Does Supplemental Hormone Therapy Exacerbate Lipedema?
I didn’t realize until a couple of years ago that I had Lipedema. I started going through menopause, and I wasn’t coping well. My menopausal symptoms were so severe I thought I was going to lose my mind! To help with my symptoms, my doctor put me on an antidepressant and estrogen replacement therapy (HRT).
My first try was an estrogen patch, but that failed to stay in place. So, I was switched to oral medications of estrogen and progesterone. I was hopeful that my symptoms would lessen, but they didn’t.
Instead, my legs started swelling. I was gaining weight, even though I was going through a weight loss program. And my body was in PAIN.
My ongoing search for an answer finally led me to Lipedema.
At the time, it made sense that menopause was triggering my condition. All the articles said Lipedema was triggered by hormone fluctuation in life: Puberty, Pregnancy, and Menopause. But I never read anything about HRT as a cause of a Lipedema trigger.
As my body worsened, nobody, and I mean nobody, suggested I stop taking my HRT.
Instead, I decided to stop taking my estrogen and progesterone on my own. It’s hard to say if my progression slowed down. If so, it was subtle.
Even now, as I search for the answer, I’ve found information on how estrogen and its receptors have a major impact on Lipedema. Here’s a summary of what I’ve found:
Estrogen and Lipedema
Through a Lipedema.org registry, women report that Lipedema symptoms began not only during puberty, pregnancy, and menopause but also while breastfeeding, with birth control or hormone-replacement therapy (HRT).
Hormones, particularly estrogens, are known to help regulate fat metabolism and accumulation. Higher estrogen levels can be correlated with exacerbations of Lipedema symptoms.
Since Lipedema manifests during these hormonal fluctuations, it makes sense that estrogen dysregulation is connected to Lipedema progression.
Estrogen and Inflammation
Estrogen can signal certain immune cells to become more active and release substances called cytokines, which can lead to inflammation, causing swelling and pain.
The theory is that as Lipedema patients’ estrogen levels fluctuate, the inflammatory signals in the tissue may as well.
More research is needed to show the connection between estrogen levels and tissue inflammation, which could provide insight into the pathophysiology of lipedema-associated inflammation and further pinpoint better treatment avenues for us.
Estrogen Receptors and Lipedema
In an NIH article, scientists have a theory that two types of estrogen receptors, ERα and ERß, might be involved in making the fat cells in the lower body act strangely.
ERα and ERß receptors are stored in adipose tissue (estrogen is also stored in our fat cells). They have the job of acting like a "lock" that estrogen, the "key," fits into. When estrogen binds to these receptors, it triggers various biological responses in our cells and tissues.
Scientists speculate that in women with Lipedema, the fat cells in their lower bodies might have more estrogen receptors stored in the adipose tissue.
Introducing more estrogen into the body and increasing estrogen receptors might be why Lipedema is triggered during hormonal fluctuations.
Scientists theorize that these things might cause the lower body's fat cells to grow bigger and store more fat.
So, does HRT trigger Lipedema?
With all of this information above, scientists still aren’t saying that HRT actively plays a role in Lipedema exacerbation.
As a medical person, I respect that HRT triggering Lipedema needs to be studied more. Correlation does not imply causation.
As a Lipedema patient, I have personally experienced the correlation between HRT and Lipedema exacerbation. Can I say that my Lipedema was triggered by HRT more so than menopause? Nope, I can’t. But I believe there’s something there that explains my own exacerbation and for those women who have also seen their Lipedema triggered by HRT.
Thank you for reading Lipedema and Me. Without you, I wouldn’t be doing this!
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Take Care,
Michelle