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The Link Between Menopause and Cholesterol Levels

Edited By: Shai K.

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Hot flashes, sleep problems, and mood changes are common symptoms during menopause, and along with them comes another dangerous symptom that many are not aware of, which is an increase in cholesterol levels. High cholesterol levels increase the risk of heart disease and stroke, and menopause itself is associated with an increased risk of heart disease due to numerous changes occurring in the body. However, it is possible to maintain a healthy heart during menopause if you understand how it affects cholesterol levels and how to address these changes. That’s what we’ll help you do now.

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The Connection Between Menopause and Cholesterol

Bad cholesterol (LDL) and good cholesterol (HDL) play many roles in the body (even influencing each other), and to perform these roles, they rely on special receptors that transport them from the bloodstream into cells, which is necessary for them to do their job. Estrogen is a hormone that helps LDL receptors function efficiently, and when estrogen levels drop due to menopause, these receptors work much less effectively, allowing high LDL levels to remain in the bloodstream.

How to Prevent High Cholesterol During Menopause: Cholesterol in the Blood

At the same time, HDL levels decrease as estrogen levels decline. HDL’s role is to transport excess cholesterol from the blood and body back to the liver. A decrease in HDL levels, which sometimes occurs during menopause due to the drop in estrogen, makes it harder for the body to get rid of excess cholesterol – and therefore, LDL levels may remain higher for longer.

During menopause, a phenomenon called "muscle wasting" also occurs, and this is another issue that affects cholesterol levels. Muscles help the body use glucose (blood sugar) and fats, and as muscle mass decreases, the body becomes less able to manage blood sugar and fat levels, leading to impaired HDL function and higher LDL levels.

Additionally, many women struggle to maintain a healthy weight during menopause, and excess weight can affect cholesterol levels because it leads to insulin resistance. When the body develops insulin resistance, it requires more insulin to regulate blood sugar levels, which results in an increase in LDL and fat levels.

What Changes Should Be Made to Prevent Cholesterol Increase?

There are things you cannot change on your own right now, such as the decline in estrogen levels, but there are some things you can control, like your diet. In general, a Mediterranean diet is recommended, as well as avoiding processed foods and those high in sugar. You should consume more fiber, omega-3 fatty acids, antioxidants, and plant sterols, and here are some sources for these that are recommended to include in your diet:

Beans and legumes
Green leafy vegetables
Fruits
Nuts and seeds
Whole grains
Fatty fish like salmon and tuna

How to Prevent High Cholesterol During Menopause: Mediterranean Diet

In particular, it appears that consuming more mangoes is recommended, as a new study published in 2025 found that two servings of mangoes a day help maintain heart health during menopause. At the same time, you should ensure you engage in at least 150 minutes of aerobic activity per week and strength training 2-3 times a week, as well as learn how to manage stress levels, quit smoking, and reduce alcohol consumption.

Are There Treatments That Help Reduce Cholesterol During Menopause?

In addition to the changes we recommended, you should consult a doctor to understand whether any medical treatment is needed to manage cholesterol levels. They may recommend statins, which are the most common medication for treating cholesterol and help slow its production in the body and remove it through the liver. Additionally, there are other medications your doctor might suggest, such as cholesterol absorption inhibitors, PCSK9 inhibitors, fibrates, and more.

There are also hormonal treatments that help alleviate other menopausal symptoms, and they have some effect on cholesterol levels, though minimal. Furthermore, it may be recommended to start taking certain dietary supplements, such as:

Plant sterols: These are natural compounds found in plants that reduce cholesterol levels, but they may cause diarrhea, so it’s important to be aware of this.
Berberine: This is a natural compound found in plants that reduces LDL and triglyceride levels, but it may also cause diarrhea and even vomiting.
Ground flaxseed: May reduce LDL levels and provide the body with fiber and omega-3.
Green tea leaf extract: Helps reduce LDL levels.

How to Prevent High Cholesterol During Menopause: Doctor Visit

In Summary

Menopause brings with it unpleasant symptoms and dangers to heart and blood vessel health. One of the critical factors is cholesterol, whose levels rise due to various phenomena associated with menopause, making it important to know how to reduce them. The key lies in proper nutrition, with an emphasis on a Mediterranean diet, and physical activity, but lifestyle changes alone are not enough to fully address the issue.

You should consult your doctor for appropriate treatment to manage the rising cholesterol levels in your body, and the fact that you’ve become aware of this is already the first and most important step. So, share this article with your friends who are going through menopause so they too can learn about the danger and what they need to do now to avoid it. This could truly save their lives.

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