As we transition from our child-bearing years into menopause, the decreasing levels of estrogen pose a significant risk to our heart health. Prior to menopause, women's risk of heart disease is typically lower than men's. However, as we enter post-menopause, we often find ourselves on par with men, making cardiovascular disease, such as heart disease and stroke, the leading cause of death for both women and men. That's the bad news. The good news is that knowledge is power, and when we know where we stand, there are a lot of lifestyle changes (including medical interventions, if needed) we can utilize to manage the risk and set the foundation for a healthy future.
Understanding Cholesterol Levels
Cholesterol is a fatty substance in the blood, essential for building cells but potentially harmful in excess. It's categorized into:
LDL (Low-Density Lipoprotein): Known as "bad" cholesterol, high levels can lead to plaque buildup in arteries, causing arteriosclerosis.
HDL (High-Density Lipoprotein): Known as "good" cholesterol, it helps remove LDL cholesterol from the arteries.
Triglycerides: A type of fat in the blood. High levels can increase heart disease risk.
Optimal levels vary, but generally, lower LDL and higher HDL levels are desirable. The American Heart Association has a great number of downloadable resources you can use to go into a bit more detail.
Impact of Menopause on Cholesterol
Menopause can lead to unfavorable changes in cholesterol levels:
Increase in LDL Cholesterol: Estrogen helps maintain healthy cholesterol levels. As estrogen levels drop during menopause, LDL levels can rise.
Decrease in HDL Cholesterol: HDL levels may also decline, reducing the body's ability to remove LDL cholesterol.
These changes elevate the risk of heart disease, making it essential for us to monitor our cholesterol closely.
Lifestyle Changes for Managing Cholesterol
Whilst this trend may be daunting, there are a number of lifestyle changes we can implement to mitigate the risk.
Heart-Healthy Diet: Focus on a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats. Limit saturated and trans fats, which can raise cholesterol levels. Plant sterols and stanols (cholesterol-like compounds found in plant foods), may also help lower LDL cholesterol. Lastly, include Omega-3-Fatty Acids in your diet to help reduce triglycerides and overall improved lipid levels.
Exercise: Regular physical activity can help raise HDL levels and lower LDL levels. Aim for at least 150 min per week.
Weight Management: Maintaining a healthy weight can improve cholesterol levels.
Smoking Cessation: Quitting smoking can increase HDL levels and improve overall heart health.
Alcohol Moderation: Limiting alcohol intake can help manage cholesterol levels.
Stress Reduction: Chronic stress can affect cholesterol levels. Practicing relaxation techniques such as meditation, yoga, or deep breathing may be very beneficial.
Medication and Monitoring
For some women, lifestyle changes may not be enough, and medication may be necessary to manage cholesterol levels. Statins are commonly prescribed to lower LDL cholesterol. Regular check-ups are crucial - please talk with your doctor! In addition to keeping an eye on lipids, I also like to suggest a cardiac baseline when entering menopause - because: "Knowledge is power and gives us a choice in how we navigate this challenge!"
Hormone Replacement Therapy (HRT) may be considered for managing menopausal symptoms. Some older studies show a favorable impact, but recent studies suggest that HRT does not improve our cholesterol levels, unlike its positive impact on osteoporosis. Please discuss this with your healthcare provider.
In conclusion, by understanding the changes that occur during our transition and taking proactive steps through lifestyle changes and regular monitoring, we can manage our cholesterol levels and thereby reduce their risk of heart disease.
Further reading
This was a very high level look at cholesterol and menopause and if you'd like to dig a little deeper, here are some helpful links to increase your knowledge and therefore your ability to make the changes that will benefit you wellbeing & health in years to come!
From The Journal of The Menopause Society: "Lipid profile changes during the menopausal transition"
From Norton Healthcare: "Age, lifestyle and menopause can affect cholesterol levels for women"
From The American Heart Association: "Estrogen therapy in early menopause may help keep arteries clear"
From Medical News Today: "What is the link between menopause and cholesterol?"
In relation to the awareness of this increased risk for cardiovascular disease, I found this alarming statistic in an article in US Cardiology Review: "Sadly and surprisingly, awareness of this major health risk to women appears to be very low, with a recent survey showing that only 31% of healthcare professionals and 38% of women were aware that menopausal women are at an equal or greater risk of CVD than men, and that only 31% of women associate menopause with heart disease."