Amy C., I am not sure how long it takes for the total cholesterol or total LDL cholesterol to go down into the officially ‘desirable’ range, but I have read a lot of evidence that having a lower total or total LDL cholesterol is not advantageous for women, and especially not for older women, who actually have better health outcomes with higher cholesterol levels (actually, maybe everyone except middle-aged men with cardiovascular disease seems to do better with higher cholesterol levels, according to recent research). I have steadfastly ignored my total and LDL numbers for years, even with other risk factors for cardiovascular disease, because of this. I know this seems weird, I will try to dig up references if you want.

The problem is that the official guidelines have not caught up with the research. A couple of excellent, well-researched books that touch on this are ‘Good Calories, Bad Calories’ by Gary Taubes and ‘The Big Fat Surprise’ by Nina Teicholz. Very low total cholesterol is associated with deaths from cancer, suicide, and violence; high total LDL has actually not been shown to be associated with cardiovascular disease, even though sites that repeat the official guidelines still state that this is the case. What has been shown is that men who already have cardiovascular disease may experience benefit from lowering their cholesterol by taking statins, but it is also possible that statins exert their beneficial effects on cardiovascular disease prevention (which are smaller than we may have been led to believe) through anti-inflammatory or other effects, rather than by lowering cholesterol. What is true is that high levels of very small, dense LDL (which are rarely directly measured) and triglycerides and low levels of HDL cholesterol do have some association with heart disease, which is now thought to be much more complex than the old idea of ‘artery-clogging cholesterol’, involving inflammation and perhaps other factors. Anyway, there are no studies to date that actually show that women benefit from having lower cholesterol levels. Recommendations have been extrapolated from the apparent benefit derived from lowering cholesterol in middle-aged men with cardiovascular disease to other groups, such as healthy people, women, the elderly, etc. Other studies seem to show that women (and some men) with lower cholesterol levels have higher mortality rates from all causes. It takes a lot of digging to wade through the details. For example, one relevant, if rather old, abstract is at https://www.ncbi.nlm.nih.gov/pubmed/1342267 In this study it says “Cholesterol was a significant predictor of fatal CHD plus nonfatal myocardial infarction in middle-aged, but not elderly women”, but it does not tell you what the relative risks for all-causes mortality were. This can be a very tricky subject.