Lipoedema: a neglected area of women's health
Lipoedema is an adipose tissue disorder almost exclusively affecting women. Evidence shows lipoedema is both poorly recognised and misdiagnosed which results in many women struggling to get a diagnosis and to gain access to specialist NHS services.
This article aims to raise awareness of lipoedema and highlight the main role that community and primary care nurses can play in identifying this long-term condition earlier. It provides detail on the condition to help signpost, refer for diagnosis and initiate conservative management for those individuals with this challenging condition.
Lipoedema is a chronic, debilitating, connective and adipose tissue disorder that occurs almost exclusively in people assigned female at birth, with only a few cases reported in men with a hormonal dysfunction (Child et al, 2010). Lipoedema is characterised by a build-up of abnormal, excessive adipose tissue that develops on the buttocks, hips, lower limbs and sometimes, the arms. Its cause is unclear, but it is thought to be hereditary and associated with reproductive hormones, particularly oestrogen (Keith et al, 2021). The genetic composition of lipoedema is not yet fully understood, but there have been a few recent studies looking at gene identification specific to lipoedema (Grigoriadis et al, 2022; Michelini et al, 2022).
Evidence suggests that lipoedema is both poorly recognised and often misdiagnosed as obesity or lymphoedema (Kruppa et al, 2020; Lipoedema UK, 2021). Many women remain undiagnosed and go on to develop other co-morbidities such as obesity, joint problems and secondary lymphoedema. Historically, those who have received a diagnosis, receive this later in life. Inflammation, blood capillary fragility, lymphatic dysfunction, venous disease and the connective tissues disorder Ehlers Danlos Syndrome (EDS) may also be associated with lipoedema (Forner-Cordero, 2021; Chava et al, 2015).
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