Why Legs Swell Before Menstruation and During the Climacteric

Examining the wisdom of the Donguibogam through modern medicine clearly shows how strongly sex hormones influence fluid metabolism. The body operates through precise regulatory systems, and hormones serve as a primary foundation. A woman's body undergoes major shifts across monthly cycles and throughout life depending on the delicate balance between two primary hormones: estrogen and progesterone. A primary factor in premenstrual edema is progesterone. Progesterone, which surges rapidly from ovulation until menstruation, influences aldosterone. Aldosterone promotes the reabsorption of sodium and water in the kidney. When progesterone fluctuations enhance aldosterone activity, more sodium and fluid are retained in the body. This aligns directly with the Donguibogam concept that the kidney governs water flow and the spleen regulates dampness, explaining why fluid metabolism falters during this phase. Moreover, capillary permeability increases during this period, allowing fluid in the bloodstream to move more readily into surrounding tissues and worsening edema. An imbalance between estrogen and progesterone also affects serotonin levels, inducing mood shifts or increased appetite, which in turn influences the autonomic nervous system and further impairs fluid regulation. Climacteric edema is likewise tied to hormonal shifts. As menopause approaches, estrogen production declines sharply. Estrogen typically assists with blood vessel dilation and healthy circulation. When estrogen levels drop, blood vessels constrict and circulation slows, hindering the normal elimination of metabolic waste and fluid. In addition, the climacteric often brings reductions in basal metabolic rate and muscle mass, slowing lymph circulation and making edema chronic. This corresponds to the principle in the Donguibogam that when qi circulation is obstructed, the waterways become blocked. Ultimately, this type of edema is not simply caused by eating salty foods or being tired, but serves as a clear signal from a shifting hormonal system. Paying attention to these hormonal changes and choosing appropriate ways to support the body is an essential part of maintaining health. Recognizing that your body is navigating an internal transition can help you address these shifts with patience and care.