Did your cholesterol ‘suddenly’ increase? Does your doctor insist on you taking Statins? Are you suffering with meno-belly? Then you need to read this article.
Before women go through menopause, they tend to have healthier cholesterol profiles and lower rates of cardiovascular disease than males, but at the onset of menopause, that advantage starts to decline. As Estrogen levels decrease, CV risk increases.
By the time women reach their 60s and 70s, the rates of cardiovascular disease are almost even with males, and in their 80’s women surpass men. The earlier the menopause the sooner the risk increases.
Women often see an increase in blood pressure, glucose, inflammation, weight, as well as dyslipidaemia during and after menopause. Dyslipidaemia usually shows up as:
- Increases in total cholesterol (TC), LDL cholesterol (LDL-C), triglycerides (TG)
- Decrease in high density lipoprotein cholesterol (HDL-C).
All About the Liver
Estrogen’s protective effect on cholesterol is already noticeable in its rise and fall with Estrogen fluctuations throughout the menstrual cycle (if we measured).
The liver has Estrogen receptors, which are involved in lipid production, control and profiles. Once the body stops making as much Estrogen, overall lipid profiles turn more unfavourable:
- LDL and triglycerides increase
- HDL decreases
FSH / Follicle Stimulating Hormone
FSH has been overlooked but studies are showing that higher FSH in postmenopausal women is related to higher levels of both TC and LDL-C.
- Study – Follicle Stimulating Hormone is Associated with Lipids in Postmenopausal Women – published in Menopause, 2019 May
- Study – Follicle-Stimulating Hormone Linked to LDL Cholesterol in Postmenopausal Women – Journal of Clinical Endocrinology and Metabolism 2015
The huge menopausal endocrine change, especially the sharply raised serum FSH levels, exhibits negative effects on lipid levels and inhibited the LDL receptors.
FSH may elevate LDL cholesterol levels by inhibiting hepatic cholesterol metabolism in postmenopausal women,
When researchers examined serum FSH and lipid levels in 400 postmenopausal Chinese women aged 42 to 60 years, who underwent hormone replacement therapy they found:
- FSH may interact with its receptors in hepatocytes/liver cells and reduce LDL receptor levels, which subsequently reduce the uptake of LDL cholesterol, resulting in an elevated circulating LDL cholesterol level.
- Postmenopausal women with serum FSH ≥78.3 IU/L had higher serum LDL and total cholesterol levels than women with lower FSH levels.
- After taking Estradiol valerate 1 mg tablets per day for 12 months – Women with FSH levels that decreased by more than 30% had significantly improved levels of total and LDL cholesterol.
- Researchers predict that hormone replacement therapy may have preventive effects in postmenopausal women with higher FSH levels, and these women should be encouraged to take hormone replacement therapy.
- Study – Follicle-Stimulating Hormone Induces Postmenopausal Dyslipidemia Through Inhibiting Hepatic Cholesterol Metabolism – 2016 Journal of Clinical Endocrinology Metabolism
- Study – Blocking FSH inhibits hepatic cholesterol biosynthesis and reduces serum cholesterol – Cell 2019
- Study – Follicle-stimulating hormone is associated with lipids in postmenopausal women – Menopause 2019
Conclusion – Data suggest that higher FSH in postmenopausal women is related to higher levels of both TC and LDL-C.
FSH is also connected to weight gain
- Study – FSH regulates fat accumulation and redistribution in aging through the Gαi/Ca2+/CREB pathway – Aging Cell 2025
Conclusion – FSH was found to promote lipid biosynthesis and lipid droplet formation and FSH could also alter the secretion of leptin (satiety) and adiponectin (hunger)
Solutions
- Regular exercise
– Can raise HDL, lower LDL and triglycerides
– Generally, improve your lipid profile
– Can also reduce inflammation
– So active women, may have better lipid profiles than sedentary women
– Especially if combined with diets rich in monounsaturated fats like olive oil and avocado, fruits and berries (all rich in soluble fibre) animal proteins.
- Statins
– Should women be offered cholesterol lowering drugs to prevent cardiovascular disease? – No BMJ – 2007
– To date, none of the large trials of secondary prevention with statins has shown a reduction in overall mortality in women.
– Perhaps more critically, the primary prevention trials have shown neither an overall mortality benefit, nor even a reduction in cardiovascular end points in women.
– This raises the important question whether women should be prescribed statins at all. – NO
- Hormone Replacement Therapy
– ERT – yes decreases FSH
– DHEA – maybe decreases FSH
– TRT – decreases FSH in males – not tested in women
Study – The effect of exogenous testosterone upon serum FSH and LH concentrations in normal males – Contraception 1972
– This study was designed to investigate the effect of pharmacologic doses of testosterone on serum FSH and LH levels in normal males.
– Testosterone Proprionate, 100mgm, was administered intramuscularly daily for 4 days to 4 normal males.
– As anticipated, serum LH levels promptly suppressed to undetectable levels.
– Serum FSH levels suppressed significantly to 60–70% of baseline values in all 4 subjects.
– These results suggest that testosterone may have some part in the control of serum FSH as well as LH levels in normal males.
- Ashwagandha
Study – Effect of an ashwagandha (Withania Somnifera) root extract on climacteric symptoms in women during perimenopause: A randomized, double-blind, placebo-controlled study – Japan Society of Obstetrics and Gynaecology – 2021.
Results
– Increase in serum Estradiol
– Significant decrease in serum FSH and LH.
– No significant effect on serum testosterone levels.
– The women in this study took 300 mg of ashwagandha root extract twice daily for 8 weeks
- Traditional Chinese Medicine (TCM)
TCM believe lifestyle changes can lower FSH, such as:
– Dietary changes – remove UPF
– Intake of certain herbs and supplements – Ashwagandha, Omega 3, Q10, Vitamin D
– Exercising
– Reducing stress
– Electroacupuncture.
