This article was clinically reviewed by Haley C., FNP.
Introduction
Managing high cholesterol is critical to maintaining heart health and preventing cardiovascular diseases. At FOLX, we provide specialized, affirming care for the LGBTQIA+ community, offering tailored treatment plans and supportive resources to manage your cholesterol effectively.
Cardiovascular disease is the leading cause of death in the United States, and lesbian, gay and bisexual adults are 36 percent less likely than heterosexual adults to have ideal cardiovascular health, according to research from the American Heart Association. Transgender and gender diverse individuals also have high rates of heart disease, in part due to the stress that comes from discrimination and transphobia.
It’s important to know that high cholesterol is highly treatable, and the Center for Disease Control estimates that 80 percent of premature heart disease and strokes are preventable! If you have high cholesterol, have a family history of high cholesterol, or are looking to prevent cardiovascular disease, we are here to help. A FOLX clinician can evaluate and discuss your risk factors, complete screening labs and work with you to make the best decisions for your health.
How do I know when I should see a clinician about high cholesterol?
It is difficult to detect high cholesterol without a blood test, as it almost always presents no symptoms. However, you should consider getting tested if you have a family history of high cholesterol or heart disease, are over the age of 40, or have factors that increase the risk, such as smoking, diabetes, or high blood pressure. FOLX clinicians can order this testing and help interpret the results for you.
Gender-affirming testosterone therapy can also impact cholesterol levels. Research indicates that testosterone therapy can lead to increases in LDL ("bad") cholesterol and decreases in HDL ("good") cholesterol. These changes can contribute to a higher risk of cardiovascular diseases.
Because of these potential changes in cholesterol levels, it's important for individuals undergoing testosterone therapy to have their lipid profiles monitored regularly, which we do here at FOLX if you’re seeing us for gender-affirming hormone therapy. This ensures that any negative shifts in cholesterol can be addressed promptly through dietary management, lifestyle modifications, or medication if necessary.
FOLX clinicians, understanding the specific needs of the transgender community, can provide comprehensive monitoring and tailored management plans to maintain overall cardiovascular health while on hormone therapy. They can integrate cholesterol management with your gender-affirming care to ensure both are handled safely and effectively.
What kind of treatment options are there for high cholesterol?
Treatment for high cholesterol generally involves a combination of lifestyle changes and medications. Here’s how we approach it:
- Lifestyle Changes:
- Improving diet, such as reducing saturated fats and increasing fiber intake
- Regular physical activity
- Maintaining a healthy-for-you weight
- Quitting smoking (we can help!)
- Reducing alcohol consumption
- Medications:
- Statins, the most common medication for lowering cholesterol
- Cholesterol absorption inhibitors
- Bile acid-binding resins
- PCSK9 inhibitors, which are used in certain situations
Our clinicians will work with you to find the best combination of treatments that suit your lifestyle and health needs.
We will never blame your health conditions on your body size or your hormone therapy.
Is there anything I should prepare for my visit?
For your visit with a FOLX clinician, it's helpful to have any previous cholesterol test results available, along with a list of any medications you're currently taking. Also, jotting down any family history of cholesterol or cardiovascular problems will assist in creating a more effective care plan tailored to you. Your FOLX clinician may also ask for a recent weight to better evaluate your overall cardiovascular risk (sometimes known as an ASCVD risk assessment).
If you haven’t yet had cholesterol testing, we’ll use the visit to review your medical history and risk factors, and any other concerns you might have. Your FOLX clinician can order a cholesterol lab test at a local lab as well as any other screening tests that are deemed appropriate during your visit. We can also talk about all those lifestyle habits that are healthy no matter your cholesterol levels. Once you get your lab work done, we’ll follow up with the results and work with you on a treatment plan from there. We may ask for a second visit to discuss all your options for treatment or we can discuss your lab results via messaging if no further intervention is needed.
Other resources / further reading
For more detailed information on managing high cholesterol and how it affects the LGBTQIA+ community specifically, the following resources can be beneficial:
Frequently Asked Questions
Can FOLX prescribe cholesterol-lowering medication?
Yes, our clinicians can prescribe all necessary medications for managing high cholesterol, including statins and other lipid-lowering therapies, based on your individual health needs.
What diet changes does FOLX recommend for lowering cholesterol?
FOLX supports dietary adjustments that focus on reducing intake of saturated fats and trans fats, increasing fiber through fruits, vegetables, and whole grains, and incorporating healthy fats from sources like avocados, nuts, and fish.
How does FOLX accommodate the needs of LGBTQIA+ individuals with high cholesterol?
FOLX provides a non-judgmental, inclusive environment that respects the unique needs of the LGBTQIA+ community, including transgender folks taking testosterone. Our treatment plans consider all aspects of your identity and lifestyle, ensuring that care recommendations are both effective and affirming.
Can hormone therapy impact my cholesterol levels?
Yes, testosterone hormone therapy can impact cholesterol levels. FOLX clinicians are skilled in managing and adjusting treatments to safely accommodate both hormone therapy and cholesterol management. We will not discontinue your hormone therapy due to cholesterol levels.
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FOLX Health is the first digital healthcare company designed by and for the LGBTQIA+ community. Our services include primary care, gender-affirming hormone therapy including estrogen and testosterone (HRT), mental health care, sexual and reproductive health care, and fertility consultations. FOLX memberships give you access to LGBTQIA+ expert clinicians, peer support, thousands of LGBTQIA+ resources, and more. Whether you’re lesbian, gay, bisexual, transgender, queer, gender non-conforming, nonbinary, or another identity, you can find LGBTQ-specialized health care that helps you meet your wellness goals. Get all the benefits of becoming a FOLX member and sign up today!
