Written by Dr. Sudarshan Cheral

Medically reviewed by Dr Godmi Tresa

Updated on February 12, 2025

Cholesterol Levels and Menopause: What's the Relationship? 

What is the link between menopause and cholesterol levels? What are the effects of menopause on lipid profile? Can your cholesterol level increase during menopause? If the answer is 'yes', you might be eager to know the reason, isn't that so? 

Okay, let us explore this more. 

The influence of menopause on blood cholesterol levels in women is significant. Your cholesterol levels can increase during or after menopause due to reduced levels of oestrogen production. Oestrogen helps regulate cholesterol levels.

In this blog, you will read about the relationship between menopause and cholesterol levels. Also, you will understand how the menopause contributes to increased cholesterol. 

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Menopause is a natural life stage which is uncomfortable and causes some symptoms which are difficult to cope with. Hot flashes, poor sleep, vaginal dryness, night sweats, mood changes, and a slower metabolism are common during menopause. In addition to these symptoms, it may also pose some health risks, including an increased risk of heart disease. The increased risk of heart disease is mainly due to variations in cholesterol levels that happen due to hormonal changes that happen during menopause.

How Menopause Affects Cholesterol Levels

Cholesterol is a waxy, fat-like substance produced in the body. Depending on the lipoprotein that carries it, it falls into two categories: 

  • Low-density lipoprotein (LDL) cholesterol.
  • High-density lipoprotein (HDL) cholesterol.

Hormonal changes cause most of the health challenges that occur during menopause. Menopause can lead to changes in hormone levels and metabolism, which contribute to altering one's lipid profile.

  • During menopause, your ovaries produce less oestrogen. Oestrogen helps the liver regulate lipid metabolism and maintain a healthy lipid profile. When menopause begins and oestrogen levels decrease, your body's ability to maintain that healthy lipid profile gets affected, which can lead to increases in cholesterol.
  • Oestrogen and heart health are closely linked, as oestrogen has a role in maintaining cholesterol levels. It has a protective action against heart disease before menopause. So, a decrease in oestrogen levels may increase certain health risks. 

According to a study, women who attain menopause early are twice as likely to develop heart disease compared with women who have not yet entered menopause at that age. 

A high level of LDL cholesterol and triglycerides can increase the risk of heart disease.

Key Changes in Cholesterol During Menopause

If you ask what happens to cholesterol levels during menopause, the answer is simple – "they go up"

Yes, your cholesterol levels go up during menopause as the hormone estrogen decreases. Hormonal imbalances and changes in metabolism during menopause can cause a difference in your lipid values.

Estrogen acts on the liver to regulate lipid metabolism and maintain a healthy lipid profile. But when estrogen levels drop, it affects the liver's regulatory function over lipid metabolism. This leads to an increase in LDL or bad cholesterol and triglycerides and a decrease in high-density lipoprotein or good cholesterol.

Why Cholesterol Levels Matter During Menopause

Menopause and cardiovascular health are related. The main reason you should be concerned about your cholesterol levels during menopause is its influence on increased cardiovascular risks. As discussed earlier, decreased oestrogen levels during menopause cause disturbance in the lipid profile. A drop in oestrogen level affects your liver's ability to regulate lipid metabolism and maintain a healthy lipid profile. This, in turn, impairs the lipid profile. Specifically, it increases LDL hormone and triglycerides.

Total cholesterol, LDL cholesterol, and triglyceride levels will be much higher after menopause. And it will cause a reduction in HDL cholesterol. High cholesterol usually doesn't show any symptoms, and you may realise it only after experiencing cardiovascular issues.

Therefore, testing your lipid profile is a must at least once every six to twelve months, especially when you attain menopause

An increase in the level of lipids, including LDL cholesterol and triglycerides, can increase the risk of heart disease.

Factors That Influence Cholesterol Changes During Menopause

Even though the decrease in oestrogen hormone is the main reason for your cholesterol levels to fluctuate during menopause, there are other factors that can also affect your cholesterol levels. Generally, when we look at the factors that cause cholesterol levels to rise in the body, we find various reasons. Similar is the case with menopausal cholesterol variations. Here is the list of factors that can affect your cholesterol level during menopause:

  • Obesity: It is linked to higher triglyceride levels, higher LDL cholesterol levels, and decreased HDL cholesterol. 
  • Diseases like Type 2 diabetes and hypothyroidism: Lowers high-density lipoprotein levels and raises low-density lipoprotein levels. 
  • Familial hypercholesterolemia: If someone in your blood relatives has high cholesterol, meaning you have a family history of high cholesterol, you are more likely to have high cholesterol.
  • Smoking: Smoking can lower high-density lipoprotein cholesterol levels. 
  • Mental stress: Stress triggers hormonal changes that cause your body to produce more cholesterol.
  • Diet: Certain types of foods can raise or lower your cholesterol levels. 

How to Manage Cholesterol Levels During Menopause

Managing cholesterol during menopause demands some changes in your routine. Lifestyle modification is the best natural way to lower cholesterol levels during menopause and at any stage of life. Here are some tips for the management of hypercholesterolaemia during menopause:

  • When you consider lifestyle, diet plays a significant role. Some foods can help reduce cholesterol. 
  • You must increase your intake of soluble fibre. Fibre can bind to cholesterol and eliminate it through stools. Consume fibre-rich foods such as legumes like beans, edamame, chickpeas, peas, and lentils, whole grains like barley and oats, and fresh fruits and vegetables like apples and carrots. You can also consume fibre supplements like psyllium.
  • Consume foods high in omega-3 fatty acids, such as salmon, walnuts, ground flax, olive oil, and avocado, which can help lower cholesterol levels. 
  • Reduce your intake of saturated fat from sources like red meat, high-fat dairy, and butter, which can increase LDL cholesterol levels.
  • Obesity raises LDL cholesterol levels in the body. So, maintaining a moderate body weight can help prevent high cholesterol.
  • Physical exercise is highly beneficial for heart health. Moderate-intensity aerobic activity and strength training also help reduce cholesterol levels.
  • Smoking can increase LDL cholesterol and decrease HDL cholesterol in the body. It is a significant risk factor for heart disease. If you smoke, try your level best to quit smoking.

While some people can lower their cholesterol levels through lifestyle changes, others may require medication. Statins are the main cholesterol-lowering drugs. They lower LDL cholesterol levels by reducing the body's production of cholesterol and increasing the liver's ability to remove LDL cholesterol from the blood. 

Your doctor may also recommend hormone replacement therapy (HRT) to lower cholesterol levels. Studies have shown that hormone replacement therapy (HRT) can help lower LDL cholesterol levels after menopause.

Additional Tips for Women Going Through Menopause

Menopause is a natural, inevitable stage in your life. But facing the challenges of menopause may be difficult for you. Here are some tips to help you effectively manage your menopausal challenges:

  • Eat lots of fruit and vegetables: Intake of more fruits and vegetables can help prevent several symptoms of menopause. Consumption of fruits and vegetables helps prevent several diseases, including heart disease.
  • Avoid trigger foods: Some foods may trigger hot flashes, night sweats, and mood changes. Avoid those foods that trigger your menopause symptoms, or try to reduce your consumption.
  • Exercise regularly: Regular physical exercise improves energy and metabolism, improves joints and bone health, decreases stress, and induces better sleep.
  • Consume phytoestrogens-rich foods: Phytoestrogens are naturally occurring plant compounds that have a slight estrogen-like effect on your body, helping to balance hormones to some extent.
  • Drink enough water: Staying hydrated by consuming sufficient water or other liquids helps you overcome dryness issues caused by a lack of oestrogen.
  • Don't skip meals: Eating on time is an important part of your menopause journey. Irregular eating can worsen some of the symptoms of menopause and make weight management a difficult task.

Wrapping Up

During menopause, your body may have difficulty regulating cholesterol and other lipids as estrogen levels drop. However, making some lifestyle changes during menopause can help reduce your risk of heart disease.

Having too much cholesterol in your body may not cause any symptoms. But it can lead to serious health problems like heart disease, heart attack, and stroke. So, you should undergo a periodic screening test to determine your cholesterol level.

If you are in menopause and your cholesterol level is elevated, Nirva's healthcare team is always ready to help. We provide customised plans to overcome the difficulties caused by your hormonal imbalance and to manage your cholesterol to lower the cardiovascular risk factors.

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Dr. Sudarshan Cheral

Dr Sudarshan Cheral is an Ayurveda practitioner with over 9 years of rich clinical experience. Also, as an experienced Ayurveda medical writer with more than 4 years in the field, he has skillfully contributed to Ayurveda literature, assisting in writing 4 books and translating 2 essential texts. Dr. Sudarshan is deeply committed to the art of teaching and has guided numerous international students on their journey to mastering Ayurveda.