The Balanced Bit

6 Things Nobody Tells You About Lipedema After Menopause

From a lymphedema therapist who has it herself.

I've had lipedema since I was twelve. So did my mother, and so did her mother before her.

I also spent twenty-four years as a certified lymphedema therapist, treating women with the exact thing I have. So when I tell you I understand this, I mean I've been treating it all day and then going home in it.

And none of it prepared me for what menopause did. My thighs ballooned faster in three years than in the previous thirty. I did everything I'd spent my career prescribing to other women. The drainage, the plate, the dry brush, the garments that cost more than my shoes.

None of it held.

It took me four months of late nights and studies I paid for out of my own pocket to work out why. And what I found is the reason nothing I was doing, or prescribing, ever worked for longer than a few days. Here are the six things nobody tells you.

Grace Faris, CLT
Grace Faris, CLT✔ Verified
Certified Lymphedema Therapist, 24 yrs
Woman's lower legs and thighs showing lipedema tissue changes

1. Your body leaks fluid into your legs all day. Something has to pump it back out.

This is the part everyone skips, and it changes the whole picture.

Lipedema tissue traps fluid. All day, every day, your legs are taking on more of it. That's the heaviness. That's the ache by the evening. That's why they're tender when someone touches them.

So the real question was never how to get the fluid out. Your body just makes more. The question is what's supposed to be moving it out, all the time, the way it's meant to. Nobody at the clinic ever answered that for me.

👉 See what finally moves it
Close-up of a leg and thigh showing skin texture changes from lipedema

2. That pump isn't your heart. It's the muscles in your legs and backside.

Your blood has a heart. A hundred thousand beats a day, moving it around whether you think about it or not.

Your lymph has nothing like that. No heart. No pump of its own. I'll say it plainly: the only thing that moves lymph is a muscle squeezing it.

Picture a boat with a slow leak. Water comes in whether you like it or not, and there's no plug in the bottom. The only thing keeping that boat afloat is the pump. Your muscles are that pump. And the biggest one you own, your glute, sits directly on top of the drainage route for your hips and thighs.

👉 See how the pump works
Mirror reflection of a woman's legs and feet standing on a wood floor

3. After menopause those muscles fade, so the fluid has nothing moving it.

Here's why it fell apart at the exact age it did.

When you go through menopause, your estrogen drops. And estrogen is what holds muscle on your body. So the muscle goes with it. Then your thighs get heavier and they hurt, so you move less. And the less you move, the quieter the muscle gets.

So the fluid keeps arriving, and the pump that's meant to move it has quietly switched off. Nobody told you it was happening. You just woke up one day heavier than you'd ever been, and blamed yourself. It was never your willpower. It was the pump.

👉 See what switches the pump back on
Both legs wrapped in compression bandaging during a lymphedema drainage session

4. Compression and lymphatic drainage don't move the fluid. They only manage it.

This is the part that made me furious once I saw it.

Everything we get handed either moves fluid or holds it. The massage moves it, for an hour, with someone else's hands. The plate shakes it. The brush sweeps it. The compression holds it still. The supplements change what's in it.

Not one of them does anything about why the fluid stopped moving on its own. We're all treating the puddle. Nobody's asking about the pump. And there's a reason for that, and it isn't a kind one. You can't bill a woman a hundred and fifty dollars an hour to switch her own glute back on.

👉 See what actually moves the fluid
Feet on a bathroom scale beside a dated note, legs showing lipedema

5. That's why the massage feels great on Tuesday and you're swollen again by Friday.

Think about your own week. You come off that table lighter than you've felt in months. And by the weekend you're right back where you started.

That's not you doing something wrong. That's the mechanism. The drainage contracts nothing. Someone else's hands are doing the moving, and the moment she stops, so does the fluid.

Your pump was never meant to run for one hour on a Tuesday. It was meant to run all the time. That's the whole reason nothing has ever held. Not because you weren't consistent enough. Because none of it was ever the pump.

👉 See what finally held past Friday

6. So here's what I now recommend to my patients instead.

Woman relaxing on her sofa wearing the Novu EMS shorts, controller in hand

Once I understood the problem, the answer was almost insultingly simple.

If the muscle is the pump, and the muscle has faded, you have to make it contract again. Really contract, not vibrate near it, not get rubbed by someone else's hands. And every day, because the pump was built to run constantly.

Normally you'd rebuild a muscle by working it. But lipedema makes that its own cruelty, because moving hurts, and the exercises they hand you are the exact thing your legs won't let you do.

So the answer is a technology that does the contracting for you, without you moving a thing. It's called EMS, and physiotherapy departments have used it for years to keep muscle from wasting when a patient can't move. Nobody thought to point it at us.

It's built into a pair of shorts called Novu. The pads sit over the glutes and upper thighs, right on the drainage route. Fifteen minutes a day, and you feel the muscle work in the first ten seconds.

It won't feel like much for the first couple of weeks. Then the heaviness starts to lift, usually around three weeks in. It's the first thing in twenty-four years that moved the fluid instead of just managing it.

See the shorts I recommend →

Why I'm willing to put my name on these

Novu EMS lymphatic pump shorts with wireless controller

People ask me this every time, so I'll answer it straight.

I've used EMS for years in my own practice. The proper clinical machines, the ones physios use to keep muscle alive after surgery. So I knew the technology worked. What I didn't believe was that a pair of shorts you wear on your sofa could do the same job as a machine I plug into the wall.

So I didn't recommend them to anyone until I'd worn them myself, every day, for two months. Then I put them on the women in my practice who had tried everything else and had nothing left. When their compression started going on easier, I stopped doubting.

That's when I agreed to work with Novu, on the condition I had a say in the thing itself. I wasn't going to attach my name to something I couldn't stand behind.

I tell every woman the same three things. Start on the lowest setting. Give it a full three weeks before you decide. And if you have a pacemaker, a clotting condition, or you're pregnant, check with your own doctor first, because EMS isn't right for everyone.

For everyone else who has been managing this for years and getting nowhere, it's the first thing I've found that moves the fluid instead of just chasing it around.

They come with a 60-day guarantee. Wear them every day for two months, and if your thighs don't feel any lighter, send them back. You'll have lost nothing but the time it took to try something that could actually help.

See the shorts I recommend →

Comments

1,204 people are talking about this

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Marianne Keeler

I managed this thing for nearly thirty years and then menopause and it all came apart. My drainage lady is lovely but I'm back to square one by Friday every single week. Nobody has ever once explained WHY to me. Reading this at 6am and I'm actually angry.

Like · Reply · 👍 41 · 38m
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Sherri Vandenberg

The vibration plate is under my bed. It's been under my bed since February. This stung.

Like · Reply · 👍 22 · 22m
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Dana Rowntree

Mine's under the bed too 😩 solidarity

Like · Reply · 👍 9 · 15m
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Patti Corliss

Diagnosed at 34 after 20 years of being told I ate too much. Managed it fine until about 49 and then it fell apart and my doctor said give it time and it would settle down. That was six years ago. Still waiting for it to settle down.

Like · Reply · 👍 67 · 45m
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Josephine Albright

Three weeks in. Being honest, first fortnight I felt absolutely nothing and I'd decided to send them back. This week my compression went on easier in the morning. Not a miracle. But it's the first thing in five years that's gone the right way.

Like · Reply · 👍 84 · 1h
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Ruth Lindqvist

My mother had this. My sister has this. I know exactly where I'm going and that's the part that keeps me up at night.

Like · Reply · 👍 51 · 1h
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Angela Tomlin

Genuine question, is this safe with venous insufficiency? I've got the varicose veins on top of everything else and I don't want to make things worse.

Like · Reply · 👍 12 · 1h
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Dr. Grace Faris, CLTAuthor

Angela, please ask your own clinician because I don't know your history. In general EMS is contraindicated with a pacemaker, in pregnancy, over an active clot, and over broken skin. Take it to your team. Don't take a stranger's word for it, including mine.

Like · Reply · 👍 38 · 52m
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Nadine Prewitt

Skeptical, if I'm honest. I have bought a LOT of things. But it's fifteen minutes on the sofa and I'm already on the sofa, so.

Like · Reply · 👍 29 · 3h
C
Carol Whitmore

I had to order a second pair because my sister kept "borrowing" mine 😂

Like · Reply · 👍 18 · 3h
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Deborah Vance

Has anyone over 65 used these? I'm 68 and I've had this since I was a teenager.

Like · Reply · 👍 7 · 4h
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Marianne Keeler

Deborah I'm 61 and I'm getting on fine with them. Start on the lowest level.

Like · Reply · 👍 11 · 3h
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Elaine Foster

The bit about sitting down more because it hurts, and then it getting worse BECAUSE you sat down. That's it. That's the whole thing. I've spent four years thinking I was just lazy.

Like · Reply · 👍 96 · 5h

Two roads

A woman at a crossroads weighing two paths: struggling versus thriving

Keep doing what you're doing. The compression, the drainage, the weekend swelling. Managing the puddle forever and never once touching the pump.

Or try the thing that actually moves it. Fifteen minutes a day, at home, and let your own muscle do what it was always meant to do. You've spent more than this on things that were gone by Friday.

See where I send my patients now →
The Balanced Bit

These statements have not been evaluated by the FDA. Novu is not intended to diagnose, treat, cure, or prevent any disease, including lipedema or lymphedema. Individual results vary. Consult your clinician before beginning any new device, especially if you have a pacemaker or other implanted electrical device, are pregnant, or have active clotting or broken skin.

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