Fluid Retention, Edema, is one of the potential menopause symptoms, commonly associated with swelling in the legs and ankles, though not limited to this area and it is unrelieved by urination.
Edema is the medical term used to describe the accumulation of fluid in the interstitial spaces beneath the skin. It is also referred to as dropsy or swelling. The degree of an edematous swelling depends on the extent of fluid leakage into the interstitial spaces and/or the rate at which this fluid is drained into the lymphatic system.
Edema can affect different parts of the body but the most common forms of this medical condition affect the limbs, especially the lower limbs.
Therefore, swollen feet, legs and ankles are the most common presentations of edema.
There are different ways to classify edema. One classification is by the site of the swelling. When classified by this factor, edema can be generalized or specific to an organ.
Organ-specific edema includes cerebral edema, pulmonary edema, pedal edema, corneal edema, periorbital edema, lymphedema and cutaneous edema caused by insect bites and contact dermatitis.
Edema can also be classified by grades. Grade + edema is a mild form of the condition and it usually affects feet or ankles of both legs. Grade ++ edema is moderate edema that affects the feet, lower legs and may even extend to the hands and lower arms.
Grade +++ edema is the most severe form of edema. It is generalized edema and it affects all limbs and even the face.
Basically, all forms of edema follow a given pattern that ends with the fluids collecting in the interstitial spaces leak from the blood vessels supplying the area.
The progression of edematous swelling follows these steps:
ü Increased hydrostatic (water) pressure in the surrounding area
ü Reduced oncotic (protein) pressure in the blood vessels
ü Increased oncotic pressure in the tissues surrounding these vessels
ü Increased permeability of the walls of the blood vessels due to factors such as inflammation
ü Blockage of the lymphatic system which prevents the draining of the fluids in the area
ü Increased water-retaining properties of the tissues surrounding the area
These steps translate to an increased water pressure in the tissues of the area affected. Coupled with the increased porosity of the blood vessels, more fluids move out these vessels to reduce the high-water pressure in the tissues.
Menopause and Edema
There are different factors that may cause edema swelling to appear. These factors include underlying medical conditions, physiological states, nutritional deficiencies, medications, diet and restricted movement.
The several studies confirmed that menopause can cause hormonal fluctuations that trigger edema. At the same time, hormone replacement therapy, which is aimed at replacing lost hormones, can also cause edema. That proves the wide fluctuation rather than specific hormones that causes edema.
A diet with high salt content is the classic cause of edema. The table salt used in cooking is sodium chloride. When ingested in high quantities and for a long time, it raises the level of sodium ions in the body. When the amount of sodium increases in the body, the kidney responds by reabsorbing more fluids to dilute the rising concentration of sodium ions.
Unfortunately, the reabsorption of fluids from the kidneys is tied to the reabsorption of more sodium ions that should have been lost in urine. Salt-driven edema is associated with congestive heart failure, high blood pressure and liver diseases.
To prevent the retention of fluids and the swelling that follows, sodium-restricted diet is commonly prescribed for those affected.
Malnutrition can also cause edema. A diet low in B vitamins especially vitamins B1, B5 and B6 can contribute to edema swelling.
Lastly, low albumin level has been associated with edema. This can be caused by nutritional deficiencies or kidney disease.
Albumin and other proteins found in the blood provide oncotic pressure by acting as a sponge retaining fluids in blood vessels. When the levels of these blood proteins are low, oncotic pressure falls and fluids can leak out of blood vessels.
Foot and Ankle Injuries
A direct injury to the foot or ankle can cause local swelling. The swelling represents the body’s normal response to the damage. Usually, getting off the injured limb can help. You can also reduce this kind of swelling by applying ice packs on it, wrapping it in compression bandages and raising up the affected limb to allow gravity to pull back the pooled fluid.
Other kinds of leg injuries that can cause swelling include open, infected wound; bursitis (fluid-filled sacs that appear at joints); tearing of the tendon or ligament; osteoarthritis, rheumatoid arthritis and gout arthritis.
Venous insufficiency is the result of an inefficient return of blood flow to the heart by veins in the legs. This is caused by damaged or weakened valves in these veins. These defective valves cannot keep the flow of blood in one direction (up towards the heart). Instead, the blood in these veins can flow back through the veins. This results in reduced pressure and the pooling of blood in the lower limbs.
When blood pools in these veins, there is an increased chance that fluids will leak out into the surrounding tissues. Therefore, venous insufficiency can cause swelling in the ankles and feet.
Edema due to chronic venous insufficiency can be recognized by the ulcers and color changes in the skin of the lower leg.
Blood Clot and Tumors
Blot clot in the leg can also impede the proper flow of blood back to the heart. Blood clots can form in the veins close to the skin surface and cause superficial swelling. However, when the blood clot is found in one of the deeper, bigger veins (deep vein thrombosis), the resulting edema affects the ankles and feet.
Deep vein thrombosis can cause more harm than just pedal edema. When the blood clot breaks off, it may travel to the heart or lungs where it can cause serious and potentially life-threatening complications.
Deep clots blocking major veins in the leg can be identified by the pain, fever and the skin color change accompanying the swelling.
Tumors can also block blood flow in the veins of the legs. When a tissue mass gets large enough, it can press on veins and gradually increase the pressure within the blood vessels. This results in the leakage of fluid into the surrounding tissues.
In addition, the lymphatic system draining the area can respond to the tumor and swell up.
The lymphatic system is responsible for draining the fluids in various sites of the body. The lymph vessels drain to the lymph nodes where foreign bodies such as bacteria are trapped and destroyed.
However, it is possible that the lymph vessels are blocked or damaged. When this happens, the protein-rich lymph fluid can build up and cause edema.
Lymphedema commonly affects cancer patients. It can be triggered by radiotherapy and deliberate surgical removal of the lymph nodes. Any other factor that blocks the lymphatic system can also cause lymphedema.
Heart, Liver and Kidney Diseases
Congestive heart failure can cause swelling in the legs, ankles and feet because it affects blood flow from the lower limbs.
During congestive heart failure, the lower chambers of the heart cannot effectively pump blood. Therefore, the venous return from the lower part of the body is affected. This means that blood flow stagnates in the legs, ankles and feet, and therefore, the chance of fluid leakage into the surrounding tissue increases.
Liver diseases especially liver cirrhosis reduces the efficiency of the liver. This affects the release of hormones and other natural compounds that regulate the amount of water in the body.
In addition, liver cirrhosis increases the pressure in the veins draining the pancreas, intestines and spleen. This rise in pressure can cause the accumulation of fluids in the abdominal cavity (ascites) and in the lower limbs (pedal edema).
The kidney is chiefly responsible for the loss of fluid in the body. The body passes fluids through the kidneys and, depending on the current needs of the body, some fluid may be reabsorbed or else lost in urine. Therefore, kidney diseases can cause the accumulation of fluids in the body.
The edema associated with kidney problems usually affects the eyes and legs.
In addition, liver diseases also cause blood albumin levels to fall. This can also lead to swelling in the legs, ankles and feet.
What to Do?
There are no clear explanations as to why edema happens during menopause, except that it has a clear correlation with the hormones fluctuation. It has been evident though, that most cases are due to too much bodily fluids. The treatment of symptoms of menopause may have greatly influenced the occurrence of edema though. It is also a very common fact that painless swollen ankles and feet happen, and is a common dilemma among older people. Some suffer intense swelling that may even include the calves and thighs. However, the swelling of ankles and feet are most common, due to the presence of gravity.
Estrogen and progestin hormones are said to have a great impact on the body’s water metabolism. Fluctuating hormone levels during the menopausal years can actually cause fluid retention, which is an effect of an increase in sodium. As with pregnancy, weight gain during menopause results in swollen ankles.
There are some treatments that can be used. Reducing the sodium intake may help minimize the fluid retention in the body. It might also help if you have a healthy eating habit, along with a healthy lifestyle. Even though menopausal symptoms are unpredictable, these may prevent you from experiencing most of the symptoms associated with menopause, including swollen ankles.
Other remedies that you might find helpful in fighting the incidence of edema during menopause are elevating your legs to a point above your heart when lying down, exercising your legs to pump fluid from the legs to the heart, and wearing support socks and stockings.
If you think your swollen ankles are serious, check with your health care provider immediately, especially if the symptoms are accompanied with fever, or if the swelling is red and has affected your abdomen. Aside from menopause, swollen ankles can also be cause by blood clot, leg infection, varicose veins, burns, insect bites, malnutrition, and surgery to the legs or feet.
Also, a common problem is that many women going through menopause and dealing with water retention will turn to diuretics, which seems like a logical solution. The problem here is that diuretics zap essential potassium from the body, which can lead to osteoporosis.
Therefore, rather than take a standard diuretic, you should consider natural remedies, which include things like Uva Ursi, Juniper, Parsley, Astragalus, Dong Quai, Dandelion, Nettle, Vitamin C, or Vitamin B6, all that help to increase fluid output. Keep in mind that while an adequate dose of Vitamin C is helpful, too much can actually cause stress on the kidneys and make water retention worse in the future.
To give you an idea of ways in which these natural remedies can help you deal with menopause and water retention, let’s look at a few, starting with Dandelion. Just 10 to 20 drops is ideal for lessening edema, or swelling. Best of all, Dandelion can be used for a long time without any ill effects.
In addition to helping with the water retention, Dandelion has another benefit – it nourishes and tones the kidneys, adrenals, and liver, while also increasing food digestibility. Next, there is Dong Quai, a popular herbal remedy. Although for menopause and water retention this remedy is not as effective, when taken long-term, it does provide relief from bloating.
Another benefit is that Dong Quai helps in inhibiting the growth of many forms of bacteria.
Just as some herbal remedies can help provide you relief from menopause water retention, there are common foods that also work. For example, corn, cornsilk tea, asparagus, cucumber, watermelon, and grapes, all work quite well and can be used as often as needed.
Other foods that help include tea, coffee, parsley, black tea, and celery but these should not be taken are freely. Of course, one of the best ways to fight water retention is to cut down your intake of salt or salty foods. Then, you can try certain essential oils that would include geranium, juniper, lavender, rosemary, and cypress.
Exercise is a great way to get rid of excess body water. Exercises like walking, running, cycling or playing tennis results in sweating. This turns your entire body into an effective outlet for getting rid of excess water, salt and other toxins. Of course, exercise in moderation and be reasonable with the level of your physical activities.
Sauna bath is another way to sweat out excess water and toxins from the body. Sauna also helps in relaxing the body.
Alcohol though an initial diuretic, turns into a potent cause of dehydration. This forces the body to retain even more water. Replace alcohol intake it herbal teas or green tea, which are known diuretics without negative side effects.
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