Cholesterol Changes During Perimenopause and Menopause

A Conversation on Women's Health

As women approach midlife, the transition through perimenopause and menopause brings significant changes to their bodies, many of which are linked to hormone fluctuations. One critical area affected by these hormonal shifts is cholesterol levels, which can have important implications for cardiovascular health. Understanding how cholesterol changes during this stage of life and what can be done to manage it is crucial for maintaining overall well-being.

The Role of Hormones in Cholesterol Regulation

Oestrogen, a hormone that plays a vital role in women's health, is known to have a protective effect on the heart. It helps regulate cholesterol by increasing levels of high-density lipoprotein (HDL), often referred to as "good cholesterol," and lowering levels of low-density lipoprotein (LDL), or "bad cholesterol." HDL cholesterol helps remove LDL cholesterol from the bloodstream, preventing it from accumulating in the arteries and reducing the risk of heart disease.

As women enter perimenopause—the years leading up to menopause—oestrogen levels start to fluctuate and eventually decline. This hormonal change can disrupt the balance of cholesterol in the body, potentially leading to an increase in LDL cholesterol  (bad cholesterol) and a decrease in HDL cholesterol. As a result, many women experience a rise in overall cholesterol levels during perimenopause and post-menopause, which can increase the risk of developing heart disease.

How Cholesterol Changes During Perimenopause and Menopause

For many women, perimenopause can begin in their 40s, though it can start earlier or later. During this time, periods may become irregular, and various symptoms such as hot flushes, night sweats, and mood swings can appear. Cholesterol levels may also start to shift during this phase.

The most significant changes often occur after menopause, which is defined as the point when a woman has gone 12 consecutive months without a menstrual period. The drop in oestrogen levels after menopause is associated with an increase in LDL (bad cholesterol) cholesterol and a decrease in HDL cholesterol (good cholesterol). This change can lead to a build-up of fatty deposits in the arteries, increasing the risk of atherosclerosis (hardening of the arteries), heart attack, and stroke.

What Else Can Impact Our Cholesterol Levels?

In addition to hormonal changes, other factors can influence cholesterol levels during perimenopause and menopause. These include:

- Age: As we age, cholesterol levels naturally tend to rise, even in the absence of menopause. This can compound the effects of hormonal changes.

- Weight gain: Many women experience weight gain during midlife, which can contribute to higher cholesterol levels and an increased risk of heart disease.

- Diet and lifestyle: A diet high in saturated fats ( butter, palm and coconut oils, cheese, and red meat), lack of physical activity, and smoking can all negatively impact cholesterol levels.

Managing Cholesterol 

While the changes in cholesterol during perimenopause and menopause can be concerning, there are several steps women can take to manage their cholesterol and reduce the risk of heart disease:

The common advice is to lead a healthy lifestyle, including improving your diet and increasing exercise. However, it's often easier said than done. Changing deeply ingrained habits, like diet and physical activity, requires a strong commitment and the willingness to alter your routine. That’s why my advice is to start with small, manageable steps.

For example, to improve your diet, try cutting out one or two foods high in saturated fat every couple of weeks, and gradually replace them with healthier options, such as leafy greens, fish, or fruit. The same approach applies to exercise. If you lead a sedentary lifestyle, it can be difficult to find the motivation to go to the gym or even take long walks in the park. Start small by going for a brisk 15-minute walk each day or every other day, and then increase the time each week. You might also add a swimming session or a gym workout once a week, slowly building up the frequency.

As you begin to replace old habits with new, healthier routines, your commitment will be key to establishing a lasting, healthier lifestyle.

Managing stress and quitting smoking are both important steps in controlling cholesterol. However, sometimes lifestyle changes alone aren't enough to keep cholesterol levels in check. In such cases, your doctor may suggest cholesterol-lowering medications, such as statins, to help you manage it more effectively.

The Importance of Regular Cholesterol Monitoring

As women transition through perimenopause and menopause, it’s essential to keep track of cholesterol levels through regular health check-ups. Routine blood tests can help identify any changes early on, allowing for timely intervention if needed.

The hormonal changes that occur during perimenopause and menopause can significantly affect cholesterol levels, potentially increasing the risk of heart disease. However, by adopting a heart-healthy lifestyle, staying active, and monitoring cholesterol levels, women can take control of their health during this life stage and reduce the risk of cardiovascular issues. Always consult with a healthcare professional to discuss the best strategies for managing cholesterol and supporting long-term well-being.

As I conclude, know that you are not alone on this path to better health and wellness. Your journey is unique but together we form a community of strength and support.

Let’s thrive together,

Cristina x