Cholesterol, Hormones, and Heart Health

September is National Cholesterol Education Month. Maintaining a healthy cholesterol level is a very important preventive health action for women of every age! High cholesterol is a main risk factor for stroke and heart disease. The body needs cholesterol, but when there is too much, fatty deposits can build up on the insides of blood vessels. Blockage in your arteries can lead to heart attack or stroke.

Only about 25% of your total cholesterol comes from the foods you eat (meat and dairy). Your body also makes cholesterol and packages it into little particles called lipoproteins so it can move through the blood. There are two types of particles, high-density and low-density lipoproteins (HDL and LDL). Very simply, HDL is the good one and LDL is the bad one. The ratio of HDL to LDL in your blood affects your risk for cholesterol-related health problems. Both your diet and your family history influence this ratio.

What do women need to know about controlling cholesterol?

For women of childbearing age:

Estrogen helps to protect blood vessels—keeping them more relaxed and elastic so that blood flows freely. Even though pre-menopausal women have this protection, newer medical research tells us that high cholesterol levels during these years influence your long term risk of cardiovascular disease more than we previously thought.  A young woman should begin a lifetime habit of having her cholesterol checked every five years. She should discuss family risk factors with her doctor. Risk factors may suggest the need for more frequent cholesterol screening.

After menopause:

When a woman’s estrogen levels decline (either through natural menopause or because of surgery to remove her ovaries), her blood vessels lose its protective benefit.  What’s more, the effects of unhealthy habits like smoking, poor diet, excess weight, or sedentary lifestyle have now accumulated over several decades. During menopause, your doctor may recommend that you have your cholesterol checked more frequently. You can be sure that, even after years of smoking, struggles with weight, poor diet or little exercise, you will notice real wellness improvements if you take positive steps for one or more of these problems.

What about hormone replacement? More research is needed for this important women’s health issue. Health statistics indicate that, once a woman loses the protective effect of estrogen, her risk of heart disease increases. But we do not yet have the conclusive research to advise a menopausal woman that hormone replacement therapy (HRT) will reduce her heart-related risk or extend her life. The subject is controversial and changes may come.  We do know that women who have been in menopause for a number of years should not begin HRT without considering the increased risk of this decision. When a woman has been without the protective effect of estrogen through five or more years of menopause, the chance is greater that changes in her arteries have already started to occur. Beginning HRT at this point could increase her risk of a serious heart problem or stroke. We can help you to make an informed decision about HRT by taking into account all of its potential benefits and risks along with your individual and family history.

Managing cholesterol for women of every age:

  • Get cholesterol screenings as your doctor recommends (at least every 5 years)
  • Limit saturated fats (animal fats and fats from tropical oils like coconut or palm), and especially avoid trans-fats, which raise your bad cholesterol and lower the good.
  • Eating poly-unsaturated fats can also help to lower your cholesterol, although the amount you choose should fit into your total weight management plan.
  • Dietary fiber can lower your cholesterol
  • If you are overweight, losing weight can help to reduce your cholesterol. Physical activity can also improve your cholesterol numbers.
  • Work hard to quit smoking. Ask us about resources to help you.

Wishing you a beautiful fall and many healthy years!