Menopause & Cholesterol
Why Your Cholesterol Can Rise and What You Can Do
If your cholesterol has gone up during your 40s or 50s, you might be wondering what's changed.
You may be eating the same foods, exercising just as much and living much as you did before. The answer could, at least partly, be menopause.
As you move through perimenopause and menopause, changing hormone levels can affect the way your body manages cholesterol. LDL cholesterol can rise, and the overall balance of cholesterol in your blood can become less favourable. heartuk.org.uk, bhf.org.uk
So, if you've recently received an unexpectedly high cholesterol result, it isn't necessarily because you've done anything wrong.
Understanding what's happening is a good first step towards doing something about it.
Does Menopause Cause High Cholesterol?
Menopause can contribute to rising cholesterol levels.
One reason is the decline in the hormone oestrogen.
Before menopause, oestrogen has beneficial effects on the heart and blood vessels and helps regulate cholesterol. As oestrogen levels fluctuate during perimenopause and eventually fall, this protection changes. bhf.org.uk, heartuk.org.uk
As a result:
- LDL cholesterol can rise. This is the type commonly referred to as "bad" cholesterol. heartuk.org.uk
- HDL cholesterol may also rise, but this doesn't necessarily mean the overall cholesterol picture has improved. The balance between HDL and non-HDL cholesterol can become less healthy. heartuk.org.uk
- Other cardiovascular risk factors may change too, including blood pressure, blood sugar control, body composition and where fat is stored. bhf.org.uk, womens-health-concern.org
That's why menopause is an important time to start paying more attention to heart health, not just hot flushes.
Can Cholesterol Rise During Perimenopause?
Yes. You don't need to wait until after your final period for changes to begin.
Perimenopause is the transition leading up to menopause, when hormone levels begin fluctuating and symptoms such as changes to periods, hot flushes or sleep disruption may appear.
Your oestrogen levels are already changing during this transition, and cardiovascular risk factors can change alongside them. bhf.org.uk, heartuk.org.uk
So, if you're perimenopausal and your cholesterol result is different from a few years ago, it's worth discussing the change with your healthcare professional.
Why Has My Cholesterol Suddenly Gone Up During Menopause?
This is perhaps the most important question on this page.
A higher cholesterol result doesn't necessarily mean your lifestyle has become less healthy.
Hormonal changes are one possible reason, but they're not the only factor.
Cholesterol can also be influenced by:
- Your age
- Genetics and family history
- DietPhysical activity
- Weight and body composition
- Smoking
- Alcohol
- Certain health conditions
- Some medicines
Menopause itself can also be accompanied by changes in weight, particularly around the waist, blood pressure and blood sugar control. bhf.org.uk, heartuk.org.uk
The important thing is not to blame yourself. Treat your cholesterol result as useful information about what your body needs now.
Is High Cholesterol a Symptom of Menopause?
Not in the same way as hot flushes, night sweats or changes to your periods.
You can't usually feel high cholesterol.
That makes it different from many of the menopause changes you may already be noticing.
The hormonal changes associated with menopause can contribute to changing cholesterol levels, but high cholesterol itself usually doesn't cause symptoms.
That's why a blood test matters.
Should I Get My Cholesterol Checked During Menopause?
If you're going through perimenopause or menopause and don't know your cholesterol level, it's worth discussing your cardiovascular health with a healthcare professional.
This is especially important if you have other risk factors, such as:
- A family history of high cholesterol or cardiovascular disease
- High blood pressure
- Diabetes
- Smoking
- Excess weight
- Previous cardiovascular problems
- Early or premature menopause
Early menopause is associated with increased cardiovascular risk, making awareness of heart health particularly important for those affected. heartuk.org.uk
A cholesterol test may include several measurements, such as total cholesterol, HDL, non-HDL, LDL and triglycerides. Your healthcare professional can interpret these alongside your wider cardiovascular risk rather than focusing on a single number.
Understanding your cholesterol results
How Can I Lower My Cholesterol During Menopause?
Menopause is something you can't control, but there are plenty of heart-healthy habits you can influence.
And you don't need to completely reinvent the way you live.
1. Make the Fat Swap
Rather than trying to eliminate fat, focus on replacing foods high in saturated fat with foods containing healthier unsaturated fats.
For example:
- Butter or ghee → vegetable oil-based spreads
- Fatty processed meat → fish, beans or pulses
- Biscuits or pastries → unsalted nuts or other lower-saturated-fat choices
- Cooking fats high in saturated fat → olive or rapeseed oil
Making these swaps can form an important part of a cholesterol-lowering diet.
2. Put More Fibre on Your Plate
Try including more:
- Oats and barley
- Wholegrains
- Beans and lentils
- Fruit and vegetables
- Nuts and seeds
You don't have to eat perfectly. Think about what you can add or swap, not just what you need to take away.
3. Keep Moving
Regular physical activity is valuable for cholesterol, blood pressure, weight management and wider cardiovascular health.
Walking, cycling, swimming, dancing or strength-based activities can all form part of an active lifestyle.
Pick something you actually enjoy. Consistency beats perfection.
4. Don't Ignore Your Wider Heart Health
Menopause isn't only about cholesterol.
Changes in blood pressure, blood sugar and where the body stores fat can occur during the menopausal transition too. [bhf.org.uk], [womens-health-concern.org]
That's why it's worth thinking about your heart health as a whole rather than trying to improve one cholesterol number in isolation.
5. If You Need to Lower Your Cholesterol, Consider Plant Sterols
Plant sterols help reduce the absorption of cholesterol from the gut.
Foods with added plant sterols, such as ProActiv® spreads, can therefore be incorporated into a healthy diet by people who need to lower their cholesterol.
What are plant sterols and how do they work?
Does HRT Lower Cholesterol?
Hormone replacement therapy (HRT) is primarily used to manage menopause symptoms, and the appropriate treatment and its benefits and risks vary between individuals and types of HRT. NICE's updated menopause guidance considers cardiovascular outcomes as part of personalised discussions about HRT. nice.org.uk, nice.org.uk
HRT can affect cholesterol and other cardiovascular markers, but it shouldn't be treated as a cholesterol-lowering treatment or started simply to lower cholesterol.
If you're considering HRT, taking cholesterol-lowering medicine or have an existing cardiovascular condition, talk to your healthcare professional about your individual circumstances. The latest professional guidance emphasises an individual assessment of cardiovascular risk when discussing HRT. thebms.org.uk, nice.org.uk
Can I Take Statins During Menopause?
Some people will be able to manage elevated cholesterol through diet and lifestyle changes, while others may also need cholesterol-lowering medication.
Whether medication is appropriate depends on your cholesterol results and overall cardiovascular risk, rather than menopause alone.
If you've been prescribed a statin, don't stop or change your medication without discussing it with your healthcare professional.
What to do if your cholesterol is high
"Nothing Else Has Changed. Why Has My Cholesterol?"
If there's one message to take away from this article, it's this:
Menopause changes more than your periods. It can change your cholesterol too.
For many women, an unexpected cholesterol result in midlife may feel unfair. You've eaten well. You've stayed reasonably active. Perhaps your weight hasn't changed significantly. So why should your cholesterol suddenly be higher?
Your hormones are part of your health too.
As oestrogen declines, cholesterol and other aspects of cardiovascular health can change. bhf.org.uk, heartuk.org.uk
Your higher number isn't a failure.
It's information.
And once you know about it, you can decide what to do next.
The Bottom Line
Menopause and cholesterol are connected.
Changes in oestrogen during perimenopause and menopause can contribute to higher LDL cholesterol and changes in your overall cholesterol profile. Other cardiovascular risk factors can shift during this stage of life too. bhf.org.uk, heartuk.org.uk
That doesn't mean heart problems are inevitable.
Think of menopause as an opportunity to check in with your heart health:
Know your numbers.
Understand what's changing.
Make small changes you can maintain.
Talk to your healthcare professional about your individual risk.
If you need to lower your cholesterol, explore our practical guides to cholesterol-lowering food swaps, heart-healthy recipes and how plant sterols work.
