How Does Menopause Affect Cholesterol Levels?

Menopause can lead to changes in hormones and metabolism, ultimately altering your lipid profile.

A lipid profile is a panel of blood tests that measure the type of fats in your blood, which can help determine risk factors for developing heart conditions. A lipid panel includes the following markers:

• total cholesterol
• high density lipoprotein (HDL), also known as “good cholesterol”
• low density lipoprotein (LDL), also known as “bad cholesterol”
• triglycerides

A high level of lipids, including LDL cholesterol and triglycerides, can increase the risk of developing heart disease.

So where does menopause fit into this? Turns out, estrogen — the sex hormone that decreases during this stage of life — has many heart-protective mechanisms.

Estrogen works on the liver to regulate lipid metabolism and maintain a healthy lipid profile.

So when menopause begins and estrogen levels go down, your body’s ability to maintain that healthy lipid profile can be affected. That can lead to increases in cholesterol.

A review of 66 studies found that postmenopausal people had higher LDL and total cholesterol as well as higher triglyceride levels compared with pre-menopausal people. These higher levels increase the risk of heart disease and stroke.

Another observational study found similar results, except postmenopausal people also had lower HDL cholesterol, which would further elevate the risk of heart complications.

(However, observational studies are designed to find associations but can’t explain cause and effect — or why the associations exist. Their findings don’t always tell the full story compared to other types of studies due to confounding variables.)

Thankfully, there are many lifestyle modifications you can make to manage your cholesterol levels during menopause — or at any age and stage of life.

Diet can play a significant role. Focus on increasing your intake of soluble fiber, which can bind to cholesterol and help it leave your body via stools.

Enjoy various foods rich in soluble fiber, such as:

• legumes like beans, edamame, chickpeas, peas, and lentils
• whole grains like barley and oats
• fresh fruits and vegetables like apples and carrots
• fiber supplements like psyllium

As well, enjoy foods high in heart-healthy omega-3 fatty acids like salmon, walnuts, ground flax, olive oil and avocado. Increased intake of omega-3 fatty acids can help lower cholesterol levels.

Be mindful of your saturated fat intake. Excess saturated fat in the diet — from sources like red meat, high fat dairy, and butter — is linked to increased LDL cholesterol levels.

Soy protein may have a favorable effect on cholesterol levels in postmenopausal people. Enjoy tofu, edamame, soy nuts, and soy milk more often.

Exercise can be incredibly beneficial for heart health. The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity and strength training at least 2 days per week.

Finally, smoking is a major risk factor for heart disease. If you smoke, you may consider joining a smoking cessation program to help you quit.

Here are some questions people often ask about menopause and cholesterol.

Can menopause cause high cholesterol?

Menopause does not cause high cholesterol, but it does increase the risk.

High cholesterol has many risk factors, including family history, lifestyle, hormones, co-morbidities, environment, and more.

Does cholesterol go down after menopause?

No, because estrogen levels are reduced after menopause. Estrogen plays a role in keeping cholesterol low, so when estrogen levels go down, cholesterol levels may go up.

It’s important to focus on managing cholesterol levels through diet and lifestyle.

How can I lower my cholesterol during menopause?

Focus on eating more foods that are high in fiber and healthy fats, such as nuts, seeds, legumes, whole grains, fruits, vegetables, fatty fish, and olive oil. Incorporate an exercise routine if you don’t already have one. And if you smoke, consider quitting.

During menopause, estrogen levels decrease. That’s associated with increased cholesterol levels, because estrogen helps your body regulate cholesterol and other lipids.

However, there are many lifestyle changes you can make to lower your risk of heart disease after menopause.

These include enjoying a varied and balanced diet rich in plant-based foods and fatty fish, adopting or maintaining an exercise routine, and quitting smoking if you currently smoke.

Keep in mind that menopause and reduced estrogen is just one of many risk factors. Focus on what is within your control and do your best.