The Complex Connection Between Lipedema & Chronic Venous Insufficiency: What You Need to Know
Studies indicate that approximately 25% of women with lipedema also have chronic venous disease, and this figure rises to 50% among those with both lipedema and lymphedema. Addressing chronic venous insufficiency (CVI) can significantly reduce painful swelling and other symptoms associated with lipedema. Moreover, effective management of CVI can lower the risk of developing secondary lymphedema, a condition that can further complicate lipedema. Maintaining an optimal venous system is crucial for managing lipedema symptoms and achieving successful outcomes from lipedema surgery.
Lipedema is often mistaken for other conditions due to similarities in symptoms. For example, it is commonly confused with lymphedema. While these are distinct conditions—lipedema involves an abnormal buildup of fat tissue, and lymphedema is caused by fluid retention—they can occur together in some individuals, which adds complexity to diagnosis and treatment. Additionally, lipedema is frequently linked to chronic venous insufficiency (CVI), a condition that can further contribute to swelling and discomfort.
The overlap between lipedema and CVI highlights the complexity of diagnosing and treating these conditions. For example, hypermobile joints are linked to both venous disease and lipedema. While distinct, lipedema and venous disease often coexist and exacerbate one another, leading to more severe symptoms and a greater impact on patients' quality of life. Understanding how CVI influences lipedema and vice versa is crucial for effective treatment and management.
What is Chronic Venous Insufficiency?
Chronic venous insufficiency occurs when the vein valves in the legs malfunction, disrupting the flow of blood back to the heart. This dysfunction causes blood to pool in the veins and backflow into smaller veins in the legs and even into the tissue, leading to swelling and changes in the skin, such as discoloration and altered texture. This condition where the valves in the veins fail to close properly, blood struggles to flow upward and instead flows backward, is known as venous reflux.
If left untreated, CVI can increase pressure within the veins, eventually causing tiny blood vessels, or capillaries, to burst. Over time, this can result in chronic inflammation, skin discoloration, ulcers, and other complications that may hinder the management of conditions like lipedema. Affected areas often develop a reddish-brown hue and become fragile, with an increased risk of breaking open if bumped or scratched.
The most notable symptoms of CVI can include one or any of the following:
Causes of valve malfunction may be hereditary or due to deep vein thrombosis (DVT), which leaves scar tissue behind that damages the vein’s valve.
Venous Insufficiency and Lipedema: The Likely Link
Lipedema and CVI often coexist, forming a complex relationship that exacerbates symptoms in patients. The abnormal fat accumulation associated with lipedema puts pressure on the veins, impairing blood flow and increasing the risk of venous dysfunction. The lymphatic vessels and the veins in the saphenous vein compartments in the leg (along the inner leg and back of the calf) share the same compartment. Therefore, CVI—characterized by poor vein valve function and blood pooling in the legs—contributes to swelling, as does lymphatic dysfunction, further intensifying the heaviness and discomfort already experienced with lipedema. When both conditions are present, this combination places strain on the interstitial space causing it to expand with fluid. The excess interstitial fluid moves cells away from their oxygen source, a condition called hypoxia. Hypoxia is well known to be one of the ways that inflammation begins in the tissue. Lipedema can therefore worsen CVI, and vice versa, and both can worsen lipedema symptoms and significantly increase the risk of developing secondary lymphedema—a challenging trifecta for patients.
Managing CVI is crucial for lipedema patients, as untreated venous issues can lead to complications like poor wound healing and blood clots during surgery. By addressing CVI either before or after surgery with treatments such as compression therapy or procedures like endovenous laser therapy (EVLT) or radiofrequency ablation (RFA), patients can reduce swelling, improve circulation, and establish a stronger foundation for successful lipedema management, including surgical outcomes.
Recognizing the signs of CVI in lipedema patients is critical for effective treatment. Symptoms to watch for include:
If you experience any of these symptoms alongside lipedema, it’s essential to discuss them with your healthcare provider to determine if CVI is contributing to your condition.
Like lipedema, there is no cure for chronic venous insufficiency (CVI). However, a variety of strategic interventions—ranging from noninvasive to surgical—can help alleviate and manage symptoms. These include:
For more severe cases, surgical interventions such as ligation and stripping, microincision/ambulatory phlebectomy, and vein bypass can be effective in removing damaged veins and rerouting blood flow. However, minimally less invasive methods are often preferred due to their lower risk and faster recovery times. These include:
(Source: Cleveland Clinic)
Proactive Care for Lipedema and CVI: What to Watch For
Like lipedema, CVI is a progressive disease that can impact mobility and overall quality of life. While they are not the same disorder, both share strikingly similar symptoms. If you suspect CVI may be contributing to your chronic, unexplained fatigue, it’s highly recommended to consult a healthcare provider who specializes in vein health. Although CVI cannot cause lipedema, advanced lipedema can increase the likelihood of developing CVI as a secondary condition. While vein-related diseases do not cause lipedema, the two conditions can co-exist and exacerbate each other if proper medical care is not applied and regularly monitored.
Managing both lipedema and chronic venous insufficiency requires a comprehensive, multidisciplinary approach. At the Advanced Lipedema Treatment program, we take a holistic approach by working with vein specialists to evaluate and determine whether treatment for venous insufficiency should be addressed prior to or after lipedema reduction surgery. This integrated method ensures that venous dysfunction is effectively treated while simultaneously managing lipedema symptoms, leading to improved outcomes and enhanced quality of life for our patients.
If you’re experiencing symptoms of lipedema, CVI, or both, seeking care from a knowledgeable healthcare provider is the first step toward relief. At the Advanced Lipedema Treatment program, we focus on creating personalized diagnoses and treatment plans to help patients navigate these interconnected conditions with confidence and support. With offices in Los Angeles, Tucson, and Salt Lake City, we are committed to providing accessible, expert care. A proactive approach can make all the difference in achieving lasting results.
