At Advanced Lipedema Treatment, we understand that lipedema is a complex condition influenced by various factors, including hormones. Many patients have noticed the onset or progression of their symptoms during significant hormonal changes such as puberty, pregnancy, and menopause. While the exact role of hormones in lipedema is still being studied, our team, including Dr. Karen Herbst, Ph.D., M.D., Head of Research and Director of Diagnostic and Preventative Medicine at The Roxbury Institute, is actively involved in research to better understand this connection.
As Dr. Karen Herbst explains in the Lippy Logic™ Educational Series episode Hormones and Endocrinology, "We know that inflammation makes fat grow... Lipedema is an inflammatory disease, hormones influence inflammation, so we think it's a hormonal inflammatory disease that makes fat grow." This perspective highlights how hormonal changes may drive inflammation and fat accumulation, offering valuable insights into the underlying mechanisms of lipedema. Watch the full episode here: Hormones and Endocrinology.
In this blog, we’ll explore these connections further and share how our comprehensive approach at ALT prioritizes personalized care informed by the latest research.
Estrogen, a hormone predominant in females, has been observed to play a potential role in fat distribution and tissue health, which may help explain its involvement in lipedema.
Estrogen plays a vital role in regulating numerous physiological processes in the body, including:
Primarily produced in the ovaries, estrogen is also synthesized in smaller amounts by the adrenal glands and fat tissue. Its widespread influence on various bodily functions makes it an essential hormone for overall health and a potential factor in the development and progression of lipedema.
While lipedema’s exact origins remain undefined, its onset often coincides with periods of hormonal fluctuation, such as puberty, pregnancy, or menopause. Estrogen’s role as a regulator of fat metabolism and distribution may provide insights into this connection. Research suggests that excess estrogen can bind to fat cells, potentially contributing to fat cell dysfunction—a hallmark of lipedema.
Additionally, variations in the number or function of estrogen receptors in the fat cells of the hips, thighs, and arms—areas where lipedema typically manifests—could play a role. Dysfunctional estrogen signaling may lead to abnormal fat accumulation and inflammation, while impaired fat tissue can, in turn, disrupt estrogen signaling. This cycle may explain why lipedema symptoms often appear or worsen during hormonal milestones or with the use of hormonal contraceptives, such as birth control pills.
As explained by Dr. Sara Al-Ghadban in her paper, The Expression of Adipogenic Marker Is Significantly Increased in Estrogen-Treated Lipedema Adipocytes Differentiated from Adipose Stem Cells In Vitro (PMCID: PMC11117526), estrogen-treated lipedema fat cells show a significant increase in adipogenic marker expression. This suggests that estrogen plays a direct role in fat accumulation in lipedema-affected tissue, further supporting the connection between hormonal regulation and the progression of the condition.
Estrogen plays a complex role in regulating immune and inflammatory responses. It can either suppress or amplify inflammation, depending on factors such as hormone levels and the type of immune pathways it interacts with. For instance, estrogen may reduce the production of certain inflammatory molecules under steady state conditions, but during hormonal fluctuations, it may increase inflammation in some areas.
Tissues particularly sensitive to these hormonal changes that are relevant to lipedema include fat tissue, connective tissue, fascia, blood vessels, and skin. Estrogen impacts fat distribution and inflammation in adipose tissue, supports the structural integrity of connective tissue, and influences vascular tone in blood vessels. These tissues, rich in estrogen receptors, are more likely to experience heightened inflammatory responses during hormonal milestones such as puberty, pregnancy, and menopause.
This connection highlights how fluctuations in estrogen levels influence inflammatory processes and overall tissue health.
(SOURCE: https://pmc.ncbi.nlm.nih.gov/articles/PMC8583809/)
Estrogen levels outside of their steady state are believed to potentially contribute to the development or aggravation of lipedema, as estrogen plays a crucial role in regulating fat distribution and metabolism. Lower-than-normal estrogen production may result in increased fat deposition in areas commonly affected by lipedema, such as the arms, buttocks, and legs. Additionally, low estrogen levels could disrupt normal fat regulation, potentially leading to excessive fat accumulation in the subcutaneous tissues. However, the exact relationship between estrogen levels and lipedema remains an area of ongoing research.
Hormonal changes are closely tied to the onset and progression of lipedema. Many of our patients at Advanced Lipedema Treatment report that significant life stages involving hormonal shifts—such as puberty, pregnancy, and menopause—mark the first appearance or worsening of symptoms. These milestones highlight the potential role of hormones in influencing fat distribution and inflammation, which are key factors in lipedema.
Puberty
For many women with lipedema, symptoms first emerge during puberty. This stage is marked by dramatic changes in estrogen and other hormone levels, which play a central role in fat distribution. The body is thought to respond to these hormonal shifts by depositing excess fat in areas commonly affected by lipedema, such as the hips, thighs, and arms. However, the underlying connection between these hormonal changes and lipedema remains an area of active research.
Pregnancy
Pregnancy is another significant hormonal milestone that can exacerbate lipedema symptoms. During pregnancy, elevated levels of estrogen and progesterone can influence fat storage and water retention, potentially leading to increased fat deposition and swelling in affected areas. For some women, this stage may also mark the progression of lipedema symptoms, as hormonal fluctuations may trigger inflammation and changes in connective tissue.
Menopause
Menopause, characterized by a natural decline in estrogen levels, is another life stage where many women notice changes in their lipedema symptoms. While overall estrogen levels drop, the hormone's regulation of fat distribution may become less effective, potentially contributing to increased fat accumulation in the legs and arms. This stage often presents unique challenges, as hormonal fluctuations during menopause can also lead to increased inflammation and changes in lymphatic flow.
For more information on how pregnancy and menopause might influence lipedema, please watch our Lippy Logic™ YouTube video featuring Dr. David Amron answering the question of the week, “Surgery Before or After Pregnancy orMenopause?”.
Finding Balance: Understanding Hormones and Their Role in Lipedema Treatment
Hormones are thought to play a role in the onset and progression of lipedema, influencing symptoms, flare-ups, and possibly even the condition’s stage progression. While research on the exact connection is ongoing, hormonal imbalances may complicate symptom management and add to the challenges of effective treatment. A personalized approach that considers hormonal factors alongside other therapies can help patients achieve better outcomes.
Hormone Therapy
For some patients, addressing hormonal imbalances may be part of a comprehensive management plan for lipedema. At Advanced Lipedema Treatment, we offer the option to monitor hormone levels before and after surgery for patients who desire it, allowing for a more personalized approach to care. Hormone therapy, when prescribed and monitored by a hormone specialist, can help regulate estrogen and other hormone levels, potentially mitigating some of the factors that influence fat distribution and inflammation. However, it’s important to note that hormone therapy is not a standalone solution, and its effectiveness in treating lipedema specifically remains an area of ongoing research.
Lifestyle Modifications
Lifestyle changes that support overall hormonal balance and reduce inflammation can be valuable in managing lipedema symptoms. Stress management, adequate sleep, regular physical activity, and an anti-inflammatory diet may help stabilize hormones and reduce the likelihood of symptom flare-ups. While these adjustments cannot reverse lipedema, they contribute to a healthier, more balanced approach to care.
Non-Hormonal Birth Control
For women who notice symptoms worsening with hormonal contraceptives, switching to non-hormonal options may provide relief. While not a guaranteed solution, this adjustment could help reduce symptom triggers linked to hormonal fluctuations. It’s important to consult both a lipedema specialist and an OB/GYN to explore the best options.
Surgical Solutions
Surgery is the gold standard for treating lipedema, offering effective relief at any stage. However, optimal results depend not only on surgery itself but also on comprehensive preoperative and postoperative medical care. Proper preparation before surgery—including metabolic optimization, lymphatic support, and inflammation management—can significantly impact long-term success by reducing complications such as excessive swelling or tissue regrowth.
While early detection and treatment before significant hormonal milestones such as pregnancy or menopause can help minimize progression, the majority of our patients undergo surgery after these life stages and still achieve transformative results. At Advanced Lipedema Treatment, we focus on creating personalized treatment plans that address each patient’s unique needs, ensuring lasting symptom relief and improved quality of life regardless of timing. A key part of this approach includes medical optimization before surgery to prepare the body for better healing, reducing the likelihood of swelling and tissue regrowth.
Our innovative surgical approach is designed for safety, precision, and rapid recovery. Using local and/or twilight anesthesia, we eliminate the need for general anesthesia, reducing risks and promoting a faster healing process. Dr. Amron’s proprietary 360° circumferential method and Five Step Multi-System Approach ensure precise fat removal while also prioritizing proper medical preparation to optimize patient outcomes. By integrating surgery with a strategic preoperative plan, we help patients achieve lasting relief, improved mobility, and restored confidence.
Key Takeaways
