Cholesterol: Gender Differences

Just like a lot of biological aspects, men and women are naturally different, and when it comes to cholesterol levels, there are both similarities and differences. High LDL cholesterol is equally bad in males and females, but there are certain trends regarding risk factors for heart disease, and other ailments, associated with high cholesterol levels. The fact is that in men over 45 and women over 55, heart disease and stroke are the number one killers, and show no gender bias. But the cholesterol gender differences are more pronounced in younger adults.

Younger adult males have higher total cholesterol levels than their female counterparts, which is the primary reason why men under 45 tend to suffer heart attacks more than women in the same age bracket. This shifts when women attain the age of about 55 and are post-menopausal; their HDL cholesterol levels plummet and LDL levels grow. This evens the risk factor for heart disease and stroke.

Age is the single greatest factor in shifting cholesterol levels and coronary disease risk between males and females. Younger women have naturally higher levels of HDL cholesterol than younger men, especially those who are overweight and also at risk for diabetes. Both genders should begin at age 20 having the blood test that determines cholesterol levels. This test should be conducted every five years, minimum, increasing in frequency as they age.


Separating the Sexes

Here are factors and proven cholesterol gender differences as cited by the American Heart Association (AHA) and other coronary disease authorities:

  • Pre-menopausal women enjoy very low risk of heart disease and stroke thanks to an abundance of healthy HDL cholesterol, the result of natural estrogen in their bodies.
  • This cholesterol safety net changes for women when they either enter the natural onset of menopause, or endure early menopause due to a hysterectomy (that includes an oophorectomy (removal of one or both ovaries, producers of estrogen)), or simply cease to have menstrual periods at an early age.
  • Hormone replacement therapy (HRT) does not appear to mimic the effects of natural estrogen in lowering LDL cholesterol levels or keeping HDL levels high, but has shown a tendency to worsen the risk of heart disease, so it is not a solution to post-menopausal increased LDL cholesterol levels.
  • Pregnant women generally have an increase in total cholesterol, but it’s temporary and ends shortly after their baby is born. Because the growing fetus needs cholesterol for normal hormonal growth and healthy brain function, an increase in cholesterol levels during gestation is regarded as common and necessary.
  • Men aged 45 and older are at the greatest risk of developing heart disease, especially if they are over-weight and have poor eating habits, or if there are other underlying conditions, most notably, diabetes.
  • Insulin resistance is a more common and dangerous issue in men than in women with high LDL cholesterol levels; it is connected to an increase in triglycerides and a reduction of HDL cholesterol levels, the combination of which can prove fatal. Insulin resistance plays an integral part in the odds of developing diabetes, and resultantly ups the likelihood of developing heart disease in younger males.


Underlying Factors in Cholesterol Gender Differences

It’s not solely heart disease that is affected by high cholesterol levels. Other major diseases, such as diabetes, have a direct correlation in men and women. A study performed at the Division of Nephrology and Hypertension, Diabetes Centre, Tokyo Women’s Medical University School of Medicine, Tokyo, Japan, and entitled “Gender differences in the association between HDL cholesterol and the progression of diabetic kidney disease in type 2 diabetic patients”, took into account 723 people, all of whom had type 2 (mature onset) diabetes, participating in a controlled study.

Part of the study’s findings were reported in these results: “A significant interaction between high-density lipoprotein (HDL) cholesterol and gender was detected…” The study concluded that lower HDL cholesterol levels appeared to be directly connected to the development of diabetic kidney disease in men, but not so with women. The full report, published in the July 2011 edition of the journal Nephrology, Dialysis, Transplantation, a publication of the European Dialysis and Transplantation Association can be found here:


A Gender-based Approach to Cholesterol Levels

It is easy to draw the conclusion from this information that young women have nothing to worry about, but that would be misleading. The forgotten fact herein is that in our younger years we develop what tends to be the habits we retain for a lifetime. If a younger female adopts, for example, poor dietary habits, those will serve to endanger her when she reaches menopause. Given that diet and lifestyle are hugely influential when it comes to healthy cholesterol levels, proper lifestyle choices should be made in the formative years, regardless of gender.

We know that heart disease and stroke are equal-opportunity killers by the time males and females reach their middle years, so a youth spent in sensible health practices can help thwart what is otherwise inevitable. Cholesterol gender differences are exacerbated by age and lifestyle; we can’t avoid aging, but the way we live is a choice.