Among the dozens of symptoms associated with the onset of perimenopause and menopause, some women experience a rise in their cholesterol levels. High cholesterol is one of the major risk factors for heart and cardiovascular disease, so it’s important for women to understand the relationship between menopause and high cholesterol.

What is high cholesterol?

High cholesterol is a condition in which the waxy substance called cholesterol accumulates as fatty deposits in the blood vessels. Over time, these deposits can interfere with blood flow as well as break off and form clots that can result in a stroke or heart attack. 

Read about the link between heart health and menopause

The two main types of cholesterol, which are transported in your blood on lipoproteins, are low-density lipoprotein (LDL, or “bad”) cholesterol and high-density lipoprotein (HDL, or “good”) cholesterol. If you have high levels of LDL in your blood, you also have deposits of plaque that can lead to a stroke, heart attack, or other health problems. High levels of HDL cholesterol, however, may reduce your health risks. That’s because it can transport plaque and cholesterol from your blood vessels to your liver, where it can be flushed out of your body.

Good cholesterol is also closely associated with triglycerides, another type of fat found in the bloodstream. Individuals with high triglycerides often have low HDL. To determine your triglyceride-to-HDL ratio, divide your triglyceride level by your HDL level. A healthy ratio is 2 or less. A ratio of 4 is high and 6 or greater is very high.

How is high cholesterol associated with menopause?

One role of estrogen in the body is to regulate the breakdown of lipids (e.g., cholesterol, triglycerides) in the liver. When estrogen levels decline, the result is an increase in LDL cholesterol and triglycerides.

A 2020 research study has shown that levels of LDL, cholesterol, and total cholesterol are much higher among women after menopause than women in perimenopause and menopause. It’s also been noted by the Australasian Menopause Society that women who start menopause early are twice as likely to develop heart disease when compared with women of a similar age who have not entered it yet.

How to lower high cholesterol naturally

Although many doctors may recommend taking prescription medications to lower cholesterol, there are both lifestyle and dietary changes that can make a significant difference in bringing cholesterol levels down. Consider these tips.

Watch your fats. Minimize your intake of saturated fats (meat, dairy, many processed foods) and focus instead on monounsaturated fats found in avocados, olive oil, and tree nuts. These healthy fats can help reduce LDL cholesterol, raise HDL cholesterol, and put the brakes on oxidation, which contributes to clogged arteries. Also include omega-3 fatty acids from cold water fish or fish oil supplements in your diet.

Read about omega-3 fatty acids vital for women’s health

Feast on fiber. Experts have shown that foods rich in soluble fiber, such as whole grains, beans, fruit, lentils, and various vegetables, lower LDL and total cholesterol and don’t decrease HDL levels. Be sure to include fiber at every meal. If you don’t get the 25 to 30 grams of fiber recommended daily, take a fiber supplement.

Enjoy exercise. Routine exercise, especially activities that raise your heart rate to 85 percent of your maximum rate, can lower LDL and increase HDL cholesterol, according to researchers. The longer you exercise—and the activities can include aerobic, strength, and resistance training—the more you will benefit.

Consider supplements. Several supplements may help lower cholesterol levels, including fish oil, coenzyme Q10, and psyllium (fiber). In a three-month study, older adults with high cholesterol were given either a soybean oil supplement or one with fish oil, coenzyme Q10, lycopene, vitamins E, B6, and B12. Participants who took the fish oil supplement had a reduction in total and LDL cholesterol as well as blood pressure. 

Go with garlic. A 2022 review of 22 studies reported that garlic can be an effective way to lower LDL and total cholesterol. The reviewers found that a lower dosage and taking garlic for a prolonged produced more noticeable results.  

Bottom line

High cholesterol is a significant risk factor for heart disease and stroke and thus a concern among women in perimenopause and menopause, who have a higher chance of experiencing these health events. Lifestyle and dietary changes can help reduce cholesterol and thus the risk of heart and stroke issues.