Cholesterol after menopause: what our members' tests show

Cholesterol often rises after menopause, and our members' blood tests show it clearly. Among 820 Vively members aged 45 to 55, 40% of women past menopause had LDL cholesterol above the lab range of 3.5 mmol/L, against 24% of women the same age in perimenopause. Total cholesterol above 5.6 mmol/L followed the same pattern: 43% against 29%.

Why we compared women of the same age

Cholesterol rises with age in everyone. So if you compare a 40 year old woman with a 60 year old, you can't tell how much of the difference comes from menopause and how much from 20 extra years.

To get around that, we looked only at women aged 45 to 55 at their first Vively blood test, from January 2024 to October 2026. In that age range, some women are still in perimenopause and some have been through menopause. We grouped them by the stage they told us in the Vively app: 506 in perimenopause and 314 who had reached menopause or were past it. Women who weren't sure of their stage are left out.

Comparing women of similar age shows a gap that age alone doesn't explain.

What changed after menopause

Against women the same age in perimenopause, women past menopause had:

• LDL cholesterol above 3.5 mmol/L: 40%, against 24%. The typical (median) LDL was 3.3 against 3.0 mmol/L.
• Total cholesterol above 5.6 mmol/L: 43%, against 29%. The median was 5.5 against 5.1 mmol/L.
• HOMA-IR above 2.9: 15%, against 10%. HOMA-IR is a measure of insulin resistance.
• Ferritin, your iron stores: a median of 80 µg/L, against 53 µg/L. Once periods stop, women stop losing iron each month.

Some markers barely moved. HDL cholesterol, triglycerides and HbA1c were much the same in both groups. That fits what longer studies have found: the change around menopause shows up mostly in LDL.

Women's cholesterol catches up with men's after 50

Across all ages, the picture flips around 50. Under 50, fewer women than men had cholesterol above the lab range in every age group. From 50 the gap closes, and at 60 and over, 52% of women had total cholesterol above 5.6 mmol/L, against 34% of men. For LDL above 3.5 mmol/L, women 60 and over were at 42% and men at 37%. Our cholesterol levels by age guide has total cholesterol, LDL and HDL for every age group.

What oestrogen has to do with cholesterol

Oestrogen helps your liver clear LDL cholesterol from your blood. As oestrogen falls through the menopause transition, LDL tends to rise. Jean Hailes for Women's Health describes the same change.

A large US study of midlife women, the Study of Women's Health Across the Nation, followed women through menopause. It found LDL and apolipoprotein B (ApoB) rose sharply in the year around the final period, faster than at any other time. Age alone didn't explain the jump.

Higher LDL over many years adds to the risk of heart disease, one of the leading causes of death for Australian women. Cholesterol is one risk factor among many, alongside blood pressure, smoking, diabetes, weight and family history.

What our data can't tell you

• Menopause stage is self-reported. Women told us their stage in the app. We don't know how long ago their last period was.
• Similar age, not identical. Women past menopause in the 45 to 55 group are likely to be a little older on average, so a small part of the gap may still be age.
• One test each. We used each woman's first result, so we can't show change in the same person over time.
• We can't see treatment. We don't know who was on menopausal hormone therapy or cholesterol medicine.
• Our members chose to test. These numbers describe Vively members, not all Australian women.

What to test around menopause, and when

A lipid panel (total cholesterol, LDL, HDL and triglycerides) is the starting point. ApoB counts the particles that carry LDL and is worth asking about if your LDL is borderline or heart disease runs in your family. Our post on ApoB and lipoprotein(a) explains both.

If you had your cholesterol checked in your early 40s, it is worth checking again once your periods become irregular or stop. A result that was fine at 42 may not be at 52. Read your result against the range on your own report: labs set their own ranges, and typical ones are LDL up to 3.5 mmol/L and total cholesterol up to 5.6 mmol/L.

Hormone tests can help describe where you are in the transition, though during perimenopause they swing from week to week. Our perimenopause blood test guide and women's hormone blood tests guide cover which tests help and when to have them.

See your GP to talk about your heart risk if your LDL is well above the lab range, if heart disease or stroke happened early in your family, or if you have high blood pressure or diabetes. Your GP can work out your overall risk with the Australian cardiovascular risk calculator and talk through options, including whether medicine makes sense.

How Vively can help

The Vively Baseline Health Check includes a full lipid panel, HbA1c, fasting insulin, HOMA-IR and ferritin, so you can see the markers in this story in one test. ApoB and hormone tests can be added. Re-testing every 3 months shows how your numbers move through the transition, and a practitioner helps you read them. See the LDL cholesterol test and total cholesterol test pages for more on each result.

Frequently asked questions

Does cholesterol go up after menopause?

For many women, yes. LDL cholesterol tends to rise as oestrogen falls. Among Vively members aged 45 to 55, 40% of women past menopause had LDL above 3.5 mmol/L, against 24% of women the same age still in perimenopause.

Does perimenopause raise cholesterol?

It can start to. A large US study found the sharpest rise in LDL came in the year around the final period, which falls at the end of perimenopause.

What is a normal cholesterol level for a woman over 50?

The lab ranges are the same at any age. Typical ranges are LDL up to 3.5 mmol/L and total cholesterol up to 5.6 mmol/L, but use the range on your own report. Among Vively members aged 50 to 59, the typical (median) total cholesterol for women was 5.5 mmol/L and LDL was 3.2 mmol/L.

Will my cholesterol go back down after menopause?

It usually doesn't fall back on its own. Diet, activity, weight and, where your GP advises it, medicine can all lower LDL. Some women also discuss menopausal hormone therapy with their GP, mainly for symptoms rather than for cholesterol.

How often should I check my cholesterol around menopause?

Ask your GP, as it depends on your results and overall risk. A check once periods become irregular or stop, and again within a year or two, will show whether your numbers have moved.

Sources

1. Vively: how we collect and publish member data.
2. Matthews KA and colleagues. Are changes in cardiovascular disease risk factors in midlife women due to chronological aging or to the menopausal transition? Journal of the American College of Cardiology, 2009.
3. Jean Hailes for Women's Health: menopause and heart health.
4. Heart Foundation: blood cholesterol.
5. Australian cardiovascular disease risk calculator.