Puffy, Bloated and Swollen in Perimenopause? Here's How to Improve Your Body's Natural Drainage System
- mariekesteen
- 10 hours ago
- 6 min read
This summer has been pretty hot so far and over the past couple of weeks, I've been asked the same question over and over again.
"What can I do about this water retention?"
For some women it's swollen fingers. Others notice their rings no longer fit by the end of the day. Their shoes suddenly feel tight, their legs feel heavy, their cellulite seems more noticeable, or they simply feel puffy and uncomfortable in their own skin.
The heat certainly makes these symptoms worse, but here's the interesting part: the heat just exposes what was already there.
Interestingly, I've never been someone whose ankles disappear in the summer. My partner, on the other hand, gets what we jokingly call "sausage fingers" when it gets really hot.
For years I assumed I wasn't someone who retained water.
Then, when I was going through my mold recovery, I started having lymphatic drainage treatments.
And I noticed how I felt lighter and my clothes more loose after the treatment. Not because I'd magically lost body fat overnight, but because I'd released fluid that I hadn't even realised I was holding onto. In my case, it seems to collect more around my abdomen and upper legs than around my ankles or lower legs.
Water retention doesn't always look dramatic.
You don't have to have extremely swollen ankles for your circulation or drainage systems to need support. Sometimes it's simply that persistent bloated feeling. Sometimes it's brain fog. Sometimes it's cellulite that suddenly looks worse in warm weather. Sometimes it's just feeling heavy, sluggish and uncomfortable.
As we get older, especially during perimenopause, many of these symptoms become more noticeable.
And yes, hormones do play a role (especially low progesterone). But they aren't the whole story.
Your body is taking out the trash every single day
One thing I tell my clients all the time is that your body is detoxifying every single day.
Your liver doesn't decide to work for two weeks in January and then take the rest of the year off.
Every single day your body is processing hormones, environmental chemicals, inflammatory compounds, bacteria, damaged cells and the waste products that are produced simply by being alive.
What we need to do is support the systems that are already designed to do it.
And those systems don't work in isolation.
Healthy drainage depends on good circulation, efficient lymphatic flow, healthy digestion, bile production, regular bowel movements, good breathing, movement and a well-regulated nervous system.
When one of those systems slows down, the others often have to work much harder.
Ready to Put This Into Practice?
If you're reading this and thinking... "This all makes sense, but where do I actually start?"
You will love The Daily Flow Method.
It's a simple step-by-step system designed to help you support your body's natural drainage system in just a few minutes a day.
Inside, I'll show you exactly what I do myself and what I recommend to my clients to help reduce puffiness, support circulation and keep everything moving.
You'll get:
A practical Daily Flow Guide you can refer back to again and again
My favourite morning lymphatic routine
Simple lymphatic exercises, dry brushing and other daily habits
My hydration and mineral strategy (including why I'm not afraid of good-quality salt)
Tips for supporting digestion, bile flow and healthy elimination
My favourite herbs, tools and products that support healthy circulation and lymphatic flow
I've intentionally kept this very simple so that it's easy to implement and not requiring you to spend too much time or needing all kinds of equipment.
Just practical habits that take a few minutes each day but can make a real difference over time.
The goal is to help your body do what it was designed to do - every single day.
Why hormones still matter
Many women notice they retain more water just before their period. That's no coincidence.
Progesterone naturally helps counterbalance some of estrogen's fluid-retaining effects. As progesterone drops before menstruation and we get another little peak of estradiol, many women experience bloating, swollen breasts and that familiar feeling of suddenly weighing a couple of kilos more.
During perimenopause, progesterone is usually the first hormone to decline, while estrogen starts to fluctuate quite dramatically.
The result?
You may feel puffier.
Your rings feel tighter.
Your abdomen feels more bloated.
Your legs feel heavier.
You wake up looking more swollen than you used to.
Optimising hormones definitely helps, but hormones are only one part of the picture.
If the body's natural drainage systems are already under pressure, these hormonal fluctuations often become much more noticeable.
Your gut is one of your biggest drainage organs
Something I hadn't fully appreciated until recently is just how closely the digestive system and the lymphatic system are linked.
Most of us think of the gut as simply a place where food is digested.
In reality, it's one of the busiest transport hubs in the entire body.
Every meal requires your digestive system to absorb nutrients, produce and recycle bile, transport healthy fats through specialised lymph vessels called lacteals, support your microbiome, maintain your gut barrier and coordinate a huge part of your immune system.
If you think about it for a minute, a large proportion of your lymphatic system surrounds your digestive tract.
So when digestion is sluggish, inflammation is high, bile flow isn't optimal or we're living under chronic stress, we're not just affecting digestion.
We're placing extra strain on one of the body's most important waste removal systems.
Perhaps that's one reason why so many women who struggle with bloating, food sensitivities or IBS-like symptoms also tell me they feel puffy, foggy and swollen.
Don't underestimate bile flow
When people hear the word bile, they usually think about digesting fats.
But bile has another important job: It helps carry excess cholesterol, hormone metabolites and waste products out of the body through the digestive tract.
If bile flow becomes sluggish, digestion often suffers.
This doesn't mean everyone with water retention has poor bile flow.
It is simply a reminder that all these systems are connected.
The healthier our digestion, the easier it becomes for our body to remove what it no longer needs.
Stress slows everything down
This is where I think stress is often underestimated: When we're stuck in fight-or-flight mode, we breathe more shallowly.
Our diaphragm doesn’t expand as it should
Digestion slows
Blood flow is redirected away from the gut
Our muscles become tighter
Our fascia becomes less mobile
And because the lymphatic system doesn't have a pump like the heart, it relies on movement to keep fluid flowing.
Every walk
Every stretch
Every muscle contraction
Every deep diaphragmatic breath
They're all helping your body move nutrients in and waste products out.
It's one more reason why nervous system regulation isn't just about feeling calmer.
It's also about helping your physiology work the way it was designed to.
Improve flow, every single day
If there's one message I'd love you to take away from this article, it's this:
Don't think about supporting your body's drainage systems as something you do twice a year during a detox. Think about it as daily maintenance.
Just like brushing your teeth.
Walking after meals
Strength training
Deep breathing
Supporting healthy digestion
Eating enough protein and healthy fats to stimulate bile flow
Drinking enough water with added minerals!
Keeping your bowels moving every day
Dry brushing if you enjoy it
Booking a lymphatic drainage massage if it helps you feel better
None of these habits are glamorous. None of them are quick fixes.
But together they create an environment where your body can move fluid, nutrients and waste much more efficiently.
Feel lighter naturally by supporting your body's drainage system every day.
The Stress Detective's takeaway
One of the reasons I love functional medicine is that it teaches us to stop looking at symptoms in isolation.
Water retention isn't about eating less salt.
It’s also not "just your hormones."
More often, it's your body telling you that one or more of its natural drainage systems could use a little extra support.
Your circulation
Your lymphatic system
Your digestion
Your bile flow
Your breathing
Your nervous system
Your hormones
They are all connected.
So if you're feeling puffier than you used to, don't assume it's simply something you have to accept because you're getting older or that will be fixed by eating less salt.
Instead, ask yourself: How can I help my body improve its natural flow today?
Because when we support the body's ability to move nutrients where they're needed and remove what no longer serves us, we often start to feel lighter - not just physically, but mentally too.
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