Lipoprotein(a) and menopause: the hidden heart health risk most women have never heard of
When women think about their heart health, they often focus on cholesterol, blood pressure, weight or blood sugar levels. However, there is another important cardiovascular risk factor that is rarely discussed yet may become increasingly relevant during perimenopause and menopause: Lipoprotein(a), often referred to as Lp(a).
Lp(a) and the associated risk factors
Lp(a) is a specialised type of cholesterol particle that is largely determined by your genetics. Unlike other cholesterol markers, diet and exercise have very little impact on Lp(a) levels. Research now shows that elevated Lp(a) is an independent risk factor for heart disease, stroke and aortic valve disease.
For many women, cardiovascular risk begins to change during the menopause transition. As oestrogen levels decline, there is often an increase in LDL cholesterol, insulin resistance, abdominal weight gain, inflammation and blood vessel stiffness. Studies have also found that Lp(a) levels may increase after menopause, potentially contributing to the rise in cardiovascular disease seen in women during their postmenopausal years.
The challenge is that Lp(a) is not routinely included in standard cholesterol testing. This means many women may be unaware they have an inherited cardiovascular risk factor.
What can you do about elevated Lp(a)?
While there is currently no simple dietary or lifestyle intervention proven to significantly lower Lp(a), there is still plenty you can do to reduce your overall cardiovascular risk.
Key strategies include:
Having your Lp(a) tested at least once in your lifetime
Optimising LDL cholesterol and ApoB levels
Managing blood pressure and blood sugar
Addressing insulin resistance
Following a Mediterranean-style eating pattern
Exercising regularly, including resistance training
Prioritising sleep and stress management
Discussing hormone balancing therapies including complementary medicines and Menopausal Hormone Therapy (MHT) with your healthcare practitioner if appropriate
The good news is that identifying elevated Lp(a) early allows you to focus on the cardiovascular risk factors you can influence. Menopause provides an ideal opportunity to assess your future heart health and take proactive steps to protect it for decades to come.
Your menopause transition is about more than symptom management, it’s also a chance to build the foundation for healthy longevity and long-term cardiovascular wellbeing.
Wondering if hidden risk factors could be affecting your future health?
A comprehensive menopause health assessment can help identify important markers such as lipoprotein(a), cholesterol, blood sugar regulation, inflammation and cardiovascular risk. Book a personalised consultation today and gain clarity, confidence and a proactive plan to support your long-term health through menopause and beyond.
References:
Reyes-Soffer G, Ginsberg HN, Berglund L, et al. Lipoprotein(a): A Genetically Determined, Causal and Prevalent Risk Factor for Atherosclerotic Cardiovascular Disease. Arteriosclerosis, Thrombosis, and Vascular Biology. 2022;42:e48-e60.
Anagnostis P, Stevenson JC, Crook D, Johnston DG, Godsland IF. Effects of menopause, gender and age on lipoprotein(a) concentrations. Maturitas. 2023;169:1-8.
Tsimikas S. A Test in Context: Lipoprotein(a). Diagnosis, Prognosis, Controversies and Emerging Therapies. Journal of the American College of Cardiology. 2017;69(6):692-711.
American Heart Association. Lipoprotein(a): What You Need to Know. 2024.
Michos ED, et al. Lipoprotein(a) and Women's Cardiovascular Health. JACC Advances. 2026.