Whether your cholesterol levels have always been healthy or you’ve had high readings in the past, your next blood work results may surprise you. Declining estrogen during menopause can raise cholesterol levels. Some women have seen increases of 20 points or more. While elevated cholesterol is common during midlife, you shouldn’t ignore increases, even if they’re small. “Knowing your cholesterol levels can help you take meaningful action to improve your health,” says gynecologist Ghazaleh Moayedi, D.O. And the sooner you take steps to curb the rise, the lower your risk of a future heart attack or stroke will be.
High cholesterol is a key risk factor for heart disease, the leading killer of women. While cholesterol levels tend to rise as you get older, menopause can accelerate the increase. The incidence of high cholesterol in women is more than three times greater in those over 40 than in younger women. This spike coincides with menopause and declining estrogen levels that impact cholesterol. Men’s increase during this stage of life is only about 50 percent.
As with many menopause symptoms and side effects, hormones are part of the reason. “Estrogen is generally considered to have a cardioprotective effect, which means it can be beneficial to the heart and cardiovascular system,” says Dr. Moayedi. This is one of the reasons younger women are less likely to have heart attacks and develop heart disease later in life than men.
As estrogen starts to decline in perimenopause, women lose that protection. “The drop in estrogen from menopause leads to an increase in LDL cholesterol, a decrease in HDL cholesterol, and an increase in triglycerides,” says Dr. Moayedi. The longer your body is subjected to high levels of cholesterol, the more damage it can do to your arteries, increasing your risk of a heart attack or stroke. High triglycerides and low HDL cholesterol are also some of the hallmarks of poor metabolic health, which also increases your risk for diabetes. That’s why it’s essential to monitor your cholesterol levels regularly and take action as soon as your numbers start to go up.
While you can’t stop the effects of menopause on your body, or change your genetics, high cholesterol is treatable. “Lifestyle can strongly influence your cholesterol levels,” says Gennev health coach Monika Jacobson, a registered dietitian nutritionist. “Both nutrition and exercise can play a role in improving cholesterol with consistency over time.” Here are proven strategies to lower cholesterol, improve your metabolic health, and reduce your risk for heart disease, stroke, and diabetes.
Adopt a Mediterranean way of eating. “A diet primarily composed of fiber-rich carbohydrates, lean protein, and inclusive of healthy fats may help reduce cholesterol levels,” says Monika. “This balance of nutrients is best compared to the well-researched Mediterranean Diet, which is known to prevent cardiovascular disease. Many of the nutrition tips that follow align with the Mediterranean diet.
Up your soluble fiber intake. Soluble fiber latches onto cholesterol in your small intestines and escorts it out your body before being absorbed into your bloodstream, where it builds up as plaque in your arteries. Aim for at least 25 grams of fiber a day, but gradually increase your intake while drinking lots of water so it’s easier to digest. Foods high in soluble fiber include raspberries (8 grams in 1 cup), black beans (8 grams in ½ cup), a medium-sized apple with skin (5 grams), chopped broccoli (5 grams in 1 cup), and brown rice (4 grams in 1 cup).
Reduce saturated fats. Foods high in saturated fat include red meat, processed meats (hot dogs, bacon, and lunchmeat), butter, cheese, and ice cream. Too much saturated fat impairs your liver’s ability to process cholesterol, which builds up in your bloodstream and clogs your arteries. Instead, eat more fish, poultry, and low-fat dairy.
Choose healthy fats. Monounsaturated fats, found in olive oil, nuts, seeds, and avocados, lower the bad LDL cholesterol, and omega 3 fats are known to raise “good” HDL cholesterol levels. While healthy fats are key in heart health and help you to feel full faster, be mindful of portion size because they pack a lot of calories.
Cut back on refined carbohydrates. These include sweetened drinks, baked goods, candy, juice, white bread, pasta, and alcohol. When digested, these foods quickly break down into sugar, raising blood sugar and insulin levels which may adversely affect triglyceride and HDL levels.
Add soy protein. If you’re not already eating tofu, soybeans, soy nuts, or soy milk, add some to your diet. You can also try replacing more high saturated fat protein foods with plant-based soy foods. Soy foods contain isoflavones, a type of phytoestrogens, that have been shown to reduce cholesterol. They may also help ease other menopause symptoms like hot flashes.
Get moving. You can walk, run, swim, cycle, use the elliptical, take a Zumba class, play pickleball, or do any activity that gets your heart beating faster. Any cardio exercise can improve your cholesterol levels. The key is to do it most days of the week and accumulate at least 150 minutes (30 minutes five days a week or about 21 minutes daily). You don’t have to push yourself too hard. However, an hour a day of activity or higher intensity activities like fast walking or jogging, may provide better results.
Find a way to relax. One of the many detrimental effects stress has on your body is elevated cholesterol levels. Experts aren’t sure how stress increases cholesterol, but reducing stress can minimize the damage. Common relaxation strategies include meditation, yoga, and deep breathing, but they’re not the only ways to relax. For some, watching a movie, going out with friends, reading a book, working out, petting your dog or cat, or even cooking can reduce stress. Find what works for you and make it a regular part of your life.
Consider supplements. Omega 3 fatty acids are healthy fats found in fish, such as fatty fish like salmon, mackerel, and sardines, walnuts, and seeds like flax seeds and chia seeds. Research shows that they can lower triglycerides and raise good HDL cholesterol. If you’re not eating foods high in Omega 3s, you should talk to your doctor or a Gennev Dietitian to see if supplements might be right for you. Another supplement to speak with your doctor or healthcare provider about, especially if you have diabetes, is coenzyme Q10. CoQ10 is an antioxidant made in your body; however, levels decline as you age. Some research suggests that CoQ10 supplements may help lower LDL and total cholesterol in people with diabetes.
Start with as many strategies as you can manage. Even implementing one or two of them can have an impact as long as you do them consistently. Then retest your cholesterol in six months, or as soon as your doctor suggests.
If your numbers aren’t improving as much or as quickly as you’d like, talk to your doctor or healthcare provider about other options, such as medication. Lifestyle changes aren’t always enough to lower cholesterol, especially if you have a family history of high cholesterol, certain medical conditions, or very high numbers. It’s worth the effort to find a way to bring down your cholesterol so you can live a longer, healthier life.
When you make some key lifestyle choices in menopause, it can have a lasting effect on your health as well as help to relieve symptoms. Gennev’s integrated care provides access to experts in menopause lifestyle change management. They will help you to thrive through nutrition, fitness and mindfulness practices. Schedule a one-on-one virtual visit to get started with your personalized wellness plan.
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The information on the Gennev site is never meant to replace the care of a qualified medical professional. Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev’s telemedicine doctors before beginning any new treatment or therapy.
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Not feeling in the mood lately? You’re not alone”and there’s nothing wrong with you! Low libido in midlife, or diminished sexual desire is a fact of life for up to 87 percent of women as they get older. “For many women, as we age and our relationships age, we just don’t feel spontaneously horny anymore, and that is a completely normal change,” says Laurie Mintz, Ph.D., a professor of psychology at the University of Florida and the author of A Tired Women’s Guide to Passionate Sex. “We think we’re supposed to feel like we did when we were 20 rather than accepting changes as they occur. What might have turned you on at 20 is going to be different than at 40, 50, or 60.” Understanding these changes in libido and how to get help”there are remedies for most sexual issues”could make this the perfect time to reawaken your sexual self and improve your sex life.
“Menopause does not have to be a death sentence to your sex life,” Mintz says. Many people report that the best sex they ever had started at age 50 when they got more comfortable with their bodies and with communicating their needs, according to research by Peggy J. Kleinplatz, Ph.D., a sex therapist and co-author of Magnificent Sex.
Sexual desire isn’t just about lingerie and candlelight. It’s complicated and menopause is only part of the story. Many factors can affect your sex drive:
To further complicate sexual desire, there isn’t a one-size-fits-all definition of low libido. “There’s no criteria,” says Mintz. “It’s so individual.” For one woman, sex once a month may be fine, but anything less than once a week is a problem for another. If you and your partner are satisfied with the frequency of your sexual encounters and level of intimacy, don’t compare yourself to others. However, if your lack of desire, frequency, or quality of your sexual encounters is bothering you, there are ways to improve your love life.
Unfortunately, most women are only aware of one type of desire, the spontaneous kind, where suddenly you feel horny and want to have sex. When this doesn’t happen as often or at all, women feel guilty and think something is wrong with them (even though it’s a normal part of aging). But there is another type of desire, called responsive sexual desire, which is just as important”maybe even more so in midlife.
Responsive sexual desire starts with your brain instead of your genitals. Your brain says sex is a good idea for whatever reason. (According to one study, people gave 237 different reasons for having sex, and being horny was only one of them.) Think of it like reversing the equation; you have sex to get horny. Sexual arousal springs up as a result of stimulation like being touched. “It’s like starting your car in the winter,” says Mintz. “You can still have a pleasant ride, but you have to warm it up first. A lot of times, if you wait to have sex until you’re horny, you’ll never have sex, especially at this stage of life.” And the more sex you have”including with yourself–the more sex you want.
Focusing on responsive desire can improve your sex life, but sometimes you need additional help. If you’re not getting aroused once you and your partner get going or sex hurts, you need to consider underlying conditions. Sometimes it may be as simple as a lubricant to solve the problem, but other times you may need to talk to your doctor.
As estrogen declines during menopause, blood flow to the vagina decreases, and vaginal tissue thins, causing a decrease in arousal and lubrication. These changes can make sex less enjoyable, orgasms harder to achieve, and penetration painful. About half of postmenopausal women experience pain during intercourse, called dyspareunia. It’s one of the most common reasons women shy away from sex. But, there ways to stop the pain. If a lubricant doesn’t help, talk to your doctor about other options. If dryness is causing the pain, a topical estrogen can help. Your doctor can also determine if another condition such as a urinary infection or skin condition is causing the pain and treat it appropriately.
Sex is important for a relationship. Yes, some people are happy in sexless relationships, but that’s probably not you if you’re reading this. Unfortunately, even though we say or think sex is important to us, many of our actions say otherwise. Too tired for sex? But are you staying up late binge-watching your favorite show or scrolling on social media? To get your sex life back on track, here are some steps to take.
Believe sex is important. There are physical, emotional, and relational benefits to having sex. When you’re hugging and touching each other, your body releases the feel-good hormone oxytocin, which reduces stress, anxiety, and irritability. Neurochemicals released during an orgasm can provide pain relief and help you sleep better. You’ll feel more connected with your partner, and you’ll get less annoyed and be less snippy with each other outside of the bedroom. Sex boosts immunity. “This is just the tip of the iceberg,” Mintz says. “There was a 25-page paper written summarizing all the physical, mental, and emotional benefits of sex.”
Make sex a priority. Scheduling sex is one of the most effective therapies that sex therapists prescribe. “I call them trysts rather than scheduled sex because it sounds a little sexier,” says Mintz. “If you look it up in a dictionary, a tryst is a planned meeting between lovers. People think of it related to having affairs, but it can be with your long-term partner as well.” Remember, desire doesn’t have to be spontaneous, and you don’t have to be horny to get it on.
Think about intimacy, not just sex. There’s more to a sexual relationship than just intercourse. Building connections with your partner outside of the bedroom can make your connections in the bedroom more fun and satisfying. Exercising, cooking, holding hands while taking a walk, going on a date, or dancing together can bring you closer. In or outside of the bedroom, hugging, kissing, cuddling, giving or getting massages or foot rubs, even having your hair brushed can enhance intimacy and sensual stimulation. And remember there are lots of ways to pleasure each other, including oral sex, using a vibrator together, or even masturbation. Thinking about sex as a spectrum of activities can help take pressure off of both of you, especially as you get older.
Focus on you. Take time to take care of yourself. All types of exercise can improve sleep and reduce stress, two factors affecting your sex drive. Working out, especially strength training, may also help with body image issues that can come up when your body is changing. Eating a healthy diet can boost your energy and improve your mood. Pleasuring yourself by masturbating can also be a vital part of self-care. It can help you relax, and getting in touch with your body enables you to direct your partner for more satisfying encounters for both of you.
Use your brain. “Most of us need genital stimulation, but it doesn’t matter how you’re being touched; if your brain isn’t in the game, it’s not going to happen,” says Mintz. For the best sex, you want your mind to be present in your body, not worrying about how you look or thinking about your to-do list. One of the best ways to learn to be more present in the bedroom is to practice meditation or mindfulness outside of the bedroom. Yoga can also help you become more mindful, and the flexibility you can gain from the practice can be an asset in the bedroom. One study even found that women who do yoga are more orgasmic. Another way to use your brain is to fantasize about sex even when you’re not doing it. Fantasizing can be like a form of foreplay, and doing it during sex can help keep distracting thoughts out of your head.
Be adventurous. Reminisce about how fun sex was and look for ways to spice it up now. Try different positions, read erotic books, or watch woman-centric erotica. Sex toys like vibrators offer a whole new element. Even something as simple as a blindfold or feather can enhance your experience. Or try role-playing or book a hotel room to change things up.
Talk about sex. “You can’t solve a problem, sexual or otherwise, without talking about it,” says Mintz. Let your partner know what’s going on. They’ll be much more supportive knowing that it’s the hot flashes or discomfort that’s turning you off and not them. If your partner is part of the problem, you should talk to a therapist who can help you address the topic. It can also help if you speak with your doctor about sexual issues. Don’t be embarrassed because they’ve probably heard it before. “We used to die before we hit menopause,” says Dr. Mintz. “Now, we are outliving our uterus. We are outliving our estrogen. If we’re going to have a healthy sex life after our estrogen has decreased, we need assistance from knowledgeable health care providers.” As one of Dr. Mintz’s patients summed it up, “Communication is the bedrock to make your bed rock.”
Have you experienced changes in your libido? Wonder if what you are feeling is normal? Speak with a Gennev board-certified Ob/Gyn to get your questions answered and learn about proven treatments that can help manage changes in your libido.
Listen to Dr. Mintz in the Gennev podcast where she talks about Sex, Midlife and Menopause
Check out Sex After Menopause: It is really good for you to learn about the benefits of a healthy sex life.
Are mood swings getting in the way of romance? Learn more with Menopause, Marriage and Mood Swings
The information on the Gennev site is never meant to replace the care of a qualified medical professional. Hormonal shifts throughout menopause can prompt a lot of changes in your body, and simply assuming something is “just menopause” can leave you vulnerable to other possible causes. Always consult with your physician or schedule an appointment with one of Gennev’s telemedicine doctors before beginning any new treatment or therapy.