High Cholesterol and Menopause: How Women Can Protect Their Hearts

Menopause is a natural stage in life, typically occurring around age 51, when menstruation stops for over 12 months. During this transition, estrogen levels decline, leading to hormonal shifts that can cause symptoms like hot flashes, poor sleep, mood changes, and a slower metabolism. 

Beyond these discomforts, menopause also impacts heart health. Lower estrogen levels can lead to higher cholesterol, increasing the risk of heart disease. Understanding this connection is key to taking proactive steps for a healthier future. In this blog, we’ll explore how cholesterol affects women, its link to heart disease, and practical tips to keep cholesterol levels in check.

Cholesterol and Heart Disease: What You Need to Know

High cholesterol is a major risk factor for heart disease and stroke.[NIH]  When cholesterol levels are too high, it can lead to plaque buildup in the arteries, causing them to narrow over time. This restricts blood flow to the heart and other vital organs, increasing the risk of serious health complications.

If the heart or brain doesn’t receive enough blood, it can result in a heart attack or stroke—both of which can be life-threatening. In fact, heart disease remains the leading cause of death among women, responsible for 1 in 5 female deaths in 2021, according to the CDC. [NIH]

Link Between Menopause and Cholesterol

Menopause brings significant hormonal and metabolic changes, including shifts in cholesterol levels that can impact heart health. As estrogen levels decline during this stage of life, the body's ability to regulate lipids—such as LDL cholesterol and triglycerides—can be affected, increasing the risk of heart disease. [NIH]

Estrogen plays a crucial role in maintaining a healthy lipid profile by supporting liver function and regulating cholesterol metabolism.[NIH] However, as estrogen levels drop, cholesterol levels can rise, potentially leading to plaque buildup in the arteries and an increased risk of heart complications.

A 2017 review found that when menopause occurs, cholesterol levels tend to rise, increasing the risk of heart disease

A review of 66 studies found that postmenopausal individuals tend to have higher LDL (bad) cholesterol, total cholesterol, and triglyceride levels compared to those who are premenopausal.[NIH] Another 2020  study observed that postmenopausal individuals not only had higher LDL levels but also lower HDL (good) cholesterol, further increasing the risk of heart disease and stroke. [NIH]

Tips for Managing Cholesterol Levels

A heart-healthy diet is essential for managing cholesterol levels. Boost your intake of soluble fiber by including legumes like beans, chickpeas, and lentils, whole grains such as oats and barley, and fresh fruits and vegetables like apples and carrots. Soluble fiber binds to cholesterol and aids in its removal from the body. [NIH]

Incorporate omega-3-rich foods such as salmon, walnuts, flaxseeds, olive oil, and avocado, as they support heart health and may help lower cholesterol. [NIH] Additionally, regular exercise is also essential—the American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity and strength training twice a week.  

Limit saturated fats from red meat, high-fat dairy, and butter, as they can raise LDL cholesterol. [NIH] Additionally, plant sterols and stanols help reduce cholesterol absorption. According to the FDA, consuming 1,300 mg of sterols with diet and exercise may lower cholesterol by up to 33%, making sterol-based supplements a beneficial option.

Bottom Line 

High cholesterol in women can lead to serious health risks, including heart disease, often without noticeable symptoms. That’s why regular cholesterol checks—at least every five years or as advised by a healthcare professional—are crucial. Estrogen plays a protective role in cholesterol management, but its decline after menopause increases the risk of high cholesterol. The good news? You can take control by staying active, reducing saturated fats, and incorporating plant sterol supplements into your routine.

If lifestyle changes aren’t enough, consult a healthcare professional for personalized treatment options. Prioritizing heart health today can help you stay strong and healthy for years to come!