If lifestyle changes aren’t enough to manage your cholesterol, your healthcare provider might recommend medication.
Statins
Other Cholesterol Medications
- Selective cholesterol absorption inhibitors, like ezetimibe (Zetia). Side effects include stomach pain, diarrhea, fatigue, and muscle soreness.
- PCSK9 inhibitors, like evolocumab (Repatha), which are injected into the bloodstream. Side effects are swelling, itching, or pain at the injection site.
- Fibrates, like fenofibrate (Antara) or gemfibrozil (Lopid). Nausea, stomach pain, and muscle pain are common side effects.
- Niacin (Niacor or Niaspan) Facial flushing, itching, upset stomach, and blood sugar increase are possible side effects.
- Bile acid sequestrants, such as cholestyramine (Prevalite). Side effects tend to be gastrointestinal issues, such as constipation.
Hormone Replacement Therapy
HRT may have a small impact on cholesterol levels, but it’s unlikely to get those levels back to what they were before menopause, explains Klodas. For this reason, HRT should be primarily considered for managing menopausal symptoms rather than cholesterol levels, she adds.
If you’re considering hormone therapy, discuss the potential benefits and risks with your healthcare provider.
Supplements
Certain supplements may help support healthy cholesterol levels during menopause, though they’re not a replacement for lifestyle changes or prescribed medications. Adding omega-3 supplements, such as fish oil, to your routine may help lower triglycerides and boost HDL cholesterol, though it may also slightly increase LDL, says Dweck.
- Plant stanols and sterols: These natural compounds found in plants may reduce LDL cholesterol, but they can cause digestive issues like diarrhea.
- Ground flaxseed: May help lower LDL cholesterol while providing fiber and omega-3s.
- Berberine: This natural compound found in plants may reduce LDL cholesterol and triglycerides, but can cause digestive issues like diarrhea and nausea.
- Green tea extract: May help lower LDL cholesterol.
- Garlic: May slightly lower cholesterol, though research is mixed. It can cause digestive issues and may interact with blood thinners.
Always speak with your healthcare provider before starting any supplement, as some supplements can interact with medications or have side effects.
The Takeaway
- Decreased estrogen, muscle loss, and weight gain during menopause can affect cholesterol levels.
- Low-density lipoprotein (LDL), triglycerides, and total cholesterol tend to rise after menopause, while high-density lipoprotein (HDL) levels may decrease, increasing the risk of heart disease and stroke.
- Heart-healthy habits like Mediterranean-style eating, healthy weight, and regular exercise can help manage cholesterol levels.
- If lifestyle changes aren’t enough, medications like statins can be used to manage cholesterol. Discuss the benefits and risks with your healthcare provider.