Feeling Light-Headed, Disoriented or Dizzy? It Might Be From Menopause!

As a menopause specialist, I am frequently asked this question, “Is dizziness a symptom related to perimenopause/menopause?” The answer is yes – it can be due to hormonal fluctuations as well as many other things. As we know, menopause is a natural transition every woman experiences when she goes from a reproductive stage to a non-reproductive state, which causes steep hormonal drops in estrogen and progesterone. It is defined as 12 months without having a menstrual cycle. Among the most common symptoms are hot flashes, night sweats, irregular periods (perimenopause), irritability, decreased sex drive as well as dizziness. By now, many of you are well versed on these symptoms!

Let’s first define what dizziness is. It is not a disease but rather a range of sensations, including:

• lightheadedness or feeling faint
• a false sense of spinning
• unsteadiness
• loss of balance
• feeling of floating or swimming

Sometimes, dizziness is accompanied by nausea, vomiting, or fainting. Dizziness can be used interchangeably with some other terms such as vertigo, presyncope, disequilibrium, or lightheadedness. All of these refer to the sensation of feeling off-balance, faint, dizzy, and disoriented. Interestingly, there are ethnic differences in the prevalence of this symptom in middle-aged women, with approximately 25% of Australian women reporting this symptom compared to 41% of their Japanese counterparts. Anxiety was also associated with dizziness in this latter group of women and researchers suggested that treating the anxiety might help reduce dizziness. (1)

To maintain our balance, or equilibrium, our bodies have three control systems.

Eyes: Our vision informs our brains of the body’s position in space.

Inner Ears: This is known as our vestibular system- loop-shaped canals containing fluid and sensory hair cells, known as otoconia, which monitor the fluid movement helping the body remain balanced. Within the otoconia are tiny crystals known as otoliths.

Sensory Nerves: Skin, muscles, and joints all contain nerves that provide information to the brain regarding the body’s location and movement.

So how does perimenopause/menopause fit into this?

It’s about hormonal fluctuations. Although the exact mechanism of why hormonal changes lead to dizziness is not yet known, there is a hypothesis that the drop of estrogen during these times compromises the otoconia, reducing their ability to function and communicate information. Crazy right? Who knew that the inner ear was so important?!

What are some ways to manage dizziness during this time?

Some simple lifestyle tips can help, such as adequate hydration, increased intake of nutrient dense foods, and exercises to help improve vision and balance, such as tai chi. Avoiding certain triggers such as standing up too fast, eating too much salt, smoking, and not getting enough sleep can reduce symptoms of dizziness. For some women, hormone therapy can help alleviate dizziness as well.

When do you need to seek medical advice?

If you’re having symptoms like chest pain, trouble breathing, fainting, changes in your speech or vision, or hearing loss, a visit to your doctor is needed. There may be other causes for these symptoms that may not be related to hormonal fluctuations, such as an inner ear Meniere’s disease, acoustic neuroma, dehydration, or motion sickness. This is why you need to see a doctor to get the right diagnosis.

Keep reading each week’s blog posts to stay up-to-date on how you can stay healthy, happier, wiser and AMAZING!

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In health and happiness - Dr. Diana

Citation: BioPsychoSoc Med. 2018; 12:21. Dizziness in peri- and postmenopausal women is associated with anxiety: a cross-sectional study.