Overview:
While the exact causes of Lipedema are not fully understood, researchers have identified several factors have been identified as potential contributors to its development and progression.
Lipedema primarily affects women, and its development is influenced by genetic, hormonal, cardiovascular, immunologic, venous, lymphatic and neurological factors. Understanding these causes and risk factors is essential for early detection and intervention, which can significantly improve outcomes and prevent progression.
Genetic Factors in Lipedema
Genetics plays a significant role in the development of Lipedema. The condition is thought to follow an autosomal dominant inheritance pattern, meaning it often runs in families.1
Studies have shown that most women with Lipedema have family members who are also affected, supporting the hereditary nature of the disease. However, the limited number of large-scale genetic studies makes it difficult to generalize these findings across all populations as every woman affected by Lipedema does not look the same, multiple genes are likely contributing to the condition. Further awareness and research are needed to identify specific genetic markers associated with Lipedema.2
Hormonal Influence on Lipedema
Hormonal changes are one of the most well-established triggers for the onset of Lipedema.
The condition typically manifests during puberty, pregnancy, hysterectomy or menopause—times of significant hormonal fluctuation in women.3 Medications affecting a woman’s hormones can also trigger progression, including contraception and hormone replacement.
Lipedema almost exclusively affects women, and its gender specificity highlights the role of estrogen and other female hormones in its pathogenesis.4
These hormonal influences suggest that Lipedema may be linked to estrogen’s effect on fat cells and connective tissue.
Cardiovascular, Venous and Lymphatic Factors
Several physiological changes related to the cardiovascular and lymphatic systems are observed in women with Lipedema. These include lymphatic dysfunction, increased vascular permeability, and blood capillary fragility.5
The malfunctioning lymphatic system contributes to the swelling seen in Lipedema patients, while increased capillary fragility makes them more prone to easy bruising.
Varicose veins and spider veins are often present in families with Lipedema demonstrating an association and possibly an underlying genetic pre-disposition linking both conditions. Additionally, some studies suggest that women with Lipedema have variations in cardiovascular health, further complicating the condition.
These factors may contribute to the characteristic symptoms of Lipedema, such as swelling and easy bruising.
Neurological and Endocrine Factors in Lipedema
Lipedema is also associated with neurological and endocrine alterations.
Patients often present with hormonal imbalances and elevated sodium levels in the skin, which may contribute to inflammation and fluid retention.6
Neurological symptoms such as heightened sensitivity to pain are common, which may be linked to the changes in the way fat and nerve cells interact in affected areas. Fibromyalgia, a chronic myofascial pain condition, is often present in women with Lipedema.
These factors may play a role in the development and progression of the condition.
Risk Factors of Lipedema
Several risk factors have been identified that increase the likelihood of developing Lipedema:
1️⃣ Gender: Being female is the primary risk factor, as Lipedema is almost exclusively seen in women.
2️⃣ Age: Lipedema often begins around puberty or during periods of hormonal change, such as pregnancy or menopause.
3️⃣ Family History: A strong genetic component suggests that women with relatives who have Lipedema are at higher risk.
4️⃣ Obesity: While Lipedema is distinct from obesity, excess weight can exacerbate symptoms and accelerate the progression of the condition.
5️⃣ Mental Health Conditions: A study found that 77% of Lipedema patients showed symptoms of attention-deficit/hyperactivity disorder (ADHD), indicating a potential link between the two conditions.7
6️⃣ Connective Tissue Disorders: fat tissue is a type of loose connective tissue and women with other connective tissue disorders with hypermobility present may be at increased risk of Lipedema.8
7️⃣ Other Health Conditions: Conditions like anxiety, depression, hypertension, and anaemia are commonly associated with Lipedema, further complicating diagnosis and management.9
Despite these known risk factors, the underlying mechanisms of Lipedema remain complex and are still being studied. Researchers continue to explore how these genetic, hormonal, and physiological factors interact to cause the development and progression of this chronic condition.
Sources:
- Wollina U. (2019). Lipedema-An update. Dermatologic therapy, 32(2), e12805. https://doi.org/10.1111/dth.12805 ↩︎
- Poojari, A., Dev, K., & Rabiee, A. (2022). Lipedema: Insights into Morphology, Pathophysiology, and Challenges. Biomedicines, 10(12), 3081. https://doi.org/10.3390/biomedicines10123081 ↩︎
- Wollina U. (2019). Lipedema-An update. Dermatologic therapy, 32(2), e12805. https://doi.org/10.1111/dth.12805 ↩︎
- Poojari, A., Dev, K., & Rabiee, A. (2022). Lipedema: Insights into Morphology, Pathophysiology, and Challenges. Biomedicines, 10(12), 3081. https://doi.org/10.3390/biomedicines10123081 ↩︎
- Forner-Cordero, I., Forner-Cordero, A., & Szolnoky, G. (2021). Update in the management of lipedema. International angiology : a journal of the International Union of Angiology, 40(4), 345–357. https://doi.org/10.23736/S0392-9590.21.04604-6 ↩︎
- Forner-Cordero, I., Forner-Cordero, A., & Szolnoky, G. (2021). Update in the management of lipedema. International angiology : a journal of the International Union of Angiology, 40(4), 345–357. https://doi.org/10.23736/S0392-9590.21.04604-6 ↩︎
- Amato, A. C., Amato, J. L., & Benitti, D. A. (2023). The Association Between Lipedema and Attention-Deficit/Hyperactivity Disorder. Cureus, 15(2), e35570. https://doi.org/10.7759/cureus.35570 ↩︎
- Amato, A. C. M., Amato, F. C. M., Amato, J. L. S., & Benitti, D. A. (2022). Lipedema prevalence and risk factors in Brazil. Jornal vascular brasileiro, 21, e20210198. https://doi.org/10.1590/1677-5449.202101981 ↩︎
- Amato, A. C. M., Amato, F. C. M., Amato, J. L. S., & Benitti, D. A. (2022). Lipedema prevalence and risk factors in Brazil. Jornal vascular brasileiro, 21, e20210198. https://doi.org/10.1590/1677-5449.202101981 ↩︎