Feeling puffy, foggy, or inflamed lately? It could be your lymphatic system — not just your hormones

Written By Fiona Parkes

When I was going through perimenopause ten years ago, I didn't know there was a physiological reason behind the wide range of physical and mental changes I was experiencing. I hadn’t even heard the word perimenopause. I’m now on the other side of it and, truthfully, feeling the best I ever have. I'm 57, a massage therapist with a special interest in the lymphatic system, and I also hold a BSc in Anthropology. I'm fascinated by what we can do to support ourselves in this life phase.

There is a lot of chatter about perimenopause, and it often feels overwhelming and negative. But I feel lucky to have reached this time in my life. That said, how we live now has changed radically from just three generations ago. Our modern lifestyle, later childbearing years, and altered work-life balance all affect how we manage our health. While awareness of hormonal changes is growing, few people talk about the role of the lymphatic system during perimenopause and menopause. Symptoms like brain fog, bloating, aching joints, and fatigue can often relate to how your body manages fluid, waste, and inflammation. That’s where the lymphatic system — and how we support it, including with specialised techniques like Manual Lymphatic Drainage (MLD) — becomes important.

Bookends to Our Reproductive Years

Menarche and menopause mark the beginning and end of a woman’s reproductive cycle. Although they involve opposite hormonal shifts, both are full-body transitions: emotional, psychological, social, and physical. In Western societies, women are often valued for youth and reproductive potential. Aging can feel like becoming invisible. Yet in cultures like traditional Māori, menopause is honoured. The word for menopause, ruahinetanga, refers to a wise and important woman.

The Grandmother Hypothesis

Unlike most female mammals, human women live long after reproduction ends. This may be no accident. The Grandmother Hypothesis proposes that older women’s post-menopausal roles — caring for grandchildren, passing on knowledge, guiding families — offer a genetic advantage. This idea echoes the role of post-reproductive orca whales, who lead pods and help protect younger generations.

Modern Midlife Stress and Sedentary Lifestyles

Today’s midlife women are often part of the sandwich generation, juggling work, teens, and aging parents. Our ancestors were active, connected to nature, and part of a community. Now we face long hours sitting, processed food, and relentless stress — all of which affect lymph flow and inflammation.

Hormones and the Lymphatic System: What’s the Connection?

Estrogen and progesterone influence fluid balance. When they fluctuate:

  • Blood vessels lose elasticity

  • Lymph vessels struggle to return fluid efficiently

  • Sodium retention increases

This can result in swelling, puffiness, and a feeling of internal congestion. Modern lifestyles — with little time for movement, social connection, and preparing nourishing food — can make it hard for the body to transition smoothly.

Lymphatic system in perimenopause and menopause

Roles of the Lymphatic System

  • Fluid balance: Clears fluid from tissues and returns it to the bloodstream

  • Immune surveillance: Filters lymph through nodes filled with immune cells

  • Detoxification: Removes waste and inflammatory proteins

  • Fat transport: Gut lacteals move dietary fats and cholesterol

  • Hormone clearance: Hormones like estrogen and cortisol are protein-based and travel through lymph

When lymph is stagnant or overloaded, the system can’t clear these substances properly, which may contribute to hormone-related symptoms, fatigue, and bloating.

What Is Manual Lymphatic Drainage (MLD)?

MLD is a gentle, rhythmic massage technique developed by Dr. Emil Vodder n the 1930s, it is well recognized across the world in the medical and wellness arena. It follows the anatomy of the lymphatic vessels, starting at the neck and moving through key drainage areas. The movements are slow, light, and precise. MLD stimulates:

  • Lymphangion contraction (the muscular units of lymph vessels)

  • Flow toward major lymphatic ducts

  • Parasympathetic nervous system activity (rest, digest, repair)

What Might You Notice After an MLD Session?

  • Decreased fluid retention: Bloating and puffiness reduce

  • Improved digestion: Abdominal lymph nodes respond well

  • Better sleep and calm: MLD supports the vagus nerve function

  • Clearer skin: Waste is cleared more efficiently

  • Less brain fog: Many clients feel lighter and more mentally clear

Supporting Your Lymphatic System at Home

  • Move daily: Walking, stretching, swimming and yoga are helpful

  • Practice diaphragmatic breathing: Supports fluid removal, massages the abdomen, reduces constipation, and calms the nervous system

  • Eat supportive foods: Reduce processed food

  • Use compression garments when needed: For flights or long hours on your feet

  • Stay hydrated

  • Let go of perfection: Connect with friends and share the load when possible

Perimenopause Is a Transition, Not a Problem

This stage is not something to fix — it’s something to support. With care and knowledge, we can ease the shift with self-awareness, community, and body-based tools like MLD.

If you’re feeling swollen, foggy, bloated, or just not yourself, lymphatic work may help. Manual Lymphatic Drainage is a gentle, intelligent way to restore calm, flow, and connection.

References

Inoue, K., & Maruoka, H. (2017). Effects of simplified lymph drainage on the body: in females with menopausal disorder. Journal of Physical Therapy Science, 29, 115–118. Knight, J., & Nigam, Y. (2020). The lymphatic system 1: structure, function and oedema. Nursing Times, 116(10), 39–43. Porges, S. (2007). The polyvagal perspective. Biological Psychology, 74(2), 116–143. Stachenfeld, N. (2014). Hormonal changes during menopause and the impact on fluid regulation. Reproductive Sciences, 21(5), 555–561. Zolla, I., Nizamutdinova, T., Scharf, B., et al. (2015). Aging-related anatomical and biochemical changes in lymphatic collectors impair lymph transport, fluid homeostasis, and pathogen clearance. Aging Cell, 14, 582–594. Ayurvedic Perspective: "The Ancient Science of the Lymphatic System: Understanding the Causes of Imbalance." Lifespa.com – Menopause, PMS, and lymphatic imbalance NWF.org – Grandmother Hypothesis in killer whales and human longevity

Fiona Parkes
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