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Menopause and cholesterol: why it matters for heart health

Menopause and cholesterol: why it matters for heart health

Menopause is a natural stage of life, but it often comes with changes that affect heart health. One of the biggest shifts is in cholesterol levels, which can rise when oestrogen levels fall. Higher cholesterol increases the risk of heart and circulation problems, making it important to understand and manage these changes.

Many women may not realise that heart disease risk increases after menopause, and symptoms can be overlooked. Knowing your numbers, including cholesterol levels, can give a clearer picture of your health. At-home testing makes it easier to check your cholesterol and take steps early.

Why menopause affects cholesterol

Oestrogen has a protective role in the body, supporting blood vessels and helping keep cholesterol in balance. During menopause, when oestrogen levels decline, this protective effect reduces.

This can lead to:

  • Higher LDL cholesterol (the “bad” type that can build up in arteries)
  • Lower HDL cholesterol (the “good” type that helps remove excess cholesterol)
  • Increased triglycerides (a type of blood fat linked with heart risk)

Weight gain around the waist is also common after menopause. This central weight increases the risk of problems with your cardiovascular system (heart and blood vessels), including high cholesterol, high blood pressure and type 2 diabetes.

Cholesterol and heart health in women

Cholesterol is a fatty substance in the blood. The body needs some cholesterol to function, but when levels are too high it can build up in the arteries. This build-up restricts blood flow and increases the risk of heart problems.

There are four main markers to look at. LDL cholesterol is the type most likely to cause build-up in arteries if levels are too high. HDL cholesterol helps remove excess cholesterol from the blood, so higher levels of this type are protective. Triglycerides are another kind of blood fat, and having too much can be harmful. Total cholesterol refers to your overall level of cholesterol, and is calculated from your HDL, LDL and triglyceride readings.

After menopause, cholesterol levels can change without causing any obvious symptoms. Because you can’t “feel” high cholesterol, checking your numbers regularly becomes even more important.

Risk factors after menopause

Cholesterol changes after menopause combine with other risks, including:

  • Family history of high cholesterol or heart disease
  • Being overweight
  • High blood pressure
  • Diabetes
  • Smoking
  • Low activity levels

If you already had risk factors before menopause, the hormonal changes may compound them. Being aware of these risks helps you make targeted lifestyle changes.

Lifestyle steps to support heart health

Simple daily choices can make a big difference in keeping cholesterol under control. These include:

  • Eating a balanced diet: Choose more wholegrains, fruit, vegetables, beans and pulses. Cut back on foods high in saturated fat like fatty meat, butter and pastries. Swap for healthier fats such as olive oil, nuts and seeds
  • Adding more fibre: Oats, beans, lentils and fruit can help lower cholesterol
  • Including heart-friendly foods: Oily fish, soya foods, and plant stanols/sterols can help keep cholesterol in check
  • Staying active: Aim for at least 150 minutes of brisk walking, swimming or cycling each week. Add some strength training for extra benefit
  • Limiting alcohol and quitting smoking: Both can worsen cholesterol levels and heart strain
  • Managing stress and sleep: Poor sleep and high stress can affect weight, activity and food choices, indirectly raising risk

The role of at-home cholesterol testing

High cholesterol usually has no symptoms, and the only way to know your levels is through a blood test. Regular checks are especially recommended after menopause, when hormonal shifts often affect cholesterol.

MyHealthChecked’s Cholesterol Profile Blood Test is a simple finger-prick test you complete at home. Once your sample arrives at the UK-based laboratory, you can expect clear, GP-reviewed results within 2–3 working days. This quick turnaround means you're not waiting weeks to understand your numbers.

The test measures four essential markers: total cholesterol, LDL (the “bad” cholesterol), HDL (the “good” cholesterol), and triglycerides. These combine to provide a full picture of your heart health. The report comes with easy-to-understand explanations and personalised recommendations based on what you’d like to address (such as diet or activity changes) or whether to discuss results further with your GP.

When to speak to a doctor

While at-home testing is useful, there are times when speaking with your doctor is important. If your cholesterol results are consistently high, it is worth booking an appointment. A strong family history of heart problems is another reason to seek medical advice, as is having other health conditions such as diabetes or high blood pressure.

It is also sensible to contact your GP if you notice any concerning symptoms, including chest discomfort, unusual shortness of breath, or feeling more tired than normal. These could point to an issue worth checking further.

In summary

Menopause is a key time for heart health, with cholesterol changes playing a major role. Falling oestrogen can lead to higher LDL, lower HDL and rising triglycerides. Combined with weight gain and other lifestyle factors, this can raise the risk of heart problems. The good news is that daily choices – eating more fibre, cutting back on saturated fat, moving more, sleeping well and reducing stress – can all make a difference.

Checking your cholesterol regularly is the only way to know your numbers. With MyHealthChecked’s Cholesterol Profile Blood Test, you can monitor your heart health and take action early to protect your future wellbeing.

Reviewed by Dr Dave Nichols

References

1. British Dietetic Association. Eating well for the perimenopause and menopause. BDA; 2021. :https://www.bda.uk.com/resource/menopause-diet.html

2. British Dietetic Association. Top ten nutrition tips for the menopause. BDA; 2020. https://www.bda.uk.com/resource/top-ten-nutrition-tips-for-the-menopause.html

3. British Dietetic Association. Diet and the menopause: key facts. BDA; 2020. https://www.bda.uk.com/resource/diet-and-the-menopause.html

4. British Dietetic Association. Cholesterol – Lowering your cholesterol with diet. BDA; 2020. https://www.bda.uk.com/resource/cholesterol.html

5. British Heart Foundation. High cholesterol – symptoms, causes and levels. BHF; 2022. https://www.bhf.org.uk/informationsupport/risk-factors/high-cholesterol

6. British Heart Foundation. Menopause and your heart. BHF; 1 Oct 2023. https://www.bhf.org.uk/informationsupport/support/women-with-a-heart-condition/menopause-and-heart-disease

7. Heart (BMJ). Age of menopause, healthy lifestyle and cardiovascular health. Heart. 2025;111(6):262. https://heart.bmj.com/content/111/6/262

8. Ryćzkowska K, Janikowski T, Banach M. Menopause and women's cardiovascular health: is it really an obvious relationship? Arch Med Sci. 2022;19(2):157–308. doi:10.5114/aoms/157308.