Cholesterol is one of those vaguely ominous threats to our health that remain stubbornly difficult to fully comprehend. But cholesterol can contribute to increased risks of both heart attack and stroke, so some basic understanding of it is important.
An awareness of cholesterol and its risk factors can be especially important to women because heart disease and stroke account for nearly 30% of women’s mortality. Combined, heart disease and stroke surpass all other individual causes of death among women. And the inevitable interactions between menopause and cholesterol levels can heighten each of those risks.
So what is cholesterol, anyway?
Cholesterol isn’t intrinsically bad. As a matter of fact, cholesterol is absolutely necessary because it makes up the walls of each and every one of the 37 trillion (give or take a billion or so) cells in our bodies. And we need cholesterol to produce vital hormones, such as estrogen, progesterone, and vitamin D.
Our livers use our dietary intake to create all the cholesterol that we need. Sometimes, the nature of our diet, combined with our lifestyle, can cause high cholesterol in our bloodstream. When excessive cholesterol in our bloodstream combines with fats known as triglycerides, the resulting accumulations can lead to a higher risk of heart disease and/or stroke.
Good cholesterol vs. bad cholesterol
Cholesterol is ferried through the bloodstream in small particles called lipoproteins. There are two major types of lipoproteins:
- High-Density Lipoprotein (HDL) which tends to prevent cholesterol buildup in the arteries
- Low-Density Lipoprotein (LDL) the sort of cholesterol that leads to a higher risk of arterial blockages
So, generally speaking, HDL = good; LDL = bad. And that illustrates why measuring total cholesterol levels is not very helpful. The most useful way to measure cholesterol is by contrasting good HDL cholesterol levels with levels of bad LDL cholesterol.
How to manage bad cholesterol for good heart health
How many times have you heard, read, or dreamed the following mandate: “Diet and exercise.” Or, for variety’s sake, “Exercise and diet.” Just like every other cliché, these phrases get repeated so often only because they are so true.
Aim for a healthy lifestyle to prevent the risk of heart disease
Even a partially heart-healthy diet, combined with a regimen of regular exercise, will definitely lower your bad cholesterol. And that diet needs to include healthy lipids (in this context, “lipids” is just an esoteric term for fats.)
In more specific terms, a diet with zero trans-fats and limited amounts of saturated fats, but replete with unsaturated fats, whole grains, fruits, and vegetables, will significantly lower LDL cholesterol levels. For an even further reduction in bad cholesterol, adopt lifestyle changes that include weight loss as necessary and half an hour of aerobic exercise four times a week.
What are trans-fats?
Trans-fats are created by adding hydrogen to a liquid fat to help it solidify. Food manufacturers began using trans-fats because they extend the shelf life of some packaged foods. Unfortunately, trans-fats can shorten the shelf life of humans. Fortunately, artificial trans-fats have been banned in the United States.
What are saturated fats?
Saturated fats are primarily derived from red meat, whole milk products (including cheese), and some commercially prepared baked goods. These saturated fats aren’t nearly as unhealthy as trans-fats, but a healthy diet will include only limited amounts.
What are unsaturated fats?
Some fats are beneficial. In fact, cholesterol-lowering unsaturated fats are necessary. They provide healthy nourishment, build cell membranes, and coat nerves. Fats are also necessary for blood clotting and muscle movement. So it’s a good thing that good fats, such as unsaturated fats, are available.
Unsaturated fats include vegetable oils, like olive oil. Other good sources of unsaturated fats are fatty fish (such as salmon, mackerel, and sardines), flax, walnuts, canola oil, and un-hydrogenated soybean oil.
What are statins?
Sometimes exercise and diet just aren’t enough to control the buildup of cholesterol and triglycerides. That’s when your doctor is likely to prescribe medication, known as statins. These medications help you maintain the low levels of LDL cholesterol and triglycerides that will enable you to avoid coronary heart disease.
Menopause and cholesterol
During a woman’s childbearing years, her levels of estrogen remain high. These elevated estrogen levels lead to increased levels of HDL (that’s the good kind). Elevated HDL, in turn, reduces accumulations of cholesterol in blood vessels and helps avert heart and cardiovascular diseases.
Women have significantly lower risks of heart attack and stroke than men in the same age brackets.
Recent research from the American Heart Association shows that, as perimenopause and menopause approach, estrogen levels diminish. At this age, women can become more likely to suffer from high blood pressure, and the risk of cardiovascular disease and heart attacks accordingly increases.
In any event, for a time it did seem clear that a woman’s postmenopausal reduction in estrogen led directly to her corresponding increased risk of heart attack and stroke. This conclusion led to the further assumption that artificially replacing estrogen would restore that protection, and thus reduce heart attacks and stroke in postmenopausal women.
What is hormone replacement therapy?
For a couple of decades, in the 1980s and 90s, hormone replacement therapy (HRT) became almost automatic for women whose natural sources of estrogen had been diminished during menopause. HRT works by artificially replenishing estrogen levels for menopausal women.
As we more fully discussed in an earlier blog article, these assumptions, as natural and logical as they may have been at the time, were to some extent undermined by findings from two large-scale studies of women’s health.
Today, further research shows that women whose uteruses have been surgically removed do indeed receive substantial protection against heart disease from HRT.
However, women who retain their uteruses, and who are interested in the healthcare benefits of HRT, are advised to seek medical advice via a thorough, lengthy, and candid discussion with their OB/GYN.
About Dr. Aliabadi
As one of the nation’s leading OB/GYN’s, Dr. Thaïs Aliabadi offers the very best in obstetrics and gynecology, including telehealth appointments. Together with her warm professional team, Dr. Aliabadi supports wellness for women through all phases of life. She creates a special one-on-one relationship between patient and doctor.
We invite you to establish care with Dr. Aliabadi. Please click here to make an appointment or call us at (844) 863-6700.
We take our patients’ safety very seriously. Our facility’s Covid-19 patient safety procedures exceed all CDC and World Health Organization recommendations. Masks are required in our office at all times during the coronavirus pandemic.
The practice of Dr. Thais Aliabadi and the Outpatient Hysterectomy Center are conveniently located for patients throughout Southern California and the Los Angeles area. We are near Beverly Hills, West Hollywood, Santa Monica, West Los Angeles, Culver City, Hollywood, Venice, Marina del Rey, Malibu, Manhattan Beach, and Downtown Los Angeles.