Myths vs facts: HDL and menopause

Menopause alters lipid profiles, but HDL myths persist. A common myth is that high HDL always protects against heart disease. In reality, HDL levels often drop during menopause while LDL rises, increasing cardiovascular risk. However, HDL function (e.g., cholesterol efflux capacity) may matter more than its concentration. Some evidence suggests that postmenopausal HDL can become dysfunctional, losing its protective properties. The evidence is mostly observational and mixed; no large trials prove that raising HDL alone reduces risk. Lifestyle factors (diet, exercise, hormone therapy) have stronger effects. A DNA or blood test for HDL alone is insufficient; comprehensive lipid panels and clinical context are needed. Beware of marketing that oversimplifies HDL as a universal 'good' cholesterol.