The female sex hormone estrogen tends to raise HDL cholesterol, and as a rule, women have higher HDL (good) cholesterol levels than men do. Estrogen production is highest during the childbearing years. This may help explain why premenopausal women are usually protected from developing heart disease.
Women also tend to have higher triglyceride levels. Triglyceride levels range from about 50 to 250 mg/dL, depending on age and sex. As people get older, more overweight or both, their triglyceride and cholesterol levels tend to rise.
Postmenopausal hormone therapy (PHT) may benefit some women with osteoporosis or other medical conditions associated with menopause. However, the American Heart Association recommends that PHT not be used for cardiovascular prevention. The HERS trial of women who had previously had a heart attack showed that these women did not benefit from PHT. Recent clinical trials appear to confirm that PHT does not appear to reduce risk of cardiovascular disease and stroke in postmenopausal women. Women with a personal or family history of breast cancer or other endocrine-related cancers should not receive PHT either.
The American Heart Association recommends LDL (bad) cholesterol-lowering drug therapy for most women with heart disease. Drug therapy should be combined with a diet low in saturated fat, trans fat, cholesterol and sodium, and rich in fruits, vegetables, whole-grain and high-fiber foods, and fat-free and low-fat dairy. Fish (such as salmon, trout or haddock) should be eaten twice a week. In addition, women should manage their weight, get regular physical activity and not smoke.