risk of cardiovascular disease, such as high cholesterol, they may be concerned about the additional risk of blood clots linked to some types of HT.
If you have high cholesterol your healthcare provider may recommend:
- Types of HT that are applied to and absorbed through the skin such as a patch, gel, or spray. These come with a lower risk of blood clots and strokes
- Micronized progesterone – if you still have a uterus as the progesterone part of your HT. This has less of an impact on your blood lipids
Your healthcare provider will prescribe the lowest dose needed to control your symptoms for the shortest time possible.
Final word
Taking control of your cholesterol is a great way to invest in your future health, especially during and after menopause. You are one just appointment away from making a real difference to the rest of your life.
Find out more about menopause on our blog or in our symptoms library.
- Ambikairajah A, Walsh E, Cherbuin N 2019, ‘Lipid profile differences during menopause: a review with meta-analysis’, Menopause, vol. 26, no. 11, pp. 1327-1333
- Anagnostis P, Bitzer J, Cano A, Ceausu I, Chedraui P, Durmusoglu F, Erkkola R, Goulis DG, Hirschberg AL, Kiesel L, Lopes P, Pines A, van Trotsenburg M, Lambrinoudaki I, Rees M 2020, ‘Menopause symptom management in women with dyslipidemias: An EMAS clinical guide’, Maturitas, vol. 135, pp. 82-88
- Beckett N, Nunes M, Bulpitt C 2000. Is it advantageous to lower cholesterol in the elderly hypertensive? Cardiovasc Drugs Ther. 2000;14(4), pp397-405
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