Women’s increased risk of heart disease post-menopause has been fairly well documented over the last decade. The medical profession has thought the root cause of this increase was related to the hormonal changes that take place after menopause, the natural aging process, or some combination of both. The results of a study recently published in the Journal of the American College of Cardiology shows unequivocally that the hormonal changes related to menopause result in a dramatic increase in cholesterol levels, specifically LDL (bad cholesterol). This may help explain the reasoning why incidence of heart disease rises drastically post-menopause. “As they approach menopause, many women show a very striking increase in cholesterol levels, which in turn increases risk for later heart disease,” says Karen A. Matthews, Ph.D. lead author of the study and professor of psychiatry and epidemiology at the University of Pittsburgh. Matthews and her team of researchers followed 1,054 women from the United States through menopause taking measurements of their cholesterol, blood pressure and other risk factors associated with the development of heart disease. During the 2 year window around these women’s final menstrual cycle an increase of approximately 9% or 10.5 points of their LDL cholesterol (bad cholesterol) was observed. Total cholesterol levels during this time period rose nearly 6.5%. The interesting thing researchers learned from this study was the dramatic spike in LDL cholesterol in the immediate 2 year period around that final menstrual cycle compared with other risk factors for heart disease such as insulin and systolic blood pressure. Those risk factors demonstrated a much more steady increase with each passing year suggesting they were more tied in with age and not a hormone response such as was observed with LDL cholesterol and menopause. However, more research needs to be conducted in this area, especially with regard to the longer-term effects of this spike in LDL cholesterol – how does it affect the rate of heart attacks, heart disease development, and ultimately mortality? Women who are nearly menopause should consult with their physician on a regular basis and pay particular attention to maintaining a healthy weight, not smoking, and regularly participating in exercise so that cholesterol levels will remain in the healthy range. Personal Trainers should emphasize routine aerobic training for improvements in blood lipid profile along with resistance training for reduced risk of osteoporosis. (Journal of the American College of Cardiology, 2009)