HDL cholesterol

HDL cholesterol is the "good," or "healthy" cholesterol. HDL lipoproteins carry less cholesterol and triglyceride; instead they contain mostly protein. HDL lipoproteins can ‘pick up’ LDL and transport it back to the liver where it can be ‘repackaged’ into something else, or destroyed and gotten rid of. HDL does not contribute to plaque formation. Recommended HDL levels differ for men and women. Estrogen increases HDL levels, offering some additional cardiac protection prior to menopause. For women, HDL less than 50mg/dl is considered low, increasing the risk for heart disease. Low HDL levels (less than 50 mg/dl) seem to be a stronger risk indicator for women than men. HDL levels of 60mg/dl or higher are considered "cardio protective" because they lower the risk of heart disease.

Women

HDL cholesterol level HDL category
Less than 50 mg/dl Low; increased risk for heart disease
50 – 59 mg/dl Better
60 mg/dl and higher Best; helps protect from heart disease

Obesity, sedentary lifestyle, cigarette smoking, high triglyceride levels and androgenic steroids can lower HDL. Reversing those factors by losing weight, getting regular exercise, quitting smoking, reducing triglycerides, and stopping androgenic steroids have all been shown to raise HDL levels. A diet that includes omega-3-fatty acids helps raise HDL. Moderate consumption of alcohol, particularly red wine raises HDL, but is not recommended as treatment because of other risks associated with alcohol consumption such as liver damage, hypertension, and high triglyceride levels. Estrogen also raises HDL, but hormone replacement therapy (HRT) is not recommended because of the other medical risks associated with HRT. During the perimenopausal period there is usually a decrease in HDL and an increase in total cholesterol, LDL and triglycerides. This unfortunate change in lipids is more pronounced in women who gain weight. Healthy eating and regular exercise are important activities always, including during the perimenopausal period.