Fluid retention and menopause
Are your feet and ankles swollen? Do your rings feel tight and your legs heavy? These are all signs that you may have fluid retention, also known as oedema. Many women experience increased water retention during the early stages of menopause, known as perimenopause. Why is that? What can you do about it?
I used to get a swollen face and swollen fingers before my period. Since menopause started, it has become an ongoing problem. - Ana (age 49)
You can recognise oedema by applying pressure on the swollen area with your finger. Do you see an indentation of your finger after applying pressure? Then it’s oedema. Oedema happens most often in the abdomen and legs, but it can affect other parts of the body, such as the face, hands and breasts.
Your hormones play a huge role in your water storage. Many women have breasts that feel swollen and tender right before their periods. Bloating during menstrual periods is also common. The reason women experience bloating and breast swelling before and during their menstrual cycle is, unsurprisingly, due to hormone levels. This also applies to menopause.
What is happening in your body?
Oedema is swelling caused by fluid trapped in your body's tissues. Fluid is removed by the lymphatic system, but it can also leak out of the blood vessels and accumulate in your tissues. During menopause, the change in hormones can impact your body’s fluid regulation.
The decline in progesterone relative to oestrogen plays a role in this respect. At the start of perimenopause, progesterone levels drop faster than oestrogen levels, making oestrogen more dominant (oestrogen dominance). Oestrogen promotes fluid retention in the body. Declining levels of oestrogen during menopause may also adversely impact lymph circulation, causing fluid to accumulate in tissues.
Other causes
Stress is another factor that can lead to fluid retention. (And we all know that menopause can be a stressful time!) During moments of stress, cortisol works to increase salt and water retention. When you’re always on edge and don’t get enough rest, your body produces more cortisol. Elevated levels of cortisol can cause fluid in the body to build up.
Other factors, such as being overweight, lack of exercise, consuming a diet rich in sodium or the use of certain medications, can exacerbate fluid retention. This can make it difficult to say how long it takes for fluid retention to resolve. But this doesn’t mean you have to accept it and keep going. There’s a lot you can do to alleviate your symptoms.
When should I see my doctor?
Do you experience frequent or persistent swelling in your feet, legs or other parts of your body? This could be an indication of something more serious than a hormonal imbalance. Oedema can be a sign of vascular problems, or it can be a side effect of medicines to treat high blood pressure or diabetes. Oedema is also a common symptom of heart failure and it can be caused by conditions such as kidney or liver disease and thyroid disorders. If you have frequent or persistent swelling, it is advisable to consult a doctor.
What can you do?
Nutrition and lifestyle can play a big role in managing menopausal symptoms, including oedema. Here are some tips.
- What is the fastest way to reduce swelling? Move! A brisk walk stimulates blood flow and improves lymphatic function, whereas sitting or standing for a long period of time can cause fluid to build up in your tissues. Does your job involve sitting at a desk all day? Get up and move around every 30 minutes and/or do stretches.
- It might seem counterintuitive, but drink plenty of water. Drinking more water can help with fluid retention, because water plays a crucial role in metabolic processes in the body. It encourages your kidneys to flush out toxins, which helps reduce oedema, especially in your arms and legs.
- Reduce salt (sodium) in your diet. Avoid convenience foods, such as ready meals and savoury snacks. Sodium binds to water in the body. Use spices other than salt to season foods, such as paprika, garlic powder or cumin.
- Eat a balanced diet, with sufficient magnesium, potassium and vitamins B. These vitamins and minerals can help your body flush out excess fluid. Green leafy vegetables, bananas, legumes, nuts, seeds, whole grains are high in vitamins and minerals. Foods that contain a lot of water, such as cucumbers, lettuce, cabbage, watermelon and grapes, should also be part of your diet. If you are unable to increase these foods in your diet, you could consider taking a high-quality supplement.
- Alternate between hot and cold showers. Alternating between hot and cold showers stimulates metabolism and improves the transport of tissue fluid.
- Wear compression stockings. Compression stockings help manage severe swelling by improving circulation. However, always consult with a doctor before starting to use them.
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What treatments can help?
During menopause, your body is working hard for you behind the scenes. Give your body the support it needs by eating a healthy diet and getting sufficient exercise and rest. For women with severe symptoms, HRT may be an effective therapy.
Can hormone therapy help?
Do you have any other menopausal symptoms besides fluid retention, like mood swings, low mood or hot flashes? If so, you could consider hormone replacement therapy (HRT). HRT works by replacing the hormones that fall during menopause, which helps reduce these symptoms. Wondering if hormone therapy could be an option for you? The best thing you can do is read up on HRT and get medical advice.
Sources
- Cheema, M. U., Irsik, D. L., Wang, Y., Miller-Little, W., Hyndman, K. A., Marks, E. S., Frøkiær, J., Boesen, E. I., & Norregaard, R. (2015). Estradiol regulates AQP2 expression in the collecting duct - a novel inhibitory role for estrogen receptor alpha. American Journal of Physiology - Renal Physiology. https://journals.physiology.org/doi/full/10.1152/ajprenal.00685.2014?checkFormatAccess=true
- Hormone University. (2020, August 27). Water retention and hormonal imbalances. Hormone University. Retrieved June 11, 2024, from https://hormoneuniversity.com/body-body-image/water-retention-and-hormonal-imbalances/
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FAQ
Are fluid accumulations dangerous?
If your fluid retention is not related to the menopause, it may also indicate an underlying condition. See a doctor to be sure if the symptoms persist or are very severe.
