Why Perimenopause Can Raise Your Risk of High Cholesterol and What to Do About It
- Brainz Magazine
- Jun 6
- 6 min read
Written by MJ Feeke, Nutritional Therapist
MJ is a BANT Registered Nutritionist, Nutritional Therapist, Health Coach, Chef, and Certified Breathwork Facilitator with over 25 years of experience in the food industry and over 20 years as a small business owner. She is dedicated to educating and empowering others through nutrition and wellness.
Are you in your 40s or 50s and noticing shifts in your energy, weight, or heart health? You’re not imagining it, perimenopause brings more than hot flushes and mood swings. One of the lesser-known but serious risks is rising cholesterol levels, which can increase your risk of heart disease.
1. Understand how perimenopause affects cholesterol levels
During perimenopause, estrogen levels begin to decline and with it, many protective mechanisms that once supported your heart health.
Estrogen’s role in heart health
Estrogen helps keep cholesterol in balance by raising HDL, the “good” cholesterol, and lowering LDL, the “bad” cholesterol. It also supports flexible, healthy blood vessels and helps reduce inflammation in the cardiovascular system.
Lower estrogen may cause higher LDL
As estrogen drops, LDL and triglycerides often increase, especially if you’re also experiencing weight gain, stress, or poor sleep. These changes can sneak up gradually, making routine blood work even more important during midlife.
Metabolism & insulin resistance
Hormonal changes can slow your metabolism and increase insulin resistance, making it easier to gain weight and harder to maintain healthy cholesterol. This can also increase your risk of developing type 2 diabetes or metabolic syndrome.
Inflammation & arterial health
Perimenopause may raise levels of inflammation and oxidative stress, both of which can harm blood vessels and contribute to heart disease over time. Supporting your body through nutrition, movement, and stress management can help reduce this burden and protect your heart.
2. Recognize the signs of rising cholesterol
You may not feel symptoms immediately, but your body could be showing subtle clues. Don’t skip your annual check-up; early detection is key to reversing rising cholesterol before it becomes a bigger issue.
Routine blood tests
Showing higher LDL, triglycerides, or total cholesterol. Look for elevated LDL, “bad” cholesterol, low HDL, “good” cholesterol, high triglycerides, or a raised total cholesterol level. These markers can indicate early imbalances that may put your heart health at risk. Regular testing helps track changes over time and guide the right interventions.
Weight gain
Especially around the midsection as a sign of insulin resistance. This type of weight gain is often linked to insulin resistance and inflammation, both of which can worsen cholesterol levels. Hormonal changes during perimenopause can make this more common, even without big shifts in diet. It’s important to address this early with lifestyle changes.
Fatigue, sluggishness, or brain fog
When cholesterol and blood sugar are imbalanced, your cells may not get energy efficiently. This can lead to feeling tired, foggy, or unmotivated, even after a good night’s sleep. These symptoms are often brushed off but may signal deeper metabolic issues.
Elevated blood pressure
High cholesterol can damage blood vessels and lead to stiffer arteries, which can increase blood pressure over time. Combined with stress, poor diet, or low activity, this can silently raise your risk for cardiovascular problems. Monitoring both blood pressure and cholesterol gives a more complete picture. You might notice a racing heart, palpitations, or feeling off during exertion. While these symptoms can have many causes, they may be related to rising cholesterol or changes in vascular health. If persistent, they’re worth discussing with your healthcare provider.
3. Make lifestyle changes that support heart health
You don’t need a total overhaul; just a few powerful shifts in diet, movement, and stress can go a long way.
Dietary adjustments
Eat healthy fats, avocados, olive oil, nuts, seeds, and oily fish. Cut back on refined sugar and processed carbs to reduce insulin resistance. Avoid trans fats and processed meats, which can increase inflammation. Focus on whole foods rich in fiber, antioxidants, and healthy fats, like oats, flaxseeds, leafy greens, berries, nuts, and oily fish. Reducing sugar and ultra-processed foods can help manage blood sugar and lower inflammation.
Including phytoestrogen-rich foods like flax, soy, and legumes may also support hormonal balance naturally.
Exercise and movement
Regular physical activity helps lower LDL, raise HDL, and improve insulin sensitivity. Aim for a mix of strength training, cardio, and restorative movements, such as yoga or Pilates. Strength training helps build muscle and improve metabolism. Cardio, like brisk walking, swimming, and cycling, lowers LDL and triglycerides. Aim for at least 150 minutes of movement per week, but even 30 minutes a day can make a big difference in your metabolic and cardiovascular health.
Stress and sleep management
Chronic stress increases cortisol, which can negatively impact cholesterol and blood pressure. Breathwork, mindfulness practices, quality sleep, and time in nature can all help regulate your nervous system. Practice deep breathing, mindfulness, or yoga to balance cortisol. Aim for 7-9 hours of quality sleep, which supports hormone function and metabolism. Building in daily calming rituals, even just 5-10 minutes, can have powerful long-term effects on heart health and hormone balance.
4. Support your body with targeted supplements
Before turning to medications, some women benefit from natural nutrients that support cholesterol balance and metabolic health. Always speak to a healthcare provider or nutritionist to determine what’s right for your body.
Omega-3 fatty acids
Reduces triglycerides and supports heart health. Omega-3s, especially EPA and DHA from fish oil, are well-researched for reducing triglyceride levels and improving overall cardiovascular health. They help lower inflammation, improve blood vessel function, and may even support a balanced mood. For best results, look for a high-quality, purified supplement.
Magnesium
Helps to balance blood sugar and reduce inflammation. Magnesium is involved in over 300 biochemical reactions in the body, including regulating blood sugar, blood pressure, and inflammation. Many women are low in magnesium due to stress, age, or diet.
Supplementing can support vascular health and improve insulin sensitivity, both of which impact cholesterol.
Berberine
Helps to balance blood sugar and reduce inflammation. Berberine is a plant compound that acts similarly to metformin, helping to lower blood sugar and improve insulin sensitivity. It has also been shown to reduce LDL cholesterol and triglycerides while increasing HDL. It’s particularly helpful for those with metabolic syndrome or insulin resistance.
Niacin (Vitamin B3)
May increase HDL and lower LDL, used under guidance. Niacin can raise HDL cholesterol while lowering LDL and triglycerides. It works by reducing the liver’s ability to make LDL and slowing the breakdown of HDL. However, it should be used under professional guidance, as high doses can cause flushing or affect liver function.
Always consult a qualified professional before starting new supplements.
5. Know when to seek medical support
Sometimes lifestyle changes aren’t enough on their own and that’s okay. If your cholesterol remains high, it’s important to work with your GP or health practitioner to assess risk factors and explore the best treatment plan for you.
Statin medication
Statins are commonly prescribed to lower LDL cholesterol and reduce your risk of heart disease and stroke. They work by blocking a substance your liver needs to make cholesterol, helping prevent buildup in the arteries. Your doctor will monitor for side effects and adjust the dose as needed for optimal benefit.
Hormone replacement therapy (HRT)
If symptoms are severe and you're a suitable candidate HRT may be recommended if you’re experiencing difficult perimenopausal symptoms and are a suitable candidate. While it’s primarily used for symptom relief, HRT can also support cardiovascular health by partially restoring estrogen's protective effects. A full risk assessment is essential before starting HRT, especially if you have a history of heart issues or other underlying conditions.
Further testing
When other risk factors like blood pressure, inflammation, or family history are present, if your cholesterol is elevated alongside other risk markers, such as high blood pressure, systemic inflammation, or a strong family history, your practitioner may suggest additional tests. These could include a coronary calcium scan, advanced lipid panels, or markers of inflammation like C-reactive protein. Early detection of broader cardiovascular risk gives you a clearer picture and allows for proactive management.
Seek mentorship and coaching
While perimenopause can raise your risk of high cholesterol, it doesn’t have to define your health future. With a combination of smart nutrition, regular movement, stress management, and targeted support, you can reduce risk and feel stronger than ever.
Small changes today will ensure a healthier heart tomorrow. Stay informed. Be proactive. And always listen to your body. Ready to take the next step? Book a free discovery call or DM me to learn how we can work together to support your heart health and hormonal balance.
MJ Feeke, Nutritional Therapist
MJ is a leader in the wellness world who understands the transformative power of positive nutrition and lifestyle medicine. As a busy working woman, mom, wife, and daughter, she deeply relates to the challenges of managing stress and life load, especially for midlife women. MJ is passionate about empowering individuals to reclaim their health and live their best lives.
