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.
Other Causes
Diet
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
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.
Lymphedema
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.
Sources and
Additional Information:
