High cholesterol after menopause? Here’s why HRT could help

Vanessa Feltz discusses HRT with expert Dr Louise Newton

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Around a third of cardiovascular deaths are said to be caused by raised cholesterol, so it’s important to ensure your cholesterol is in the desired range. Menopause is a tricky time of life for a number of reasons, and one symptom that isn’t talked about enough is raised cholesterol levels. You probably didn’t know that hormone replacement therapy not only helps to control hot flashes and other symptoms of menopause, but it also helps to keep your cholesterol under control. Express.co.uk chatted to Dr Deborah Lee from Dr Fox Online Pharmacy to find out why you should consider taking HRT after your periods stop.

About 2.6 million deaths around the globe, every year as a result of cardiovascular diseases and conditions.

This is often linked to high cholesterol, so it’s in all our best interests to try and lower cholesterol if it’s too high.

At menopause, you’re at risk of high cholesterol even if you lead a perfectly healthy life.

Dr Lee explained: “Menopausal women experience a dramatic fall in their estrogen levels, which is thought to cause unfavourable changes to the lipid profile.

“This is one of the reasons why women’s risk of heart disease increases steeply at and after menopause.

“Cardiovascular disease is the leading cause of death in postmenopausal women, and heart disease causes more than twice as many deaths as breast cancer in the UK every year.”

There are many ways to lower cholesterol that don’t involve medication.

These include – eating a low-fat diet, eating healthy unsaturated fats instead of unhealthy saturated fats, eating more fibre, and taking regular exercise.

You should also lose weight if you are overweight and maintain your weight in the normal range, ensure you have your blood pressure checked and any high blood pressure properly treated, manage any medical conditions such as type-2 diabetes optimally, and stop smoking.

Dr Lee added: “Increasing the consumption of plant stanols (found in whole grains, nuts, seeds, fruit, vegetables, beans and vegetable oils) to 2g per day can reduce LDL cholesterol by 10 percent, and eating 25g per day of soya has also been shown to lower cholesterol.”

However, many of us will find ourselves being prescribed medication, such as statins.

One thing many women may be unaware of is taking HRT is beneficial for their cholesterol levels too.

Why would HRT help with high cholesterol?

Plenty of studies have shown that HRT could help to reduce your cholesterol.

For example, in a 2006 meta-analysis of 107 clinical trials looking at the effects of HRT on metabolism in postmenopausal women with metabolic syndrome, HRT was shown to raise HDL ‘good’ cholesterol, and lower LDL ‘bad cholesterol.’

Dr Lee noted: “Oral HRT had a greater effect on cholesterol levels than transdermal (patches and gels) HRT.

“In this study, HRT also reduced levels in visceral fat, fasting insulin levels, and numbers of cases of new-onset diabetes, and it was also associated with lowered blood pressure.”

The 2001 Women’s Health, Osteoporosis, Progestin and Estrogen (HOPE) study also found that low dose HRT was associated with a significant 10 percent increase in HDL cholesterol, and a significant seven percent fall in LDL cholesterol.

Moreover, the study showed that low dose HRT was as effective at lowering cholesterol as the higher dose alternative, Dr Lee said.

To summarise, the estrogen in HRT reduces the overall synthesis of cholesterol in the liver.

Dr Lee said: “It may be comforting for women to know if they are taking HRT, that this is likely to be having a beneficial effect on their cholesterol levels.

“HRT also slightly lowers blood pressure and reduces calcification in the arteries, and all of these changes are all beneficial to lower the risk of heart disease.”

However, you should never feel pressured to take HRT.

Dr Lee said: “The decision to take HRT is a personal decision. Each woman should have an in-depth consultation with their GP or menopause specialist to weigh up the pros and cons and decide if HRT is right for them.

“HRT is still not prescribed in the UK for the primary prevention of heart disease.

“However, for the majority of women, if HRT is being used for symptom control, for five to 10 years from the onset of menopausal symptoms, the benefits of treatment are likely to outweigh the risks.”

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