Can a woman with high triglycerides try hormone thearpy?

Question

Hello doctor,

I am a 47-year-old perimenopausal woman, and my recent lab results showed triglycerides at 360 milligrams per deciliter, low-density lipoprotein (LDL) cholesterol at 135 milligrams per deciliter, and high-density lipoprotein (HDL) cholesterol at 42 milligrams per deciliter. I have a family history of heart disease and had gestational diabetes during my last pregnancy. I have also started experiencing hot flashes, night sweats, and an increase in belly fat. I am concerned about whether hormone therapy is safe for someone with high triglycerides, and I am wondering if I should try Fish Oil supplements or a Fibrate medication. I am also curious if the recent abdominal fat gain is contributing to my worsening symptoms and increased cardiovascular risk.

Please help.

Answer 1

Hello

Welcome to icliniq.com.

I understand your concern.

Your laboratory results indicate significantly elevated triglycerides and suboptimal high-density lipoprotein (HDL) cholesterol, both of which increase your risk for cardiovascular disease, especially when combined with your family history of heart disease and your previous diagnosis of gestational diabetes during pregnancy. The recent weight gain and central (abdominal) fat accumulation can also worsen insulin resistance and further disrupt lipid (fat) metabolism.

Hormone Therapy (HT) during the perimenopausal stage may help alleviate symptoms such as hot flashes and night sweats. However, for individuals with high triglyceride levels, oral Estrogen is generally not recommended, as it can increase triglyceride levels further. If Hormone Therapy is considered necessary, a transdermal (through the skin) form of Estrogen, such as a patch or gel, is often a safer alternative because it bypasses liver metabolism and has a lesser effect on lipid levels. This approach should only be pursued following a thorough cardiovascular risk assessment by your healthcare provider.

To address your elevated triglycerides, lifestyle modifications are the first and most important step. These include reducing intake of simple carbohydrates and added sugars, increasing physical activity, and managing body weight. Omega-3 fatty acids, such as those found in Fish Oil supplements, can help lower triglycerides and are typically well-tolerated. If lifestyle measures and supplements do not sufficiently lower your triglyceride levels, particularly if they remain above 500 milligrams per deciliter (which increases the risk of pancreatitis), your doctor may consider prescribing Fibrate medications.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.