High cholesterol in females can increase their risk of developing heart disease.
Cholesterol is a wax-like substance that the body naturally produces. It is required for several processes in the body, including building cells. However, cholesterol levels that are too high can put a person at risk of developing heart disease.
Females often have lower cholesterol levels during their reproductive years, but once they go through menopause, their levels can increase. This may relate to estrogen levels.
This article reviews how cholesterol affects females, the connection between high cholesterol and heart disease, and the risk factors for high cholesterol in females.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
Differences in sex can affect a person’s cholesterol levels.
Females under the
The variation in cholesterol levels may be related to estrogen levels. An older
The fluctuation could vary as much as 19% over the course of the menstrual cycle. Females with obesity had the highest levels of fluctuation.
The researchers found that as estrogen levels increase, the amount of HDL cholesterol also increases. At the time of ovulation, the estrogen and HDL cholesterol levels peak.
At the same time, levels of LDL cholesterol and triglycerides — another form of fat in the blood — fall as estrogen levels go up. The lowering process takes a few days. The researchers found that total cholesterol, LDL cholesterol, and triglyceride levels all reach their lowest point around the time the person starts menstruation.
When menopause occurs, a female’s cholesterol levels tend to rise. A
A study from 2019 found that hormone replacement therapy helped decrease total cholesterol levels and provided an anti-clotting effect in postmenopausal people.
However, not all evidence agrees on the exact effect estrogen levels have in postmenopausal people. In another
During pregnancy, a person’s cholesterol levels
High cholesterol levels
High cholesterol levels in the blood can lead to the buildup of plaque in the arteries. As the amount of plaque increases, the arteries narrow.
Narrowed arteries can block blood flow to the heart and other organs. If not enough blood reaches the heart or brain, a person may experience a heart attack or stroke.
Heart disease is the number one cause of death in females, accounting for 1 in 5 deaths in 2021, according to the
Doctors measure cholesterol levels in milligrams (mg) of cholesterol per deciliter (dL) of blood. When a person undergoes cholesterol level tests, they will receive values for total, HDL, and LDL cholesterol levels.
A person should aim to have a total cholesterol level lower than 200 mg/dL. A total cholesterol level of 200–239 mg/dL is borderline high, and 240 mg/dL or more is high.
HDL
HDL cholesterol levels should be higher to help reduce the risk of heart disease.
For some protection against heart disease, a person should have an HDL level of 60 mg/dL or more. People with an HDL level lower than 40 mg/dL have a major risk factor for heart disease.
LDL
LDL should remain low.
The following table shows what different levels of LDL cholesterol mean for a person’s health.
| LDL level | LDL cholesterol category |
|---|---|
| less than 100 mg/dL | optimal |
| 100–129 mg/dL | nearly optimal |
| 130–159 mg/dL | borderline high |
| 160–189 mg/dL | high |
| 190 mg/dL and up | very high |
In addition to high total cholesterol levels, several other factors can increase a female’s risk of developing heart disease.
High blood pressure is a leading risk factor. Doctors do not always accurately diagnose it in females, and
Other risk factors for heart disease include:
- physical inactivity
- stress
- excess weight
- excessive alcohol consumption
- unhealthy diet
- diabetes
- smoking
- depression
About 1 in 5 females have high blood pressure during their reproductive years. Reproductive health and pregnancy can also influence a person’s risk of heart disease. A person may have an increased risk of heart disease if they:
- have a preterm delivery
- have polycystic ovary syndrome (PCOS)
- enter menopause before age 40
- have high blood pressure during pregnancy
- have gestational diabetes
- deliver an infant with either low or high birth weight
- have their first period before age 11 years
General guidelines for screening cholesterol levels vary by age. The
| Age group | Screening schedule |
|---|---|
| 19 or younger | once every 5 years, beginning at age 9–11 |
| 20–54 | every 5 years |
| 55–65 | every 1–2 years |
| over 65 | every year |
Other risk factors, such as a family history of high cholesterol, can also affect how often a person should have a cholesterol check. A person should discuss their screening schedule with a healthcare professional.
A person can take several steps to help lower their total cholesterol,
- making efforts to maintain a moderate weight
- limiting alcohol intake
- quitting or avoiding smoking
- getting about 2 hours and 30 minutes of physical activity each week
- eating a healthful diet that limits saturated fats, trans fats, and salt and emphasizes fiber, vegetables, and fruit
Even after a person has taken steps to lower their cholesterol, their levels may remain high. A person should discuss treatment options with a healthcare professional if the steps they take at home do not help lower their cholesterol levels.
High cholesterol in females can lead to serious health conditions such as heart disease. A person should know their cholesterol numbers and, if necessary, take steps to lower their bad cholesterol and total cholesterol.
High cholesterol does not generally cause any symptoms. A person should have a cholesterol check at least every 5 years, depending on their age and the recommendations of a healthcare professional.
Estrogen may play a protective role in managing cholesterol. Estrogen levels decrease after menopause, which can put many people at higher risk of high cholesterol.
A person can take steps to lower their cholesterol, such as getting enough physical activity and limiting saturated fat intake. If this is not enough, a person should discuss treatment options with a healthcare professional.