Cardiovascular disease is the leading killer of American women, according to the American Heart Association (AHA). As with men, elevated cholesterol levels signal danger for a woman’s health, putting her at risk for both heart disease and stroke.  

Women usually have higher HDL ("good") cholesterol levels prior to menopause because estrogen (the female sex hormone) raises this level. Therefore, women  are particularly at risk after menopause,  when their estrogen levels drop along with their HDL levels, and their LDL (“bad”) cholesterol levels increase. The National Heart, Lung and Blood Institute (NHLBI) found that over half of postmenopausal women needed to reduce their total cholesterol levels. 

Men and women are also advised to maintain different levels of HDL cholesterol. Whereas men are considered to have low HDL cholesterol at less than 40 mg/dL, women have low HDL cholesterol at less than 50 mg/dL. Both men and women are advised to strive for HDL levels above 60 mg/dL.

Post-menopausal women are advised to be particularly aware of the relationship between hormone replacement therapy (HRT) and cardiovascular disease. It was previously thought that replacing lost sex hormones in post-menopausal women would provide the same cardio-protective benefits experienced by women with normal levels of estrogen. However, several major studies have since found that estrogen/progestin therapy increases the risks of heart attack, stroke, breast cancer, blood clots and overall cardiovascular disease.