We know lipedema affects mostly women, potentially due to estrogen. Science has been exploring the hormonal side of lipedema, and we look forward to digging into some of this research with you so we can further look at potential management options. This is an educational overview based on current science—not medical advice. We’re not healthcare providers, so always consult a doctor for personalized guidance.

Lipedema is a chronic condition characterized by the abnormal accumulation of fat cells in the legs, arms, and other areas of the body, which often leads to pain and swelling. While diet cannot cure lipedema, it can significantly help in managing the condition and improving quality of life.

• Estrogen acts through two receptors (PMC 2021). ERα activates genes like PPARγ (fat storage) and VEGF (blood vessel growth), which in turn leads to fat storage in the hips and thighs– a common concern spot for those with lipedema.
• ERβ counterbalances that by regulating and preventing overgrowth. When ERα is more present than ERβ, a patient may be more likely to have a buildup of lipedema fat. Research, including animal studies, show a loss of ERβ = 20–30% more fat gain.
• Lipedema are hormonal imbalances contributing to increased fat storage – management approaches and treatments should be tailored to this as opposed to focusing on only weight loss.

Research suggests a correlation between lipedema and estrogen, which allows us to predict lipedema trends, when it may worsen or better throughout a woman’s life. About 80% of cases begin at puberty, when a woman’s estradiol spikes (MDPI 2025). Women may also experience worsened symptoms of lipedema during pregnancy due to increased estrogen and progesterone levels, which boosts fat growth and raises multiple inflammatory markers (MDPI 2025). Many women also report being more symptomatic during menopause.

A hormonal shift opens an opportunity for lipedema symptoms to activate. This shouldn’t make you worry or afraid – it is to understand when you’re more likely to experience worsening symptoms. During this period discuss options with your doctor and choose a treatment plan that takes this into account.

We often hear women say something along the lines of ‘my blood tests look normal’ despite struggling with lipedema, but estrogen can be sneaky. Fat cells are able to produce their own estrogen directly in your tissues, so although tests appear normal the process is still ongoing.

Localized estrogen production can create inflammation and scar-like tissue changes. Although testing is helpful to have a snapshot of your body, it’s important to understand that many blood tests underestimate the impact estrogen has on your lipedema.

If a woman is low in progesterone, estrogen is dominant– worsening her symptoms of lipedema. To create balance, progesterone is necessary. Some weakened progesterone pathways are caused by genetics (AWMF 2024) and during menopause, resistance to this type of hormone amplifies estrogen’s impact. Therefore, the estrogen to progesterone ratio is what we have to focus on.

We can monitor the estradiol and pituitary hormone FSH and LH to spot early risks (MDPI 2025). We can then see if these markers are linked to worsening symptoms during certain periods of pregnancy, perimenopause, and menopause. We combine this with basic labs and a thyroid panel to rule out other common metabolic issues that can contribute to increased fat storage.

While baseline testing is important, we also recommend eating a diet rich in omega-3s and anti-inflammatory foods to support your hormonal balance. Remember, any plans for testing or alterations to life-style should be discussed with your doctor first.

According to PMC 2025, we can start to explore bioidentical hormone replacement therapy to reduce symptoms. For this, we need accurate hormone measurements and individual doses. While this is not the standard or perhaps norm for care, it is promising that soon the standard will be focused on hormonal therapy as opposed to the more invasive approach of surgery.

We focus on holistic approaches, keeping in mind that lipedema is hormonally driven and experiencing imbalances in this area as well as various stages of life will affect lipedema and its severity.