Menopause, oestrogen, and high cholesterol: understanding the link and maintaining healthy levels
Menopause is a major transition in every woman’s life, one that brings both challenges and opportunities for renewed self-care. Among the shifting sands, one of the most significant yet often overlooked is the common increase in cholesterol levels. As oestrogen levels decline, women experience an increased cardiovascular risk. So much so that after menopause, the risk of heart disease becomes equal to that of men.
At Nina Nutrition, we believe that knowledge is empowerment. Understanding how your hormones, cholesterol, and heart health interact allows you to make proactive choices that truly support your long-term well-being. This article dives into the connection between menopause, oestrogen, and cholesterol, and offers practical menopause nutrition advice to help you stay vibrant and healthy through this natural transition.
Why you actually want and need cholesterol
Cholesterol often gets a bad reputation, but it’s not the enemy, it’s essential. It’s not only found in every cell of your body, it’s made the body every. single. day. High cholesterol levels are also correlated with longevity. So how has it become the demon? Cholesterol serves several critical functions:
- Building cell membranes: Cholesterol helps maintain structure and flexibility in your body’s cells. Cholesterol is your body’s plaster to patch you up when you have damaged arteries… so it’s important to take a step back and look at what’s damaging your arteries in the first place.
- Hormone production: It’s the foundation for steroid hormones such as oestrogen, progesterone, and cortisol.
- Vitamin D synthesis: Cholesterol enables your body to produce vitamin D from sunlight exposure.
- Digestion: It helps your liver create bile acids, necessary for breaking down fats and aiding absorption.
There are two main types of cholesterol:
- LDL (Low-Density Lipoprotein): The “bad” cholesterol, as it can build up in arteries and increase the risk of heart disease.
- HDL (High-Density Lipoprotein): The “good” cholesterol that removes excess cholesterol from the bloodstream and returns it to the liver for excretion.
In balance, cholesterol supports hormonal and metabolic health. But as oestrogen levels decline during menopause, that balance shifts.
How menopause affects cholesterol
Oestrogen plays a key role in maintaining healthy cholesterol levels. During the reproductive years, oestrogen helps to:
- Increase HDL (protective cholesterol)
- Decrease LDL (harmful cholesterol)
- Regulate triglyceride level
When oestrogen production drops during perimenopause and menopause, these protective effects fade. The result? Rising LDL and triglycerides, and often a decrease in HDL. This shift increases the likelihood of plaque buildup (atherosclerosis), high blood pressure, and eventually, heart disease. Ultimately, it’s the ratio between the different types rather than the overall levels that matter most.
This is why nutrition for perimenopause and menopause must go beyond simply managing hot flushes or mood swings. It’s about protecting your heart and long-term health.
Why heart health matters more after menopause
Before menopause, women typically have lower rates of heart disease than men due to the protective effects of oestrogen. But after menopause, that advantage disappears. In fact, cardiovascular disease becomes the leading cause of death in post-menopausal women.
Research shows that within just a few years of menopause, cholesterol levels can increase significantly, particularly LDL cholesterol. Unfortunately, many women remain unaware of these changes until symptoms or test results reveal elevated levels.
That’s why regular cholesterol monitoring and adopting menopause nutrition advice early on is so important. It’s about being aware and then prevention, not creating fear.
The role of testing in managing cholesterol
Your GP can offer a standard lipid profile, which measures:
- Total cholesterol
- LDL cholesterol (the “bad” one)
- HDL cholesterol (the “good” one)
- Triglycerides
This simple test provides a clear snapshot of your current risk. In the UK, routine cholesterol checks are recommended for anyone over 40, or earlier if you have risk factors like family history, smoking, or diabetes. (My personal story on this: It’s not necessarily genetic, it could just be lifestyle: my mum, aunt and brother all had high cholesterol so when I tested they were amazed mine wasn’t high… until I pointed out that I didn’t smoke and exercised regularly. I also eat pretty well 😉
Advanced testing
For a deeper understanding, private tests can assess:
- Lipoprotein(a): A genetic marker of heart disease risk
- C-reactive protein (CRP): A sign of inflammation
- Homocysteine: An amino acid that can damage blood vessels when elevated
- Oxidised LDL: The most dangerous form of LDL, prone to causing arterial plaques
At Nina Nutrition, we interpret both the GP and advanced tests to create personalised nutrition and lifestyle strategies to support your heart, hormones, and overall vitality.
Diet and Lifestyle: The Key to Rebalancing Cholesterol
When it comes to managing cholesterol during menopause, diet and lifestyle play a transformative role. The aim is not just to lower LDL, but to rebalance hormones naturally and create a foundation for optimal heart and metabolic health.
1. Eat for Heart and Hormone Health
The best diet for hormone balance is also the best diet for your heart. Focus on foods that nourish both systems:
- Increase soluble fibre: Oats, beans, lentils, apples, and flaxseeds help bind cholesterol in the gut and promote elimination.
- Include healthy fats: Avocados, nuts, seeds, olive oil, and oily fish (salmon, sardines, mackerel) support cell structure, reduce inflammation, and improve HDL levels.
- Load up on antioxidants: Colourful fruits and vegetables provide polyphenols and vitamins that protect blood vessels and support liver function.
- Limit saturated and trans fats: Found in processed foods, these raise LDL cholesterol.
- Reduce refined carbs and sugar: High sugar intake raises triglycerides and worsens insulin resistance.
- These choices are NOT about restriction, that’s just not how I work… They’re about creating hormone-friendly recipes that support both balance and pleasure.
2. Maintain a Healthy Weight
Weight loss and hormone support go hand in hand. Many women experience weight gain around the middle during menopause due to declining oestrogen, slower metabolism, and increased insulin resistance.
Even modest weight loss (5–10%) can improve cholesterol levels and reduce cardiovascular risk. A balanced plate with lean proteins, healthy fats, and plenty of fibre-rich vegetables helps regulate blood sugar and satiety.
3. Move Your Body Regularly
Exercise is one of the most powerful tools to support cardiovascular health and hormone balance. Aim for:
- 120 minutes of aerobic exercise per week (brisk walking, swimming, cycling)
- Two resistance training sessions weekly to build muscle (and strengthen bones) and support metabolism
- Exercise improves HDL, reduces LDL, and lowers triglycerides… a triple win for your heart.
Even if this sounds like a lot, just start. Do something and work your way up. Some is better than none.
4. Incorporate rest and calm
Chronic stress increases cortisol, which can lead to higher cholesterol and blood sugar levels. Incorporate relaxation techniques like yoga, mindfulness, or gentle stretching to support calm and recovery.
Sleep is equally important: poor sleep can raise LDL and lower HDL. Aim for 7–8 hours per night, maintaining a consistent bedtime routine.
5. Limit Alcohol and Quit Smoking
Excess alcohol contributes to higher triglycerides and liver strain, while smoking damages arteries and reduces HDL. Cutting down or eliminating both dramatically improves your cardiovascular outlook.
How Nina Nutrition Can Help
At Nina Nutrition, we specialise in menopause nutrition advice tailored to your unique body and lifestyle. Our approach includes:
- Personalised assessments: Reviewing your cholesterol profile, family history, and hormonal health.
- Custom nutrition plans: Using the best foods for hormone health to balance cholesterol, support liver detoxification, and optimise hormone metabolism.
- Lifestyle coaching: Helping you integrate new habits with ease — from meal planning to stress reduction.
- Regular progress reviews: Monitoring your health markers and celebrating your wins along the way.
We don’t believe in one-size-fits-all solutions. Every woman’s menopause journey is different, and your nutrition plan should reflect that.
A Quick Guide to Cholesterol- and Hormone-Supportive Foods
Here’s what to include regularly in your diet for better heart and hormone health:
- Oily fish: Rich in omega-3 fats to reduce inflammation and triglycerides.
- Flaxseeds and chia seeds: Contain phytoestrogens that gently mimic oestrogen’s effects.
- Leafy greens: Provide magnesium and antioxidants that support vascular health.
- Legumes: High in fibre and plant-based protein for cholesterol management.
- Avocados and olive oil: Great sources of monounsaturated fats that boost HDL.
- Berries: Packed with polyphenols that protect arteries.
This is what rebalancing hormones naturally looks like: nutrient-dense, flavourful, and satisfying meals that support both your body and mind.
Final Thoughts
Menopause may bring challenges, but it also brings an opportunity to prioritise your long-term health. By understanding the link between oestrogen and cholesterol, you can make informed decisions that protect your heart, energy, and overall well-being.
Through regular testing, the right nutrition, and supportive lifestyle habits, you can maintain balanced cholesterol levels and feel empowered through every stage of menopause.
If you’re ready to take the next step in your wellness journey, book a complimentary 30-minute consultation with Nina Nutrition today. Together, we’ll create a personalised plan to nourish your heart, rebalance your hormones naturally, and help you thrive through menopause and beyond.