What Women Need to Know About Cholesterol (And How to Lower It)
Cholesterol is often talked about in a negative way — but the reality is more nuanced.
For many women, especially in their 30s, 40s and beyond, cholesterol levels can start to rise… often without any obvious changes in diet or lifestyle.
And if you’ve ever wondered:
What is normal cholesterol?
Should I be worried about mine?
How can I lower cholesterol naturally?
You’re not alone.
Heart disease remains one of the leading causes of death in women in the UK, yet many women don’t realise their risk — or get their cholesterol checked early enough.
In this blog, we’ll break down what cholesterol actually is, what’s considered normal, and what you can do to support healthy levels.
What is Cholesterol?
High cholesterol is closely linked to cardiovascular disease. While heart disease is often thought of as a “male issue”, it remains one of the leading causes of death in women — second only to dementia and Alzheimer’s disease in the UK. Despite this, women are still less likely to be screened early or recognise their own risk.
Cholesterol has a very important role with cell development, digestion of foods, making hormones and vitamin D. Around 70–80% of our cholesterol is produced internally — mainly in the liver — with the remainder coming from food.
Good V Bad Cholesterol:
We hear about "good" cholesterol and "bad" cholesterol" but what does that actually mean?
Good cholesterol (known as HDL) is a lipoprotein that takes cholesterol from cells back to the liver to be destroyed and excreted
Bad cholesterol (know as LDL) is also a lipoprotein that carries cholesterol from the liver to the cells
Both have very important jobs but when LDL levels are high, or when LDL particles are more likely to become damaged or oxidised, cholesterol can accumulate in the artery walls, increasing the risk of heart disease and stroke...so it's only actually "bad cholesterol" when there is too much of it and there is not enough HDL to mop it up and take it back to the liver!
What is Normal Cholesterol
This is one of the most common questions I get asked.
Rather than focusing on one number, it’s important to look at the overall picture.
General UK guidelines:
Total cholesterol: ideally below 5 mmol/L
LDL (bad cholesterol): ideally below 3 mmol/L
HDL (good cholesterol): above 1.2 mmol/L (women)
Cholesterol ratio (total ÷ HDL): ideally below 6
A lower ratio is generally better with under 4 as often mentioned as great! I prefer to look at the ratio as that gives a clearer understanding.
However, cholesterol is only one part of the picture.
Other important factors, especially for women, include:
-
triglycerides
-
blood sugar balance
-
inflammation
-
metabolic health
Why Cholesterol Changes In Women
Whilst cholesterol levels are quite similar between males and females there are some key elements to consider. In particular it is good to note that cholesterol behaves differently in women especially during hormonal transitions.
- Women of childbearing age naturally have higher HDL (good) cholesterol
- Low thyroid hormones (those with hypothyroidism) are well known to increase LDL and decrease HDL levels
- The drop in oestrogen during perimenopause and menopause is linked to higher LDL, lower HDL and changes in how cholesterol is processed by the liver. This is one reason many women see cholesterol levels rise in their 40s and 50s — even if their diet, weight and lifestyle haven’t changed.
- Women often experience higher or more sustained levels of stress, and chronically raised cortisol can stimulate increased LDL production in the liver, contributing to an unfavourable cholesterol balance.
- Although diabetes is more common in men, women with diabetes are more at risk of developing heart disease than men with diabetes
- Women (and also men) are at a higher risk of high LDL cholesterol if they are of South Asian or sub-Saharan African origin.
Foods to Avoid with High Cholesterol
This isn’t about restriction — but awareness.
Certain foods can negatively impact cholesterol levels, particularly when eaten regularly.
Foods to limit:
-
Ultra-processed foods
(e.g. ready meals, packaged snacks, fast food)
→ often high in refined carbs, additives and unhealthy fats -
High saturated fat foods
(e.g. processed meats, excessive cheese, fatty cuts of meat)
→ may reduce the liver’s ability to clear LDL -
Sugary foods and drinks
(e.g. sweets, cakes, biscuits, fizzy drinks)
→ contribute to blood sugar spikes and increased triglycerides -
Fried foods and trans fats
→ can increase inflammation and worsen lipid profiles
How To Lower Cholesterol Naturally
Dietary and lifestyle adjustment may be very helpful as 20-30% of cholesterol can be moderated from the foods we eat. Genetics definitely play a big role but there is still things that can be done!
Simple changes include
More fibre: fibre from beans, lentils, fruits and vegetables bind cholesterol in the intestines and stop their absorption into the blood stream
More protein: Adequate protein supports blood sugar balance and metabolic health, and some evidence suggests whey protein may help reduce LDL cholesterol.
Exercise: Helps to boost HDL production and supports weight management, stress and diabetes
Stop smoking: it's linked to poor vascular health
Cholesterol Lowering Products - Don't Get Conned
A quick word on ‘cholesterol-lowering’ products
Some margarines, yoghurts and drinks marketed as cholesterol-lowering do contain plant sterols, which are proven to reduce LDL cholesterol. However, many of these products are highly processed and are classed as ultra processed.
In practice, similar benefits can often be achieved through whole foods — or, where appropriate, a targeted plant sterol supplement — without relying on ultra-processed options.
If you’re concerned about your cholesterol levels, or simply want a clearer picture of your heart health, checking your levels is a valuable first step. At my clinic I offer finger-prick testing (with the understanding that a full blood test remains the gold standard).
If cholesterol levels are already raised, support can make a real difference. With the right nutrition, lifestyle adjustments and personalised guidance, it’s often possible to improve cholesterol balance without extremes.
Why not come and see me and we can work on a plan to support you
Janet x