Understanding What Causes High Cholesterol in Women
Understanding What Causes High Cholesterol in Women
Understanding what causes high cholesterol in women is essential for maintaining optimal heart health. High cholesterol doesn’t happen by chance—it’s the result of a combination of factors, some within your control and others influenced by age, genetics, and lifestyle.
For women, the path to healthy cholesterol is often a balancing act, as hormones, diet, exercise, and even stress all impact cholesterol levels. Fortunately, with knowledge and proactive care, cholesterol levels can be managed and even improved.
Join us as we explore the causes of high cholesterol in women, the impact it has on the body, and the steps you can take to reduce your risks and keep your heart healthy.
Understanding Cholesterol
Cholesterol is a waxy, fat-like substance found in every cell of the body. It supports the production of hormones, vitamin D, and bile acids that help digest fats.
While cholesterol is essential for normal bodily functions, too much of it can accumulate in the blood and lead to serious health problems.
The liver produces most of the cholesterol the body needs, but dietary sources—such as meat, dairy, and processed foods—can contribute to excessive levels.
Since cholesterol does not dissolve in water, it travels through the bloodstream in lipoproteins. The balance between different types of cholesterol determines overall cardiovascular health.
LDL vs. HDL
Cholesterol is a type of lipid carried through the bloodstream by lipoproteins, which are classified into two main types: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
LDL, often called "bad" cholesterol, transports cholesterol to the arteries, where it can build up as plaque, increasing the risk of heart disease and stroke. HDL, or "good" cholesterol, helps remove excess cholesterol from the bloodstream, carrying it back to the liver for disposal.
Maintaining a healthy ratio of LDL to HDL is critical, as high LDL levels contribute to artery narrowing (atherosclerosis), while high HDL levels help protect against cardiovascular disease.
What Is Considered High Cholesterol?
Cholesterol levels are measured in milligrams per deciliter (mg/dL) of blood. A total cholesterol level below 200 mg/dL is considered desirable. LDL cholesterol should be under 100 mg/dL for optimal heart health, while HDL should be 60 mg/dL or higher.
Triglycerides, another type of blood fat, should be below 150 mg/dL. High cholesterol is typically diagnosed when LDL levels exceed 130 mg/dL, HDL falls below 40 mg/dL, or total cholesterol surpasses 240 mg/dL.
Because high cholesterol has no symptoms, regular blood tests are necessary to assess risk and prevent complications such as heart disease and stroke.
Causes of High Cholesterol in Women
High cholesterol in women can result from a combination of lifestyle, genetic, and medical factors. While the body needs cholesterol for essential functions, an imbalance—particularly high levels of LDL cholesterol—can significantly increase the risk of heart disease and stroke.
Women face unique risks due to hormonal fluctuations, pregnancy, menopause, and certain medications. Many causes of high cholesterol are preventable, but others, such as genetics, require medical intervention.
Understanding these risk factors can help women make informed choices about their health and take proactive steps to maintain balanced cholesterol levels.
Unhealthy Diet
Diet plays a major role in cholesterol levels. Consuming foods high in saturated and trans fats—such as red and processed meats, full-fat dairy, fried foods, and baked goods—raises LDL (bad) cholesterol while decreasing HDL (good) cholesterol.
Processed and sugary foods can also contribute by promoting weight gain and increasing triglyceride levels, another type of harmful blood fat. Excess dietary cholesterol, primarily from animal-based foods, can further elevate overall cholesterol levels.
Women who frequently consume these foods without balancing their diet with fiber-rich fruits, vegetables, whole grains, and healthy fats are at higher risk of developing high cholesterol.
Genetic Factors
Genetics can play a significant role in cholesterol levels. Familial hypercholesterolemia (FH) is an inherited condition that causes extremely high LDL cholesterol levels from birth, significantly increasing the risk of heart disease at an early age.
Even in women without FH, genetic variations can affect how the body processes and removes cholesterol. If a close family member has high cholesterol or heart disease, a woman may be more likely to experience similar issues.
Unlike lifestyle-related cholesterol elevations, genetic predisposition often requires medication, such as statins or PCSK9 inhibitors, alongside dietary and lifestyle modifications to manage cholesterol effectively.
Medical Conditions
Certain medical conditions can lead to high cholesterol by affecting how the body processes fats. Hypothyroidism, for example, slows metabolism and reduces the liver’s ability to remove LDL cholesterol, thus leading to elevated levels
Diabetes increases triglycerides while lowering HDL cholesterol, contributing to an overall higher risk of heart disease. Kidney disease can also disrupt lipid metabolism, leading to cholesterol imbalances.
Polycystic ovary syndrome (PCOS) and metabolic syndrome, both common in women, can cause insulin resistance, which is linked to increased LDL and triglycerides.
Managing these conditions with proper medical treatment, diet, and exercise is essential to maintaining healthy cholesterol levels.
Medicines
Certain medications can negatively impact cholesterol levels by altering the body's fat metabolism. Hormonal treatments, such as birth control pills and hormone replacement therapy (HRT), can increase triglycerides and sometimes LDL cholesterol.
Corticosteroids, often prescribed for inflammatory conditions, may raise total cholesterol and triglycerides while reducing HDL cholesterol.
Some diuretics used for blood pressure control can lower HDL and slightly increase LDL. Antidepressants and antipsychotic medications have also been linked to lipid imbalances
Women taking these medications should have regular cholesterol monitoring and may need lifestyle adjustments or medication changes to mitigate the effects on their cardiovascular health.
Age, Sex, and Race
Age, sex, and race all influence cholesterol levels. Women typically have lower LDL (bad) cholesterol and higher HDL (good) cholesterol than men before menopause due to the protective effects of estrogen.
However, after menopause, estrogen levels drop, leading to increased LDL and a higher risk of cardiovascular disease. Aging itself slows metabolism and alters how the liver processes cholesterol, often resulting in higher total cholesterol levels.
Race also plays a role—black and Hispanic women, for example, may be at a higher risk of developing high cholesterol due to genetic factors and metabolic differences. Understanding these risks helps women take proactive steps to manage cholesterol as they age.
Inactivity and Obesity
A sedentary lifestyle contributes significantly to high cholesterol by lowering HDL (good) cholesterol and increasing LDL (bad) cholesterol and triglycerides.
Regular physical activity helps stimulate enzymes that break down LDL and increase HDL levels, promoting better cardiovascular health.
Obesity further compounds the issue by increasing fat accumulation, especially around the abdomen, which is linked to insulin resistance and higher LDL levels. Excess weight also promotes chronic inflammation, which can accelerate plaque buildup in the arteries.
Women who do not engage in regular exercise or maintain a healthy weight are at an increased risk of high cholesterol and heart disease.
Smoking and Excessive Alcohol Consumption
Smoking lowers HDL (good) cholesterol while damaging blood vessels, making it easier for LDL (bad) cholesterol to stick to artery walls and form plaques. It also increases oxidative stress and inflammation, accelerating the development of atherosclerosis.
Excessive alcohol consumption contributes to high cholesterol by raising triglyceride levels, which can lead to fatty liver disease and further metabolic imbalances.
While moderate alcohol intake—such as red wine in small amounts—may have some heart benefits, excessive drinking negates these effects and increases cardiovascular risk.
Women who smoke or drink excessively should consider quitting or reducing intake to improve cholesterol levels.
Stress and Poor Sleep Habits
Chronic stress and inadequate sleep can negatively impact cholesterol levels in multiple ways. High stress triggers the release of cortisol, a hormone that increases LDL cholesterol and triglycerides while lowering HDL.
Stress can also lead to unhealthy eating habits, inactivity, and weight gain, all of which contribute to poor lipid profiles. Poor sleep disrupts metabolism and increases inflammation, further raising the risk of high cholesterol
Women who experience ongoing stress or sleep deprivation should prioritize stress management techniques, such as exercise, meditation, or therapy, and aim for at least 7–9 hours of quality sleep per night to support heart health.
Why Women Over 65 Have an Increased Risk
Women over 65 face a higher risk of high cholesterol due to hormonal changes, slower metabolism, and age-related shifts in fat distribution.
After menopause, estrogen levels drop, leading to increased LDL (bad) cholesterol and decreased HDL (good) cholesterol, which raises the risk of heart disease. Additionally, aging reduces the liver’s efficiency in clearing cholesterol from the blood.
Many older women also experience weight gain, reduced physical activity, and chronic conditions such as diabetes or hypertension, all of which contribute to elevated cholesterol levels.
How Herself Health Can Help
At Herself Health, we are committed to improving healthcare and health outcomes for Minnesota women 65+ with personalized, whole-person care. We provide comprehensive primary care services that include a strong emphasis on prevention.
We’ll carefully evaluate your health and risk factors, run necessary tests, ensure current conditions are well-managed, and develop a tailored plan to help you maintain healthy cholesterol levels.
We are currently welcoming new patients at all our senior women's health clinics. To schedule your appointment, please call 1-888-290-1209 or fill out our Contact page, and we’ll call you to book your appointment.
How High Cholesterol Affects the Body
High cholesterol negatively impacts the body by promoting the buildup of fatty deposits, known as plaque, in the arteries.
Cholesterol itself is essential for cell function and hormone production, but when LDL (bad) cholesterol levels are too high, excess cholesterol accumulates in the blood vessel walls.
Over time, this leads to a condition called atherosclerosis, where the arteries become narrow and stiff, thus restricting blood flow. Reduced circulation increases the risk of cardiovascular diseases, including heart attacks and strokes.
The body’s inflammatory response further exacerbates the problem as the immune system tries to repair cholesterol-laden artery walls. This can cause plaques to rupture, which can lead to blood clots that may completely block arteries.
High cholesterol also contributes to increased blood pressure by making arteries less flexible, thus forcing the heart to work harder.
Additionally, poor circulation from cholesterol buildup can affect various organs, including the brain, kidneys, and extremities, leading to severe health complications.
Serious Complications That Can Result From High Cholesterol
High cholesterol is a major risk factor for life-threatening conditions. One of the most serious complications is coronary artery disease (CAD), where cholesterol buildup in the heart’s arteries reduces blood supply, potentially leading to angina (chest pain) or a heart attack.
Similarly, carotid artery disease occurs when cholesterol blocks the arteries supplying blood to the brain, increasing the risk of stroke.
Peripheral artery disease (PAD) is another consequence that affects blood flow to the legs and feet, causing pain, numbness, and slow-healing wounds that may lead to infections or amputations.
High cholesterol can also contribute to high blood pressure (hypertension) by making arteries less elastic, which further strains the heart. Additionally, cholesterol deposits in the arteries of the kidneys can lead to chronic kidney disease, which impairs the body’s ability to filter waste.
Without intervention, these conditions can significantly impact a woman’s quality of life and longevity.
When To Have Your Cholesterol Checked
Cholesterol should be checked regularly, as high cholesterol has no symptoms and can silently increase the risk of heart disease.
Women should have their first cholesterol test by age 20 and at least every five years thereafter. However, women over 45 or those with risk factors—such as a family history of high cholesterol, obesity, diabetes, or high blood pressure—may need more frequent testing.
After age 65, annual screenings are recommended. A simple blood test, called a lipid panel, measures total cholesterol, LDL, HDL, and triglycerides to assess heart health.
Preventing and Managing High Cholesterol in Women
Managing high cholesterol involves a combination of lifestyle changes, dietary improvements, and, in some cases, medications. The right approach depends on cholesterol levels, overall health, and risk factors for heart disease.
A combination of these strategies—especially diet, exercise, and stress management—can significantly improve cholesterol levels and reduce heart disease risk in women. Follow your doctor’s recommendations carefully.
1. Get Regular Cholesterol Screenings
Routine cholesterol checks help detect issues before they become serious. Women should start screening in their 20s and have follow-ups every five years or more frequently if they have risk factors such as family history, obesity, or high blood pressure.
2. Heart-Healthy Diet
A diet rich in fiber, healthy fats, and lean proteins can help lower LDL (bad) cholesterol and increase HDL (good) cholesterol. Women should focus on:
• Soluble fiber (oats, beans, lentils, fruits, and vegetables) to reduce cholesterol absorption.
• Healthy fats from sources like olive oil, avocados, and nuts instead of trans fats and saturated fats.
• Lean proteins such as fish, poultry, and plant-based options like tofu and legumes.
• Limiting processed foods, red meat, and sugary beverages that contribute to weight gain and higher cholesterol.
3. Regular Exercise
Physical activity helps raise HDL and lower LDL cholesterol. Women should aim for:
• At least 150 minutes of moderate-intensity exercise (such as brisk walking) or 75 minutes of vigorous activity per week.
• Strength training twice a week to improve metabolism and overall heart health.
• Everyday movement, such as taking the stairs, walking more, or stretching to prevent prolonged inactivity.
4. Maintaining a Healthy Weight
Excess weight, particularly around the abdomen, is linked to high cholesterol and heart disease. Losing even 5–10% of body weight can significantly improve cholesterol levels and overall cardiovascular health.
5. Quitting Smoking and Limiting Alcohol
Smoking lowers HDL cholesterol and damages blood vessels, making cholesterol buildup worse. Quitting can quickly improve heart health.
Alcohol in moderation (one drink per day for women) may have some heart benefits, but excessive drinking raises cholesterol and triglycerides.
6. Managing Stress and Sleep
Chronic stress and poor sleep contribute to high cholesterol by increasing inflammation and promoting unhealthy behaviors. Techniques such as meditation, yoga, therapy, and prioritizing 7–9 hours of quality sleep each night can help regulate cholesterol levels.
7. Medications for High Cholesterol
For women with significantly high cholesterol or those at high cardiovascular risk, doctors may prescribe:
• Statins (e.g., atorvastatin and rosuvastatin) to reduce LDL production in the liver.
• Ezetimibe to block cholesterol absorption in the intestines.
• PCSK9 inhibitors for those with genetic high cholesterol or statin intolerance.
• Bile acid sequestrants help the body remove excess cholesterol.
• Fibrates or niacin for lowering triglycerides if necessary.
Final Thoughts
Cholesterol may be invisible, but its impact on a woman’s health is undeniable. It silently shapes heart health and influences the risk of heart disease, stroke, and more. However, high cholesterol isn’t a life sentence—it’s a call to action.
With the right balance of nutrition, movement, and awareness, women can take control of their cholesterol long before it becomes a problem.
Whether through small daily choices or necessary medical interventions, every step toward heart health is a step toward a longer, fuller life.
Understanding what causes high cholesterol in women empowers you to make informed choices, protect your well-being, and rewrite your heart health story.
Partner with Herself Health to experience healthcare as it should be—focused on you!