Cholesterol and menopause: the highs, the lows and the hormones

Helen Seymour is in Peri-Menopause, or at least she thinks she is. In her weekly column, we follow her on her journey towards the Menopause, learning as she does all about the big M.

Something incredible has happened. My cholesterol is down. The hardest thing in the world to get down, is down. And I am attributing it 100% to HRT.

Last October, before I started taking HRT, my cholesterol was 8.3. That’s a stroke waiting to happen. In January this year, having taken HRT for 3 months, it had dropped to 7. In February, it came down to 6.7. Pretty impressive, especially given that I haven’t changed my diet. The only thing I’ve done differently is taking HRT.

What is cholesterol?


Cholesterol is a type of fat that’s found in cell membranes throughout your body and in your bloodstream. It’s mainly made by the liver from saturated fat you get through your diet. And guess what? It also makes hormones. Not just sex hormones like oestrogen, progesterone and testosterone, but it also makes hormones for your thyroid, bones and pancreas. It helps build and repair cell walls; it helps brain function; it helps synthesise vitamin D; and it helps produce bile, which breaks down fats, which in turn helps push food through the digestive system, keeping our gut healthy. Wow. Who knew?

So if cholesterol’s so good, how can it also be so bad? For that precise and simple reason — bad cholesterol and good cholesterol. All of us have two types of cholesterol in our body:

  • HDL — the “good” cholesterol is the superhero who disposes of your LDL “bad” cholesterol. Deals with that stuff like a boss. Go HDL. We love you.
  • LDL — the “bad” cholesterol, is about as bad as bad guys get. LDL’s main power is that it causes plaque to build up in your arteries. This sticky stuff hardens, restricts the blood flow, and any one of the following nasty things can happen as a result — coronary heart disease, angina, heart attack, stroke, peripheral artery disease, vascular dementia.

Related: The Menopause Diaries: Is every successful woman over 50 on HRT?

I’m going to be really honest here. When I found out my cholesterol was 8.3 I didn’t really worry. Because I felt fine. So, therefore, I was fine, right? Wrong. High cholesterol doesn’t present any obvious symptoms at first. Then suddenly, you’re having a foot amputated because you’ve got peripheral artery disease. That’s when you realise 8.3 is more than just a number.

Menopause and cholesterol

As we get older, our cholesterol tends to rise a bit naturally, because our body’s need for it increases. We need a bit more for brain function, to help with our joints, to help produce bile and to balance our hormones. Our body is actually quite clever. It produces a little extra to help us. However, as you approach menopause, and your oestrogen levels start to decline, your HDL (the good stuff) lowers, and your LDL (the bad stuff) increases, so on top of the extra cholesterol your body is already making, you are now dealing with this.


Added into the mix is the fact that in perimenopause your weight increases (the average woman gains seven pounds), and your body puts all that extra weight directly around your middle because it’s the best place to store oestrogen. This shift of weight distribution activates a further increase in both your HDL and your LDL.

Related: The Menopause Diaries: The average woman gains 5-7 pounds during menopause

So that’s three ways you are naturally reducing the good stuff (HDL), and increasing the bad stuff (LDL).

Add into the fact that for the last thirty years, we’ve been having a pretty good time eating and drinking whatever we want. Which is something we simply can’t do anymore. So if your cholesterol is high, the first thing you need to do is take a look at your diet.


That said, my cholesterol was 8.3 last October, and it’s now 6.7, without having made any changes to my diet. The only thing I’ve done differently is taking HRT.

Few women realise there is a direct link between menopause and cholesterol. Oestrogen is believed to have a positive effect on the inner layer of the artery walls, which helps to keep blood vessels flexible. That means they can relax and expand to accommodate blood flow. The only thing I have done differently since last October is take two squirts of oestrogen gel daily, one squirt of testosterone every four days, and progesterone for the first seven calendar days of every month. So the only thing that has changed since my 8.3 cholesterol result in October 2018, to the 6.7 February result, is HRT.


Food for thought. All of it. If you’re in menopause or perimenopause, get your cholesterol checked. HRT may not be the answer for you, it may be diet, it may be another solution, but either way, get it checked.

The magic number is 5 by the way. That’s the baby we want. Onward and downwards, I hope.

If you have any questions or concerns about cholesterol, HRT, or your health in general, consult your GP.

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