Your estrogen levels decline and eventually drop off during and after menopause. And aside from the physical changes you might notice during this time, there are biological changes that are important to be aware of as well.
Estrogen has the unique quality of providing extra protection to a woman’s heart. It keeps your blood flowing smoothly and balances your cholesterol levels. However, declining estrogen during menopause can lead to leave your heart more vulnerable and at risk for many unfavorable cholesterol changes.
“Menopause is a critical window to assess your cholesterol levels,” says Jelena Arnautovic, D.O., a cardiologist at Henry Ford Health. “During this time, it is normal to see a rise in bad cholesterol levels and stagnant good cholesterol levels as the result of estrogen changes.”
For many women, this dramatic health shift can be startling – even depressing. While some may want to minimize these symptoms or think that they will go away on their own, ignoring cholesterol changes means your risk for a major heart event can develop silently and unchecked.
Here, Dr. Arnautovic shares how you can be prepared for menopause-related cholesterol changes and how your health care team can help.
Establishing A Baseline For Your Cholesterol
Unfortunately, many women don’t see providers to assess their cholesterol before age 40. However, it is now recommended that women begin paying attention to their cholesterol levels – and begin routine cholesterol screenings – in their early 20s.
Women's Heart Center
“Monitoring cholesterol should start early in life to establish a baseline,” says Dr. Arnautovic. “This allows providers to identify patients that may be at greater risk for heart disease, the leading cause of death in women, sooner. It also gives us the opportunity to educate women on what to expect for their heart health during menopause so there are no surprises when things change.”
Your cholesterol levels should continue to be monitored throughout life knowing that many reproductive-related factors can increase your risk for heart disease including:
- Eclampsia
- Pre-eclampsia
- Gestational diabetes
- Gestational hypertension
- Preterm birth
While women should direct questions about their heart health to their OB/GYN during pregnancy, it is important that they still schedule regular appointments with a primary care provider to assess their cholesterol levels over time. If there is concern, your provider will refer you to a cardiologist for additional support.
Making Cholesterol Management A Priority For Women
Women often go through perimenopause and menopause during a time in life when they are referred to as “the sandwich generation.” This refers to the fact that many women are positioned having to care for aging parents and their own children at the same time.
“Finding the time to take care of yourself becomes less of a priority when you are caring for everyone else, but it is especially important that you are talking with your doctor about how you can manage changes in your cholesterol,” says Dr. Arnautovic.
This includes:
- Knowing your numbers. While it is great to know your cholesterol levels, talk with your provider so you have a better understanding of what is considered normal or within a healthy range.
- Focusing on diet. Adopting a Mediterranean-style diet is key – prioritizing healthy fats, lean proteins, whole grains, fruits and vegetables while limiting saturated fats, processed foods and added sugars.
- Changing how you exercise. Aerobic exercise is excellent for improving good cholesterol levels. Dr. Arnautovic recommends that women also add in strength training during menopause to help soften the effects the drop in estrogen has on your body.
- Cutting out smoking and alcohol. Not only can tobacco and alcohol use make menopause symptoms worse, but they cause bodily inflammation that can impact your cholesterol levels.
- Weighing your options for medication. Sometimes lifestyle changes aren’t enough to control cholesterol fluctuations during menopause. Relying on medication to balance your cholesterol isn’t a negative thing, but rather a helpful tool to get you back on track.
After the initial transition period of menopause is over, your cholesterol will likely level off, but without the protectively qualities that estrogen has on your heart, your risk for high cholesterol and heart disease will increase dramatically as you age.
“Be sure that you are continuing with heart healthy practices and regularly talk to your provider about resources to help you navigate cholesterol changes throughout life,” adds Dr. Arnautovic.
Reviewed by Dr. Jelena Arnautovic, a cardiologist who sees patients as part of the Women’s Health Center at Henry Ford Health.
