Zebra - First were those old numbers pre menopause? If so they make perfect sense.
Second - What is your diet now compared to then? Remember diet can have an impact on triglycerides, which in turn will effect your LDL, meaning that plant fats, and carbs are bad for you, and lean meats, and real animal fats are better for you. Your HDL are high, but those are the good fats. So that's not all bad.
I do not have experience w/ Repatha. I do know it's a newer med, so probably expensive. Probably requires a PA through insurance.
If you want learn a bit more about cholesterol, what the numbers mean, and why we are all so screwed up about what we believe we are supposed to be eating, there is a recent, like last week Joe Rogan Podcast about this w/ an expert that goes against what most Dr's will tell you, but follows the science, and research. Of course it's a Joe Rogan podcast so it's long, but worth a listen. Paul Saladino is the guest. Very interesting, and validates what I have been telling patients for years.
Carbs are bad, plant "man made" fats are bad. Meat is good, meat fats are good, and there can be a balance there. Additional reinforces genetics part in this as well, some of us are destined to have low numbers regardless of our shit diets (My father), and some of us are destined to have super high numbers no matter how good we eat.
I would ask for the cardiac scan to see if you even have athrosclerosis. This can impact what you are doing too, and what meds you need, need NOT be on.