Accurate prediction of cholesterol levels is important for early diagnosis and intervention in cardiovascular health, particularly among women, whose lipid metabolism is profoundly influenced by physiological and hormonal factors, such as estrogen fluctuations during menopause. These hormonal changes contribute to increased risks of dyslipidemia, emphasizing the need for sex-specific predictive models. This study presents an explainable machine learning framework using decision treebased models trained on the Study of Women's Health Across the Nation (SWAN) dataset. By applying Recursive Feature Elimination (RFE), we demonstrated that even with just 10 features, it is possible to achieve an accuracy of 0.74 in detecting high cholesterol levels, significantly reducing the burden of data collection. Through decision tree visualization, we identified the substantial influence of the DIABETE10 feature, which received the highest SHAP value and served as the sole criterion for splitting the tree into high and low cholesterol branches. These findings highlight the importance of diabetes in cholesterol prediction, underscoring its clinical relevance. The integration of Shapley Additive Explanation (SHAP) values and decision path visualization enhances model interpretability, providing actionable insights for personalized healthcare and supporting trust in machine learning applications in high-stakes domains.