Lipedema & hormonal transition phases

Why the disease often begins in puberty

Lipedema is a chronic, hormone-dependent disease of the fatty and connective tissue that almost exclusively affects women. It is striking that initial symptoms or a significant worsening often occur during periods of hormonal change – particularly during puberty, but also during pregnancy and menopause.

The role of puberty

With the onset of puberty, there is a sharp increase in estrogen production. Estrogens influence numerous processes in the body: they regulate fat distribution, affect the maturation of fat cells, and alter the structure of connective tissue. At the same time, they increase capillary permeability. In individuals with a genetic predisposition, this can lead to an excessive proliferation and enlargement of fat cells in the subcutaneous adipose tissue.



The increased leakage of fluid from the blood vessels puts additional strain on the surrounding tissue. During puberty, however, the lymphatic system is still in a functional adaptation phase. If its transport capacity is limited, the excess fluid cannot be adequately removed. Early on, swelling, tenderness, feelings of tightness, and increased sensitivity to touch develop – symptoms that are often not recognized as lipedema for a long time.

Pregnancy and menopause also present the body with hormonal challenges. During pregnancy, widely fluctuating hormone levels, weight gain, and increased vascular permeability place additional strain on the fat and lymphatic systems. During menopause, declining and irregular estrogen levels affect metabolism, promote inflammatory processes, and can exacerbate pain and swelling.

Crucially, lipedema is not a result of poor diet, lack of exercise, or lack of discipline. It is a medically relevant, chronic, progressive disease whose course is largely determined by hormonal influences and genetic factors. Early education is therefore essential to relieve the burden on those affected and avoid misinterpretations.