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Ep. 643 What Menopause Does to Lp(a) and Cholesterol |Menopause, Perimenopause, Cholesterol
Description
Welcome to the latest Midlife Minute.
This episode unpacks ongoing research on Lp(a), explores how women’s lipids change during the perimenopause-to-menopause transition, and clarifies what we can do about it.
Stay tuned for more!
IN THIS EPISODE, YOU WILL LEARN:
How total cholesterol, LDL, and ApoB tend to rise most steeply around the final menstrual period, rather than increasing gradually with chronological aging
Why women should have their Lp(a) checked both before and after menopause
How oral and transdermal estradiol can affect LDL, HDL, triglycerides, and Lp(a) differently
Why I recommend including ApoB when checking your lipids during the perimenopause window
How your lifestyle can reduce your cardiovascular risk, even when your Lp(a) is elevated
Why omega-3 fatty acids and commonly used lipid medications do not lower Lp(a)
Why supplements are not replacements for statins in genuinely high-risk patients
I review the various PCSK9 inhibitors currently available, how they are administered, and their effects
How a CAC, a CT angiogram, and an AI-assisted CT angiogram can help women and their providers determine how aggressive their approach should be when Lp(a) is elevated
Connect with Cynthia Thurlow
Check out Cynthia’s website.
Submit your questions to support@cynthiathurlow.com
Join other like-minded women in a supportive, nurturing community: The Midlife Pause/Cynthia Thurlow.
Purchase Cynthia’s book, The Menopause Gut.
Cynthia’s Intermittent Fasting Transformation Book
References:
1. Menopause Transition and Cardiovascular Disease Risk: Implications for Timing of Early Prevention: A Scientific Statement From the American Heart Association.Circulation. 2020. El Khoudary SR, Aggarwal B, Beckie TM, et al.Guideline
2. Menopause: A Cardiometabolic Transition. The Lancet. Diabetes & Endocrinology. 2022. Nappi RE, Chedraui P, Lambrinoudaki I, Simoncini T.Review
3. Dyslipidemia Across the Menopause Transition: Mechanisms, Trajectories, and Opportunities for Cardiovascular Prevention. Maturitas. 2026. Castaneda R, Tatit CP, Hurtado Andrade MD, Faubion SS, Shufelt CL.RecentReview
4. Lipoprotein(a) and Women's Cardiovascular Health: A Review. JACC. Advances. 2026. Michos ED, Saucier S, Mehran R, Koschinsky ML.
5. Lipid Metabolism in Women: A Review. Atherosclerosis. 2025. van Oortmerssen JAE, Mulder JWCM, Kavousi M, Roeters van Lennep JE.Review
6. 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. Matthews KA, Crawford SL, Chae CU, et al.Observational
7. Trajectories of Lipids Around the Menopause Transition in Chinese Women: Results of the Kailuan Cohort Study. F