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Managing Lipoedema through Menopause

  • Jeanine Mewburn
  • 19 hours ago
  • 6 min read

Hormonal changes throughout a woman’s life may play an important role in the development and progression of lipoedema. Juliana Bicca, in her book Women’s Hormones Throughout Life, discusses the significant influence that hormonal fluctuations can have on the body.


Lipoedema is characterised by a disproportionate and usually symmetrical accumulation of fatty tissue, most commonly affecting the hips, thighs and lower legs, and sometimes the arms, while the feet and hands are generally spared. A lower waist-to-hip ratio (WHR) may be observed in women with lipoedema, although it is important to remember that WHR alone is not a diagnostic measure of the condition.


Lipoedema may occur alongside a number of other conditions, including joint hypermobility, obesity, venous insufficiency, tissue hypersensitivity and pain. Thyroid disorders, including Hashimoto’s thyroiditis, may also coexist. For some women, the physical and emotional impact of living with lipoedema can contribute to anxiety, depression and reduced quality of life.


The influence of hormones on the lymphatic system

With advances in techniques used to visualise and study the lymphatic system, researchers are beginning to gain a better understanding of the relationship between hormones, lymphatic function and adipose (fatty) tissue.


Oestrogen appears to influence lymphatic function and may contribute to maintaining lymphatic vessel integrity and fluid balance. This may help explain why lipoedema and lymphoedema can appear or worsen around important hormonal milestones in a woman’s life, including puberty, pregnancy and menopause. Current research increasingly supports the concept that lipoedema is hormonally influenced, although the exact mechanisms are still being investigated.


It is also interesting to consider the genetic role of fat distribution in women. A lower WHR has historically been associated with female attractiveness, but there may be more to this distribution than aesthetics alone. Research has proposed that fat stored around the hips and thighs may have important reproductive and metabolic functions, particularly during pregnancy and lactation.


In other words, not all body fat is simply “bad” or unnecessary. Some of the fat distribution that we may be encouraged to dislike has an important biological purpose. I think this is worth remembering when discussing lipoedema: our bodies are complex, and adipose tissue has important functions beyond simply storing energy.


Why menopause may be an important turning point

Menopause brings significant hormonal and metabolic changes. The decline and fluctuation of oestrogen can influence body-fat distribution, insulin sensitivity, lipid (fat) metabolism and inflammatory processes. Changes in cortisol and other hormones may also influence metabolism, appetite, weight regulation and where fat is stored.


Recent research is particularly interested in menopause as a potential turning point in lipoedema. Although more research is needed, emerging evidence suggests that hormonal changes during menopause may contribute to changes in adipose tissue, inflammation, fibrosis and metabolic function in women with lipoedema.


This does not mean that menopause causes lipoedema. Rather, for a woman who already has lipoedema, the hormonal changes associated with menopause may contribute to changes in symptoms and disease progression.


The importance of looking at the whole person

Because lipoedema can coexist with other endocrine and metabolic conditions, it is important to consider the whole picture rather than focusing solely on the adipose tissue.


Thyroid hormones play an important role in metabolism and many other bodily functions. Thyroid disorders can also cause symptoms such as fatigue, changes in weight, altered temperature regulation and fluid retention, which may overlap with symptoms experienced by women with lipoedema and mimic symptoms of menopause.

For this reason, discussing thyroid function and other relevant health concerns with your GP or healthcare professional may be appropriate when symptoms change, particularly around menopause. However, thyroid testing should not be considered a diagnostic test for lipoedema itself.


Is there a specific diet for lipoedema?

There is considerable misinformation about lipoedema on social media, particularly around “miracle” diets and claims that one specific diet can cure the condition.

At present, there is no single diet specifically proven to treat or cure lipoedema. Research into nutritional approaches is continuing. Mediterranean-style and lower-carbohydrate or ketogenic approaches have attracted interest because of their potential effects on metabolic health, inflammation and weight management. However, the evidence specifically relating to lipoedema remains limited and studies have generally been small and varied in quality.


A balanced, sustainable approach that supports overall health is therefore likely to be more helpful than restrictive diets or promises of a quick fix. Individual nutritional needs should always be considered, particularly during menopause.


How can lymphatic drainage massage help?

Lymphatic drainage techniques may form part of a multimodal approach to managing lipoedema, particularly when swelling, heaviness or discomfort are present.


A 2017 study by Kazuhisa Inoue and Hiroshi Maruoka investigated simplified lymph drainage in women experiencing menopausal symptoms. The study reported improvements in several measures, including physical and psychological symptoms, although it is important to note that this research was conducted in women with menopausal disorders rather than specifically in women diagnosed with lipoedema.


For women with lipoedema, lymphatic drainage may be particularly useful when there is an associated lymphatic or fluid component, venous insufficiency, decrease mobility, fatigue, skin hypersensitivity (hyperestesia). Treatment should always be individualised according to the person’s symptoms and clinical presentation.


Compression and movement

Compression garments can also play an important role in managing symptoms. They may help support fluid movement, particularly when lipoedema is accompanied by lymphatic or venous insufficiency. Compression may also help with feelings of heaviness, discomfort and fatigue and can support mobility and daily activities.


Movement is equally important. Gentle, regular physical activity can support circulation, muscle function, mobility and overall wellbeing. Finding an activity that feels enjoyable and sustainable is often more beneficial than pushing the body through exercise that causes pain or exhaustion.


A multimodal approach

There is currently no cure for lipoedema, but there are many ways to manage its symptoms and support quality of life.


A multimodal approach may include education, appropriate compression, lymphatic drainage, movement and exercise, healthy nutrition, skin care, psychological support and management of associated conditions such as venous or lymphatic insufficiency.

Menopause can be a challenging time of change, but it can also be an opportunity to become more aware of your body and what it needs.


“The important message is that management of lipoedema is not about fighting your body - it is about working with it - something to listen to - understand and care for.”


Understanding the relationship between hormones, lymphatic function and lipoedema can help women (you) feel less confused and more empowered. While we may not be able to control every hormonal change, we can learn how to support our bodies through those changes.


Moving lymph with confidence
Moving lymph with confidence

 

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