Pregnancy & Lipedema: Are you ready?

As you prepare for your wonderful journey into motherhood, there may be several challenges that you face. Let Lipedema not be one of them!

Here are some highlights that you should discuss with your primary care physician as you start your path.

Pre-pregnancy

Get a full check-up! Even if you’ve had one recently, this is the time you should go into more in depth and ensure your health is optimized.

Things to consider during your doctor’s visit…

Labs: Vitamin D, Thyroid tests, Selenium level As one’s BMI increases, the levels of Vitamin D and Selenium may be low.^1,2 Women with Lipedema can also experience alterations in thyroid hormone levels that can negatively impact pregnancy and fetal development.1

Rule out venous disease in your legs. Many women have undiagnosed venous disease, and Lipedema increases one’s odds of having venous disease. Some of the pain, skin changes, leg swelling, restless leg syndrome, and even open sores can be from venous hypertension. Without proper treatment, your symptoms will likely worsen during pregnancy, since the hemodynamics of your changing body tend to exacerbate venous hypertension.

Overall, talk to your primary care doctor about all of your leg symptoms.
If there is suspicion for venous disease, then an ultrasound can give you a formal diagnosis. Treatment can include compression or venous ablation (i.e., closing one of the major vein in your leg to prevent reflux from causing symptoms).

Rule out Lymphedema in your legs. Isolated swelling and pain can also be due to Lymphedema, which women with Lipedema can be prone to developing. Compression is key if Lymphedema exists.

Get intervention for sleep disorders. Discuss any difficulties with sleep and tiredness. You may have a sleep disorder that can be contributing to these symptoms. Sleep apnea, for example, can be one of these disorders that can affect women with Lipedema. There are several other diseases that can develop secondary to sleep apnea, so it is helpful to be formally diagnosed.

Fertility Treatment

Consider getting a mammogram prior to starting Estrogen therapy. Many women including those without Lipedema have dense breasts that can make it challenging to interpret mammograms if their breast density continues to increase with estrogen stimulation, which may be required for fertility treatment.

Of note, your Lipedema symptoms might worsen during fertility treatment as your body becomes exposed to elevated estrogen, so make it a point to work with your primary care physician and/or Lipedema specialist on the key areas discussed below.

Topics of Interest, esp. during pregnancy

• Compression
• Nutrition
• Medical
• Exercise
• Emotional Support

Checklist

Here is a handy checklist on the above topics to take with you to your doctor’s visit:

Download Checklist

References

1. Herbst KL, Kahn LA, Iker E, et al. Standard of care for lipedema in the United States. Phlebology. 2021;36(10):779-796. doi:10.1177/02683555211015887. (https://journals.sagepub.com/doi/full/10.1177/02683555211015887?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org)

2. Cannataro R, Cione E. Nutritional Supplements and Lipedema: Scientific and Rational Use. Nutraceuticals. 2022; 2(4):270-277. https://doi.org/10.3390/nutraceuticals2040020