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Causes of leg edema in women, what to do and how to treat?

Edema is a condition in which fluid in the body in an increased amount accumulates in the intercellular space, leading to an increase in the volume of one or another part of the body. Swelling of the legs in women are a fairly frequent complaint with which they go to the doctor (about 25% of cases).

This is due to the fact that this symptom is clearly visible, is a cause of concern because of possible diseases, and also causes cosmetic discomfort, especially for women wearing shoes with heels.


Causes of leg edema in women

Causes of leg edema in women

Causes of edema of the legs in women are very diverse. But in the first place - violations in the venous channel, which must be immediately eliminated or confirmed. This approach is justified, as it allows to minimize errors associated with underestimation of a threatening or developed thrombosis.

If this complication is not diagnosed in time, then the probability of limb amputation is great, and this is already a disability. However, venous disorders are not the only cause of puffiness. Many diseases are manifested by this symptom. In addition, they can be layered on venous causes.

Therefore, a detailed examination of the patient is always carried out to identify all possible causes. Only reliably knowing why swollen legs in women, you can know what to do.

The main violations that cause swelling of the legs:

  1. Increased permeability of the capillary bed.
  2. The presence of obstruction of venous or lymphatic drainage of fluid from the tissues.
  3. Reduction of oncotic (due to proteins) blood pressure.

The main diseases that lead to edema syndrome may be the result of vascular lesions, musculoskeletal system or internal organs:

  • Chronic heart failure
  • Glomerulonephritis
  • Renal amyloidosis
  • Diabetic kidney damage
  • Lupus erythematosus, systemic form
  • Lymphogranulomatosis (oncohematological disease with affection of the lymph nodes)
  • Varicose veins
  • Hereditary insufficiency of the venous valves
  • Acute thrombosis and postthrombotic state
  • Tumors that compress the veins from the outside
  • Protein deficiency due to protein deficiency in food (fasting, unbalanced nutrition)
  • Insufficient secretion of pancreatic enzymes
  • Gluten enteropathy
  • Removal of part of the intestine (resection)
  • Liver diseases in which protein synthesis is impaired
  • Relapses faces causing elephantiasis
  • Filariasis, leading to compression of the lymphatic vessels
  • Lymphostasis after injuries
  • Quincke's edema (allergic reaction with swelling of the respiratory tract and shortness of breath)
  • The defeat of the large joints in osteoarthritis, infectious or reactive arthritis
  • Hypothyroidism.

But this list is not exhaustive. So why else have swollen feet in women?

In addition to the factors listed above, taking certain medications, in particular nifedipine, may predispose to such a condition. This tool increases the pressure in the tissues due to the direct attraction of the liquid.

Another reason is leg edema in pregnant women. It can be considered a variant of the norm if they appear in the evening and are not combined with protein in the urine or an increase in pressure in the arterial system.

Otherwise, we are talking about pre-eclampsia - a terrible complication of pregnancy, requiring immediate assistance.

Circulatory disorders

Venous insufficiency is the most common cause of edema syndrome caused by impaired blood circulation. This is one of the most significant causes of leg edema in older women (up to 80% of cases). Puffiness develops due to:

  1. Reduced venous tone
  2. Structural vein changes
  3. Microbial inflammation
  4. Valve failure
  5. Damage to the skin due to leukocyte aggression.

A less common cause associated with impaired blood circulation, leading to edema, is heart failure. In this case, the fluid goes into the tissue due to the fact that the heart does not have time to pump it - its systolic and diastolic functions are disturbed.

Diagnosis of swelling of the legs

Diagnosis of swelling of the legs

In the initial diagnosis of edema syndrome, 8 questions are important. With their help, the doctor manages to guess the most likely cause of this condition. Further diagnostic search is based on the confirmation or denial of a possible causative disease.

We give the questionnaire:

1. When did the swelling appear for the first time?

  • Acute onset is characteristic of deep venous thrombosis.
  • After 40 years, edema associated with compression of the lymphatic vessels
  • In the period of puberty, girls often develop lymphatic idiopathic edema.
  • Legs swell in the evening during pregnancy (this may be an option and norms, and pathology - see above for differences)

2. Are they accompanied by pain in the leg?

  • The pain that is only revealed during palpation, which is absent at rest, usually indicates edema of adipose tissue (lipid)
  • Acute severe pain occurs with thrombophlebitis, joint diseases, and the lymphatic system.

3. Does the swelling decrease over night?

  • Chronic edema in venous insufficiency decreases after sleep, especially if the legs are elevated
  • For lymphatic edema there is no such pattern or it is only slightly expressed.

4. Is there any shortness of breath in a horizontal position or when physical exertion does not exceed normal?

  • A positive answer - a reason to think about the cardiac disease, which led to the failure of the heart muscle

5. Have kidney infections or episodes of protein in the urine ever occurred ?

  • If the answer is "yes", then the pathology of the kidneys should be excluded.

6. Was there a history of jaundice or hepatitis?

If the answer is positive, there is a high probability of liver failure, which is characterized by a low level of protein formation and, accordingly, an increased ability of plasma to leave the vessels and accumulate in the tissues.

A similar situation is observed with regular alcohol abuse.

7. Has the weight , appetite, and intestinal function changed lately ?

If there is a change in at least one parameter, then the most likely cause is the pathology of the digestive system, in which the intestinal absorption of protein suffers.

8. Is any medication treated?

Testosterone, progesterone, estrogens, methyldopes, clofelin, nifedipine, nonsteroids and antidepressants are evidence of drug edema.

In addition, you should focus on other diagnostic criteria of edema syndrome, which can be identified by an objective examination of the patient:

  1. Acutely developed edema on one leg, accompanied by pain, often indicates acute venous thrombosis.
  2. During lymphatic genesis, the flow slowly develops, does not leave a fossa after pressing, is located on the back of the foot, does not pass after sleep or an elevated position of the leg. The diagnosis is clarified using lymphography.
  3. Gradually developing edema, leaving a fossa, and passing after sleep, indicates a chronic insufficiency of the venous system.
  4. Bilateral slowly developing edema is usually a symptom of heart failure or medication.
  5. If the leg swells on the ankle and on the front of the lower leg, then most often it is associated with hypothyroidism.

Thus, a woman who has consulted a doctor for edema is prescribed a series of examinations to clarify the cause of this condition:

  • General clinical examination of urine
  • General clinical examination of peripheral blood
  • Determination of creatinine and protein in the blood
  • Ultrasound examination of vascular status
  • Knee ultrasound scan
  • Electrocardiography
  • Echocardiography and some others.

Treatment of leg edema in women

Treatment of leg edema in women

The treatment of the edematous syndrome is carried out by that specialist, whose profile includes the causative disease. Since the most frequent cause is chronic venous insufficiency, the treatment algorithm for this pathology will be considered in detail. It is based on a combination of 2 methods - drug and compression.

Drug therapy normalizes the structure and functioning of the venous wall, and also reduces the aggressive action of leukocytes, which leads to trophic changes in the skin.

The most effective is the drug Dectralex (representative of the group of phlebotonics). It was recommended for use in 2007 (including for the treatment of lymphatic edema) after a series of clinical randomized trials (the drug proved to be effective at the highest level of evidence).

Detralex reduces the severity of symptoms such as:

  • Heaviness in the legs;
  • Feeling hot;
  • Pain;
  • Edema;
  • Trophic ulcers with a diameter of not more than 10 cm.

Compression therapy is the wearing of prophylactic or therapeutic antivaricose knitwear. It is selected individually, focusing on the pressure exerted in the area over the ankles. Before wearing it is necessary to exclude possible contraindications:

  • A significant degree of obliteration of the arteries of the legs;
  • Osteoarthritis of the knee or ankle;
  • Summer;
  • Individual intolerance.

In 10-15% of cases surgical treatment may be required. It is shown with the ineffectiveness of the above methods of treatment or in the advanced stage of the disease. The operation is performed by a phlebologist (angiosurgeon) doctor.

What to do with swelling of the legs?

What to do with swelling of the legs

Traditional methods of treatment of edema syndrome can only be recommended if it is caused by chronic venous insufficiency or iodine deficiency, leading to hypothyroidism. And even in these cases, popular treatment is complementary to traditional therapy — it cannot be recommended as an independent method.

In case of insufficiency of veins, it is recommended to apply tincture or decoction of chestnut. This plant contains certain chemicals (bioflavonoids) that strengthen the vascular wall. For the manifestation of therapeutic properties intake of tincture or decoction should be continued for 3-4 months. Then a break is taken and the treatment is repeated.

Hypothyroidism requires not only hormone therapy, but also the use of iodine in the composition of food and water:

  • Seafood;
  • Iodized water;
  • Iodized salt;
  • Sea kale, etc.

Physical exercise

Exercise is effective in the initial stage of varicose veins. Their task is to improve the outflow through the veins due to the contraction of the muscles of the leg and thigh. Therefore, the recommended complex includes:

  • Lifting socks and lowering;
  • Rotational motion in the ankle;
  • Walking on the spot or at a distance;
  • Flexion and extension in the ankle;
  • Imitation cycling, etc.

If the swelling is caused by myocardial insufficiency, then heavy loads should be avoided. The best option in this case is considered regular measured walking. It exerts a light trainee effect on the heart muscle, without causing its ischemic damage.


The choice of medication to eliminate edema depends on the specific disease:

  • Phlebotonics - with venous insufficiency (strengthen the wall of the veins);
  • Antiplatelet agents - to reduce the risk of thrombosis;
  • Thyroid hormones - with hypothyroidism;
  • Cardiac glycosides - with heart failure;
  • Colchicine, Unithiol - with renal amyloidosis;
  • Hypoglycemic agents - in diabetic nephropathy;
  • Antihistamines and corticosteroids - with Quinck edema, etc.

Prevention of leg edema

Prevention of leg edema Prevention of edema is multifaceted, because The list of reasons for them is very long. Therefore, in order to prevent this syndrome, it is recommended:

  • Avoid prolonged immobility of the legs;
  • Regularly consume the daily iodine intake with food and water;
  • Eat right and balanced;
  • Avoid infectious processes (warm clothing, hygiene, etc.);
  • Wear antivaricose stockings with burdened heredity;
  • Do not abuse alcoholic beverages;
  • Wash hands to reduce the risk of hepatitis A (jaundice);
  • Do not get involved in sweet and flour products;
  • Take aspirin at high risk for blood clots, etc.
2016-07-19 06:48:38
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