Far more worrying than the hot flushes and mood swings associated with menopause are the more serious, often invisible, physiological changes such as an increase in cholesterol levels due to lower oestrogen levels.

The good news is that a healthy diet and lifestyle can still make a difference to women's cholesterol levels aged 45 and beyond. Consultant nutritionist, Helen Bond, offers advice about what your menopausal patients can do to protect themselves from this hidden condition:

Cholesterol awareness
We still tend to associate heart problems as a middle-aged man's issues. But women wrongly rate cancer as their number one health issue, yet in 2004, over 113,000 women died from heart and circulatory problems in the UK, compared to just over 12,000 deaths from breast cancer. [4]

Surprisingly, 75% of women do not associate the menopause with raised cholesterol levels. [2]

Being aware of their cholesterol level is the first step to improving and maintaining a patients' heart health and yet research by The Royal Society of Medicine reveals that around six out of ten people in the UK still don't know their cholesterol levels or what they should be. [3]

The guidelines for healthy cholesterol levels are [4]:

• Total cholesterol - Less than 5.0mmol/L
• LDL cholesterol - Less than 3.0mmol/L
• HDL cholesterol - more than 1.5mmol/L

Why does the menopause affect cholesterol levels?
During the menopause (when levels of the female hormones fall and the body stops producing eggs), the ovaries stop producing oestrogen and levels start to decrease in the body causing a number of important changes.

Before the menopause, when a woman gains weight she is likely to carry the excess weight in the hip and thigh area which is referred to as a 'pear shape'. Then following the menopause women tend to gain weight in and around the abdominal area (central obesity) commonly referred to as an 'apple' shape.

This shift of body fat distribution is thought to trigger an increase in total cholesterol, an increase in LDL (low density lipoprotein) or 'bad' cholesterol, and a decrease in HDL (high density lipoprotein) or 'good' cholesterol, leaving women at increased risk of developing heart problems. [2]

This is clearly highlighted by the fact that only 34% of women aged 16-24 have blood cholesterol concentrations that exceed 5.0mmol/L; rising to 88% in those aged 55-64. [4]

What about treatment?
Hormone replacement therapy (HRT) can be a very effective approach to treating menopausal symptoms and each patient will have to decide if this is appropriate for them after discussion with their doctor.

Useful resources at your fingertips
As life expectancy continues to increase, women will spend a larger proportion of their lives in the postmenopausal state. A healthy balanced diet and an active lifestyle is the best foundation for long term health and well being.

Download healthy living fact sheets

This article is sponsored by Benecol

References

1. United Kingdom; Estimated resident population by single year of age and sex; Mid-2006 Population Office for National Statistics, General Register.

2. Menopausematters.co.uk - an independent, clinician-led website.

3. National Institute for Health and Clinical Excellence (NICE) and Department of Health cholesterol guidelines.

4. A Royal Society of Medicine Survey, (December 2005) Digest - the magazine from Heart UK. June/July 2006.

5. Coronary Heart Disease Statistics. British Heart Foundation Statistics, 2006.