Menopause, Hormones & Cholesterol: What Women Need to Know

By Dr. Dr. Jenny Zhang

It’s common for many women to be surprised to find that their cholesterol levels are increasing during perimenopause, even if they have been maintaining a good diet and exercising regularly. But what’s behind the increase? 

The answer is hormones.

The Role of Estrogen in Heart Health

Estrogen has many benefits for the cardiovascular system. It helps to maintain healthy blood vessels, increase good cholesterol levels, regulate bad cholesterol levels, decrease inflammation, and increase insulin sensitivity. As a woman goes through perimenopause and eventually menopause, estrogen levels ebb and flow until they are no longer produced at all—and so do the benefits to the cardiovascular system.

Why Cholesterol Levels Tend to Rise After Age 40

As estrogen levels fall, we have seen increases in bad cholesterol levels, triglycerides, belly fat, and insulin resistance–even among women who are active and eat a healthy diet. It’s just what’s happening physiologically.

Cholesterol is Just Part of the Story

As naturopathic physicians, we dig deeper than the results of a standard lipid profile. Other tests might include fasting insulin levels, hemoglobin A1C, and an inflammatory marker known as hs-CRP. More in-depth lipid tests and thyroid hormone levels are also important in determining the underlying cause of high cholesterol.

Should Women Consider Hormone Therapy to Prevent Heart Disease?

This is another complex question. Hormone therapy in appropriately timed and initiated women who are considered to be at low risk of heart disease may have no effect or even positive effects on heart disease in some women. Hormone therapy is not used to treat heart disease. Hormone therapy is used to treat menopausal symptoms and prevent osteoporosis.

Natural Ways to Help Cholesterol Levels During Menopause

• Anti-inflammatory diets emphasizing fiber-rich vegetables, omega-3 fatty acids, beans, olive oil, and protein.

• Weight training to enhance insulin and lipid function.

• Sleep management to decrease inflammation and metabolic demands.

• Coping with stress to reduce cortisol-related cardiovascular risk.

• Supplements like omega-3 fatty acids, magnesium, CoQ10, soluble fiber, or plant sterols as needed.

When to Evaluate Your Heart Risk

Evaluate your need to test your heart risk if you are approaching perimenopause, have a family history of heart disease, have had pregnancy complications, notice your cholesterol levels rising, have gained weight around your middle, or have an autoimmune disorder. The menopausal years represent a metabolic change that requires proactive management.

The Takeaway

Menopause is a significant physiological event – and an opportunity. With strategic screening, hormone-smart care, and root-cause medicine, women can mitigate heart risks and promote well-being.

Schedule a wellness visit today and work with your healthcare provider to create a prevention plan tailored to you.

Your future self will thank you.