Lipedema & estrogen

The Estrogen Connection: Navigating Lipedema with Hormonal Knowledge

It was only recently after a chat with my hairdresser that I started putting 1 + 1 together over a very common condition called lipedema. Also known as lipoedema. (Lipo = fat, Oedema = swelling).

Over my 22 years in private practice and 35 years as a nurse, I certainly had come across the condition but hadn’t fully taken time to consider the causes and if my knowledge of hormones and advice could help. Of course it can! The condition is identified as a hormone related phenomena affecting 11-19% of the female population. Ref 1.

After diving deeper into what is understood about this condition, I believe the solutions lie in finding out your hormone profile (saliva testing the accurate way) and sorting out food, lifestyle, metabolic and imbalances from there.

lipedema stages ref: Research Gate

Lipedema is a complex condition that still holds many unknowns but has been acknowledged since 1940 in medical papers.

It is recognised to follow natural hormone shifts in the body such as puberty, pregnancy, menopause.

During all these natural stages a woman goes through a “hormone rebalancing” of sorts.

If equilibrium is not achieved, imbalances arise.

Many factors determine if equilibrium is achieved such as diet (too many sugar rich foods, dairy, gluten), stress, toxicity impactors and more.

Often there is a family history, particularly of obesity but in my nearly 40 years in health, I am wiser to believe it is all genetics. Usually we follow our parent’s eating, stress habits and these are changeable and that is often where solutions lie.


With lipedema, the problem shows up as a painful buildup of fat in our arms and legs. Surprisingly, despite its name, it usually doesn’t involve holding onto too much water, like in lymphedema. And while we often think of it as a fat issue, there are different ways it can show up.

Lipedema can come and go, and may progress with aging but not always.

Exploring Hormonal Links in Lipedema

There is much research into hormones and how they influence fat distribution.

The two stand outs for me are estrogen (oestrogen in UK) and testosterone.

There also seems to be a minor player, Leptin.

At the time of writing this blog my knowledge is firmly around estrogen and fat distribution, the testosterone>estrogen link, why stress in women is leading to increased testosterone levels and food/environmental impactors.

So let’s start with estrogen.

How Estrogen Shapes the Disease

Estrogen, the pre-dominate hormone in females, helps decide where and how fat gets stored.

Here’s how it works:

  1. Estrogen and Cells: Our body has special parts called estrogen receptors. Think of them as locks, and estrogen is the key that fits into these locks. These locks are found on cells that can turn into fat cells, and also on fat cells themselves.
  2. Turning into Fat Cells: Estrogen can tell certain cells to become fat cells. It does this by activating switches inside these cells. When these switches are turned on, they make the cells change into fat cells.
  3. Making More Fat Cells: Estrogen can also make the number of fat cells increase. It’s like telling the factory to make more products. So, estrogen can help make more fat cells in our body.
  4. Controlling Fat Size: Estrogen helps control how big fat cells can get. It’s like keeping the balloons from getting too big. When estrogen is around, it helps keep fat cells from getting too large.
  5. Dealing with Fat: Estrogen also helps manage how our body deals with fat. It can decide whether to store fat away for later or to use it up for energy.
  6. Keeping Things Calm: Estrogen helps keep the body calm by reducing any inflammation, which is like a small fire inside the body. When the body is calm, it’s easier for fat cells to do their job properly.

Testosterone links?

Turns out that our metabolism is strongly driven by testosterone levels. Whilst not the predominant hormone in females, high levels of testosterone definitely alter metabolism, fat distribution, lipogenesis and excessive estrogen production.

This topic (women and high testosterone levels) has formed much of my observational research, clinic data and basis for my best selling book, Beauty & the Beast Within.

Whilst classified as a sex hormone by medicine, I have found testosterone is more a stress hormone in women. It rises rapidly during stress and can be lowered equally as quick by doing oxytocin generating activities.

You can listen to my podcast @hormoneswithsam search my blog or find out more in my book on this topic.

Understanding why (we) women are experiencing stress and deeming every day stresses as “potentially death resulting experiences” is the core of my business.  The most empowering lessons I teach women is to discern between what feels like a very stressful moment and what really is potentially life threatening.

Ask oneself “is this a life threatening event?”… if not, then dial back the response. Running late, just means you are going to be late.

It is not a life threatening moment, (unless you run a red light etc).

Testosterone also plays a close relationship with estrogen.

As you can see below, it can be converted to estrogen. This is an important pathway with men in particular as aromatisation can lead to estrogen issues. The commonest cause in men is low zinc. But it is also problematic in women.

I believe understanding this pathway between high testosterone and estrogen, helps explains the close relationship between poly cystic ovaries and endometriosis.

Testosterone also competes at the cell wall with insulin. Spiking insulin levels activate lipogenesis (turning sugars in the blood stream to fat). Many women have stomach fat, due to high testosterone or cortisol and in turn, overall this hormone competes with insulin.

If insulin gets into the cell, then serum testosterone may rise (anger, aggression, pimples, whiskers, period issues). If testosterone gets into the cell, then serum insulin may rise (energy swings, anxiety, fat making, particularly around the waistline).


The best accurate way to determine your hormone status is not a blood test but a saliva test (that is because hormones are fat soluble and bind to a SHBG and blood drawing discards that component). You can discover more about saliva testing here on my podcast or to order click here.


Discovering your hormone profile can be a game changer. Now yours might be perfectly balanced but it is likely that if you are reading this blog, that they aren’t in harmony.

I prefer measuring sex and stress hormones (estrogen, progesterone, DHEA, cortisol, testosterone) on saliva testing. It is easy to do (doesn’t include a needle jab), is more accurate and can be done from home. It also gives a more accurate picture of what your hormone profile is as it is dependent on blood proteins such as SHBG etc.

Unfortunately in most countries salvia testing is not free and needs to be paid for by the person. This is something I can’t influence but this is a link to order in Australia and includes a session with me. I can also look at ordering on your behalf for other countries but best to go through my contact tab.


Once you have determined your saliva hormone profile the rest is much easier.

Foods that help your body clear hormones such as broccoli, green leafs are very beneficial.

Dairy is well known and researched to create estrogen issues and the only benefit of calcium can be gained from eating nuts, seeds, meats and green leafy veggies.

Lymphatic Drainage:

Adipose cells are transported via the lymph system so measures to assist the lymph system may have benefit.

Lymphatic massage, whilst painful versus relaxing, may assist open lymph channels so your body can drain more effectively.

There are lymph massage mits that you can use from home, herbs such as cleavers and mini trampolines.


Stress is definitely the white elephant in the room and rather than advising people not to stress (although I know discuss menopause a a strong stress issue, post partum, PCO etc) having more FUN is a better focus for women. Crazy as it is, if I suggest women stress less, they get more stressed. I’m a woman, I know how this stuff works. Ladies, have more fun!

YES! That might mean without the kids, hubby, work etc. I’m not suggesting to be negligent but make sure you get your daily dose of fun within your current constraints.

I was a single mum for 15 years and used to put the kids to bed, crank the music and believe it or not, had a disco ball that I danced to.

It made me feel sane, happy and lowered my stress hormones. (Go the disco ball)!

Other tests:

If you have other symptoms, consider doing blood sugar tests (the best one is HbA1c which indicates and averaged blood sugar level over the past 3 months).

Saliva testing is gold standard for hormones click here.

I really like the cellwell being hair test as it may indicate deficiencies such as antioxidants, polyphenols, B12, folate, toxicity etc

You can order the saliva and hair tests with a sixty minute session with me here.

This condition is incredibly distressing, affecting self esteem and positive body image in women. Spread the news and discover how to manage your hormones today. We are perfectly designed to do this… just a bit of tweaking can make a massive difference.





  1. 2021 Nov; 22(21): 11720. link :