Managing Cholesterol Rise During Menopause: Key Questions Answered

Cholesterol levels increase annually during menopause?

At the age of 50, after menopause, my cholesterol levels have been rising each year.
I am now 56 years old.
This month, I had a blood test at the internal medicine department.
My total cholesterol is 256, triglycerides are 70, high-density lipoprotein (HDL) is 52, and low-density lipoprotein (LDL) is 185.
The doctor said that if my levels do not decrease in three months, I will need to take medication to lower my cholesterol.
My blood pressure is normal, and my weight is 63 kg at a height of 158 cm.
I have four uterine fibroids, the largest being 3 cm.
For many years, I have been eating two meals a day: oatmeal with fruit for breakfast and a regular lunch, but I skip dinner.

1.
How can I determine if my high cholesterol is due to decreased estrogen levels or simply dietary causes?
2.
If it is caused by a lack of estrogen, should I supplement with estrogen or take the cholesterol-lowering medication prescribed by my internist?
3.
I usually take natto enzyme supplements.
If I start taking the cholesterol-lowering medication, can I continue taking them?
4.
Is it safe to take red yeast rice supplements?

Miss Lin, 50~59 year old female. Ask Date: 2020/09/27

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is generally not closely related to menopause.
For other issues, you may consult an endocrinologist.
Wishing you good health.

Reply Date: 2020/09/27

More Info

Managing cholesterol levels during menopause is a significant health concern for many women, particularly as hormonal changes can influence lipid metabolism. Here are some insights and recommendations based on your questions:
1. Determining the Cause of Elevated Cholesterol: To ascertain whether your elevated cholesterol levels are due to decreased estrogen or dietary factors, it’s essential to consider several factors. Estrogen has a protective effect on cardiovascular health, and its decline during menopause can lead to unfavorable changes in lipid profiles, including increased LDL (low-density lipoprotein) cholesterol. However, dietary habits also play a crucial role. Since you mentioned that your diet consists primarily of oatmeal and fruits, it seems relatively healthy, but it’s important to assess the overall quality of your diet, including the intake of saturated fats, trans fats, and processed foods. A healthcare provider may recommend further tests, such as a lipid panel over time, to see if the cholesterol levels correlate with hormonal changes or dietary habits.

2. Hormone Replacement Therapy (HRT) vs. Cholesterol Medications: If your cholesterol levels are indeed influenced by the decline in estrogen, hormone replacement therapy (HRT) could be beneficial. HRT can help restore hormonal balance and may positively impact cholesterol levels. However, the decision to start HRT should be made in consultation with your healthcare provider, considering your overall health, family history, and any potential risks associated with HRT. On the other hand, if your cholesterol levels remain high despite lifestyle changes, your doctor may recommend cholesterol-lowering medications, such as statins. These medications can effectively reduce LDL cholesterol and lower the risk of cardiovascular disease.

3. Nattokinase and Cholesterol Medications: Nattokinase is a supplement derived from fermented soybeans and is often taken for its potential cardiovascular benefits, including blood thinning properties. If you are prescribed cholesterol-lowering medications, it is crucial to discuss the use of nattokinase with your healthcare provider. While there is no direct contraindication, combining supplements with prescription medications can sometimes lead to unexpected interactions. Your doctor can provide personalized advice based on your health status and medication regimen.

4. Red Yeast Rice Supplements: Red yeast rice is another supplement that has been shown to lower cholesterol levels due to its natural statin content. However, similar to nattokinase, it’s essential to consult with your healthcare provider before starting red yeast rice, especially if you are already on cholesterol-lowering medications. The combination could increase the risk of side effects, such as muscle pain or liver issues, which are associated with statin use.

In addition to these considerations, lifestyle modifications can significantly impact cholesterol levels. Regular physical activity, maintaining a healthy weight, and incorporating a balanced diet rich in fruits, vegetables, whole grains, and healthy fats (like omega-3 fatty acids from fish) can help manage cholesterol levels effectively. It’s also advisable to limit saturated and trans fats, which are commonly found in processed foods.

Lastly, regular follow-ups with your healthcare provider are essential to monitor your cholesterol levels and overall health, especially as you navigate menopause. They can provide tailored advice and adjustments to your treatment plan as needed.

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