Dizziness and the menopause

Feeling lightheaded is a surprisingly common symptom of the perimenopause and menopause

Fluctuating hormone levels can trigger dizzy spells
There can be numerous other causes so it’s worth ruling these out
Diet, sleep and exercise can help relieve symptoms, as can HRT

Many of us have experienced dizzy spells at some point – a moment where you might feel lightheaded after bending down to put on your shoes, for example, or feeling a bit wobbly when you get up too quickly and need to steady yourself or sit down. There are different variations of dizziness: vertigo is where you feel you or your surroundings are spinning; disequilibrium or imbalance is where you feel unsteady; and pre-syncope is feeling you may faint.

Dizzy spells are common in adults but are usually not the result of something serious [1]. They can increase with age and more women than men experience them [2]. There are numerous reasons behind dizzy spells and it is worth seeking medical review so the underlying cause can be treated. Menopause can play a part.

How is dizziness linked to menopause?

Oestrogen, progesterone and testosterone all have an effect on the way your blood vessels widen and narrow, so, when hormone levels fluctuate, this can trigger feelings of light-headedness, pressure and dizziness. These hormones can also affect the function of your balance areas of the brain and your inner ear.

Hot flushes are a common symptom of perimenopause and menopause. During a hot flush, blood rushes through your dilated vessels, which can make you feel hot and you may experience palpitations, both of which can make you feel dizzy.

During perimenopause, periods can become heavy, closer together or last longer – all of which can make you feel dizzy and could be a sign of anaemia.

The menopause can be a stressful time for some women, and one study has found that dizziness in perimenopausal and postmenopausal women is associated with anxiety [3].

It’s also worth noting that there may be ethnic differences in the prevalence of dizziness in middle-aged women. One study reported 25.1% of Australian women aged 45-60 years reported “feeling dizzy or faint” at least a little, compared to 41.8% of their Japanese counterparts [4].

What else can cause it?

There are lots of other causes of dizziness, and some of these can be linked to menopause. For instance, low blood sugar can have an impact and when you are going through the menopause, hormone changes can affect how your body responds to insulin, which makes it harder to regulate blood sugar levels, leading to dizziness.

Headaches and migraines can cause dizziness and if you already experience migraines, you may find your symptoms worsen during the menopause as they can be triggered by hormonal changes.

Dehydration can cause lightheaded spells, as can lack of sleep. You may be experiencing disturbed sleep as a result of the menopause, or for other reasons, but studies have linked poor sleep to feeling dizzy during the day [5].

How can I treat it?

Keep hydrated – aim to drink two litres of water a day and reduce your caffeine intake – and keep your blood sugar levels stable by eating small healthy snacks. Avoid snacking on overly processed foods or sugary foods – high protein snacks are best.

Exercise not only helps manage stress, it can help improve your balance so you are better equipped to deal with dizziness. If you are experiencing stress or anxiety, look at how best to manage your symptoms.

If your dizziness is caused by fluctuating hormones, replacing them with hormone replacement therapy (HRT) can help. A study has found that women who take oestrogen for menopause symptoms have a significantly lower incidence of the most common form of vertigo [6].

You can also try to limit dizzy spells by standing up slowly after you’ve been sitting or lying down to give your ears and head a chance to adjust. If you do feel lightheaded, sit down or lean against a wall while the feeling passes.

When to get help

If you are experiencing frequent dizzy spells that are affecting your day-to-day life, or are regularly feeling faint, or have fainted, see your doctor to check if there are any underlying causes. Also see your doctor if you are experiencing heart palpitations along with dizzy spells.

References

1. NHS: Dizziness

2. Maarsingh, O.R., Dros, J., Schellevis, F.G. et al (2010). ‘Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics’, BMC Fam Pract 11, 2. doi: 10.1186/1471-2296-11-2

3. Terauchi M, Odai T, Hirose A, Kato K, Akiyoshi M, Masuda M, Tsunoda R, Fushiki H, Miyasaka N (2018). ‘Dizziness in peri- and postmenopausal women is associated with anxiety: a cross-sectional study’, Biopsychosoc Med. Dec 12;12:21. doi: 10.1186/s13030-018-0140-1

4. Anderson D, Yoshizawa T, Gollschewski S, Atogami F, Courtney M (2004). ‘Menopause in Australia and Japan: effects of country of residence on menopausal status and menopausal symptoms’, Climacteric. 7:165–174. doi: OI: 10.1080/13697130410001713760

5. Kim SK, Kim JH, Jeon SS, Hong SM. (2018) ‘Relationship between sleep quality and dizziness’, PLoS One. Mar 7;13(3). doi: 10.1371/journal.pone.0192705

6. Liu DH, Kuo CH, Wang CT, Chiu CC, Chen TJ, Hwang DK, Kao CL. (2017) ‘Age-Related Increases in Benign Paroxysmal Positional Vertigo Are Reversed in Women Taking Estrogen Replacement Therapy: A Population-Based Study in Taiwan’, Front Aging Neurosci. Dec 12;9:404. doi: 10.3389/fnagi.2017.00404