Age, lifestyle and menopause can affect cholesterol levels for women

Story by: Sara Thompson on May 26, 2022

There are many factors that affect good cholesterol in women: age, diet, lifestyle and menopause, to name a few. What is cholesterol? It’s a waxy substance found in two places: Your liver produces it, and cholesterol comes from animal products you eat (think meat, eggs and cheese). Like many other things in life, cholesterol is not good or bad until there’s too much of it. For women, high cholesterol can lead to heart disease, heart attack and stroke.

A cholesterol test (called a lipid panel or lipid profile) includes having some blood drawn in a lab. Then your provider examines the results that show your levels of high density lipoproteins (HDL), low density lipoproteins (LDL) and triglycerides (fats), and total blood cholesterol.

“Think of it like this,” said Monalisa M. Tailor, M.D., internal medicine physician at Norton Community Medical Associates-Barret. “You want a high level of HDL and a low level of LDL. If you have a lot of that LDL, it can get stuck in your arteries. It’s like soap scum in the pipes of your home — a little bit gets flushed out, but too much of it starts to build up.”

And arteries, like plumbing, get clogged. Unlike with your bathroom sink, you might not know you have cholesterol build up until it becomes a very serious health issue.

What are good cholesterol numbers for women?

“A good cholesterol [level] for a woman is higher than 60 mg/dl. We want total cholesterol levels to be under about 200 mg/dl.”

Here’s where things get tricky: Women generally have higher HDL than men due to the presence of estrogen.

“The hormone estrogen reduces the overall amount of cholesterol in the body, but also increases the amount of HDL, or “good” cholesterol,” Dr. Tailor said.

There is some evidence that estrogen also affects the immune system, which is responsible for inflammation caused by buildup of bad cholesterol in the arteries.

“Estrogen might protect women from heart disease, which is potentially good news,” Dr. Tailor said.

It is not thought that hormone replacement therapies (HRT) or any hormones taken via pill, cream, injection or infusion have any effect on cholesterol.

“It’s really just the estrogen made by the body that makes a difference,” Dr. Tailor said.

For women, maintaining healthy cholesterol levels is a great way to keep your heart healthy. It can lower your chances of getting heart disease or having a stroke.

“We recommend adults have cholesterol checked when they start seeing a primary care provider,” Dr. Tailor said. Low-risk individuals will re-check every five years. Higher risk people may re-check every three years or more frequently, depending on risk factors.

“Talk to your doctor. They will. Help you determine the best schedule for cholesterol checks,” Dr. Tailor said.