Sex Hormone Levels at Midlife Linked to Bad Cholesterol Carriers that Increase Heart Disease Risk in Women

As hormone levels change during the transition to menopause, the quality of a woman’s cholesterol carriers degrades, leaving her at greater risk for heart disease, researchers at the University of Pittsburgh Graduate School of Public Health discovered.

The first-of-its-kind evaluation, supported by the National Institutes of Health (NIH), was done using an advanced method to characterize cholesterol carriers in the blood and is published in the July issue of the Journal of Lipid Research.

The results call for further research to evaluate the menopause-related dynamic changes in sex hormones on the quality of cholesterol carriers over time, as well as increased emphasis on the importance of healthy diet and exercise for women undergoing menopause.

“Higher levels of HDL, or what we know as ‘good cholesterol,’ may not always be protective, as we have thought before,” said lead investigator Samar R. El Khoudary, Ph.D., M.P.H., assistant professor in Pitt Public Health’s Department of Epidemiology.

Dr. El Khoudary explains that normal levels of LDL, or “bad cholesterol,” do not imply normal cholesterol levels in all individuals. Rather, quality of cholesterol carriers may provide more accurate information about risk related to levels of cholesterol.

“We found that lower levels of estradiol, one of the main hormonal changes that mark menopause, are associated with low-quality cholesterol carriers, which have been found to predict risk for heart disease,” she said. “Our results suggest that there may be value in using advanced testing methods to evaluate changes in cholesterol carriers’ quality in women early in menopause so that doctors can recommend appropriate diet and lifestyle changes.”

Estrogen levels drop during menopause

Estrogen helps arteries be more flexible and strengthens their interior walls. Menopause leads to a decline in estrogen; this may be a reason in an increase of heart disease in post-menopausal women.

Note: The American Heart Association does not recommend using postmenopausal hormone therapies. Studies have shown that these treatments do not reduce the risk of heart disease.

According to Dr. Goldberg, scientists and doctors say a decrease of estrogen isn’t the only reason for an increase in heart disease, and that researchers are actively searching for more comprehensive answers.

Blood pressure, bad cholesterol increase during menopause

In addition to a drop in estrogen, a woman’s body goes through other changes when in menopause. For starters, blood pressure levels start to go up. In addition, bad cholesterol, or LDL cholesterol, levels may increase and good cholesterol, or HDL, may decline or stay the same.