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Cholesterol Jumps With Menopause

Doctors have known for years that a woman’s risk of developing heart disease rises after menopause, but they weren’t exactly sure why. It wasn’t clear whether the increased risk is due to the hormonal changes associated with menopause, to aging itself, or to some combination of the two.

Now, we have at least part of the answer: A new study shows beyond a doubt that menopause, not the natural aging process, is responsible for a sharp increase in cholesterol levels.

This seems to be true of all women, regardless of ethnicity, according to the study, which will be published in next week’s Journal of the American College of Cardiology.

“As they approach menopause, many, many women show a very striking increase in cholesterol levels, which in turn increases risk for later heart disease,” says the lead author of the study, Karen A. Matthews, Ph.D., a professor of psychiatry and epidemiology at the University of Pittsburgh.

Over a 10-year period, Matthews and her colleagues followed 1,054 U.S. women as they went through menopause. Each year the researchers tested study participants for cholesterol, blood pressure, and other heart disease risk factors such as blood glucose and insulin.

As they approach menopause, many, many women show a very striking increase in cholesterol levels, which in turn increases risk for later heart disease.

In nearly every woman, the study found, cholesterol levels jumped around the time of menopause. (Menopause usually occurs around age 50 but can happen naturally as early as 40 and as late as 60.)

In the two-year window surrounding their final menstrual period, the women’s average LDL, or bad cholesterol, rose by about 10.5 points, or about 9 percent. The average total cholesterol level also increased substantially, by about 6.5 percent.

Other risk factors, such as insulin and systolic blood pressure (the top number in a blood pressure reading), also rose during the study, but they did so at a steady rate, suggesting that the increases– unlike those for cholesterol– were related to aging, not menopause. Of all the risk factors measured in the study, the changes in cholesterol were the most dramatic.

The jumps in cholesterol reported in the study could definitely have an impact on a woman’s health, says Dr. Vera Bittner, a professor of medicine at the University of Alabama at Birmingham, who wrote an editorial accompanying Matthews’s study.

“The changes don’t look large, but given that the typical woman lives several decades after menopause, any adverse change becomes cumulative over time,” says Bittner. “If somebody had cholesterol levels at the lower ranges of normal, the small change may not make a difference. But if somebody’s risk factors were already borderline in several categories, this increase may tip them over the edge and put them in a risk category where treatment may be beneficial.”

In a first, the study did not find any measurable differences in the impact of menopause on cholesterol across ethnic groups.

Experts have been unsure how ethnicity may affect the link between menopause and cardiovascular risk, because most research to date has been conducted in Caucasian women. Matthews and her colleagues were able to explore the role of ethnicity because their research is part of the larger Study of Women’s Health Across the Nation (SWAN), which includes substantial numbers of African-American, Hispanic, and Asian-American women.

More research on the connection between menopause and heart disease risk is needed, according to Matthews. The current study doesn’t explain how the increases in cholesterol will affect the rate of heart attacks and mortality down the road, for instance.

As the SWAN study continues, Matthews says, she and her colleagues hope to identify warning signs that will show which women are most at risk for heart disease. “The important thing is, ultimately, when we can figure out the characteristics of women who have early signs of cardiovascular risk that, if we don’t do anything about them, could later result in a heart attack.”

Women should be aware of the changes in risk factors that occur around menopause, says Bittner, and they should talk to their doctors about whether they need to have their cholesterol checked more often or whether they should begin a cholesterol-lowering treatment, such as a statin.

Maintaining a healthy weight, not smoking, and getting plenty of exercise are essential to help keep cholesterol levels in check, Bittner adds, and she points out that menopause can be an especially difficult time for women to get enough physical activity. “It often falls by the wayside because women in this age range take care of kids, spouse, aging parents, and often work in addition,” she says.

“Midlife is a great time to make these changes,” Matthews says. “If we can essentially reset the course to a more health-promoting direction in midlife, then that will have benefits for many years to come.”

Wolf Ulian, Ph.D., the founder and executive director of the North American Menopause Society, a nonprofit organization that provides information on menopause to consumers and health-care professionals, says the findings underscore that menopause is a good time for women to adopt healthier lifestyles.

“Menopause is a milestone,” he says. “It’s a time to take stock and take control and try to enhance the quality of your second half of life.”

Comments (11)

  1. linda says:

    I know my cholesterol is higher. I didnt go thru menopause til 58. Runs in the family. But my concern is migraines which were supposed to stop past menopause. They didnt. I still need imitrex about 8x a month. Or excedrin or a percocet. Im really getting tired.

    • Dawn says:

      I’m 56 and have a period every three months and still get horrible migraines. I take stadol…a merge gave me a migraine stroke..so I stop all of those after 10 years. nueroligest at UCLA said no one should be on migraine medicine for that long.
      What do we do for the pain and the days we lose each month due to migraines and hormones???

  2. Concerned citizen says:

    I never had a problem with high cholesteral levels until menopause – now I know why. I added vigorous exercise 3 times a week and cut way back on carbs (sugar & flour and products made with them, lost 30 pounds) and take fish oil supplements, and my “bad” cholesterol dropped down and my “good” cholesterol went up. Thank you AMAC for the informative article.

  3. Nancy Allison says:

    Who is Dr Bard and does he have a website? I have high LDL bad cholesterol.

  4. Claudia Branham says:

    Everyone should read the Great Cholesterol Myth by Cardiologist, Dr. Sinatra. No one would ever again take a Statin Drug.

    • Barbara K. King says:

      Great book! It was the first thought I had when I read, “High cholesterol causes heart disease.” My first husband died with 148 cholesterol.

  5. Elle says:

    Dr. Bard is correct. Even the directional insert from Lipitor states that it doesn’t lengthen your life. This is a pharma fraud.

  6. Donald Beam says:

    I agree with the above response to this article. Its been proven that elderly people live longer with high cholesterol. Statins have many harmful side effects including memory loss. It’s great that more and more doctors are taking the time to study this. Thank you Dr. Bard

  7. Marcella A Dellaposta says:

    Dr. Bard is 100% correct.

  8. Dr Bard says:

    This a bunch of BS. What was reported in this report at best is incomplete. They reported on LDL but fail to mention if it is the healthy LDL or the bad LDL. They did not report on the HDL and did not report that there is massive evidence from research that cholesterol does not cause heart disease and when statins are given they deplete CoQ 10 which cause even more poor health.
    Who paid for this study? What drug company did this to make more profits at the expense of women in menopause. If these women were advised to healthy food like my grandparents in the early 1900′s they would have almost no health problems including heart disease. When people ate local foods with lots of healthy saturated fats and essentially organic produce and in season foods with raw grass fed beef and dairy there was almost no heart disease. If we would go back to the food God recommended in the bible and stop eating processed foods most of the disease would go away in 6 months or less. The first MI was first reported in 1921. We had almost no heart disease because there were healthy fats. Around 1916 the processed fats and trans fats were introduced and our heath has been going down hill ever since. The slope is getting steeper and heath is getting worse. Medicine went to bed with the people causing disease so the could make money and the AMA and drug corporations could have more sick people to make more money. This system is corrupt and the people have been dumbed down so they will not question the system.

    • Concerned citizen says:

      “The first MI was first reported in 1921.” What’s an MI?

      I understand your concern about the beef cattle being fed on grain rather than grasses. Most of the dairy cows I see here in southern California are eating grass or hay. What else are they being fed that is detrimental? Or are you referring to the anitbiotics and vaccines? Thanks.

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