What causes legs to swell and turn dark?

My legs are swollen, but I am 54 years old and cannot get pregnant. Also, my legs are too dark, even though I have brown skin. It is so bad that I do not want my husband to see my legs. Anita K

Dear Anita K,

Leg swelling or pedal oedema is often caused by a buildup of excess body water in the legs. This can be due to issues with blood or lymphatic flow and may result from various conditions such as being overweight, leading a sedentary lifestyle, wearing tight stockings, or having underlying health problems such as kidney, liver, or heart diseases, blood clots in the legs (DVT), anaemia, or certain medications.

In Uganda, pregnancy is commonly associated with leg swelling and darkening of the skin (chloasma). Chloasma typically affects the face and tends to disappear after delivery. 

During early pregnancy, leg swelling is attributed to water retention and pressure on the veins that return blood to the heart in the months leading up to delivery.

Even in the absence of pregnancy, problems with the veins returning blood to the heart (venous insufficiency) can cause leg swelling and discolouration. In venous insufficiency, the veins may leak blood into the leg tissues, leading to swelling and potentially causing the iron in the blood to stain the legs red, which may eventually turn black over time.

If you are experiencing leg swelling, it is important to consult a doctor to rule out any serious underlying conditions and to seek appropriate treatment.