Perimenopause, the transitional phase before menopause, is often associated with well-known symptoms such as hot flushes, mood swings, and sleep disturbances. However, one lesser-discussed yet impactful symptom is vertigo and dizziness. These sensations can be disorienting and distressing, affecting a woman’s quality of life and daily activities. Understanding their causes and management is crucial for those experiencing them.
What Are Vertigo and Dizziness?
Dizziness is a broad term used to describe a range of sensations, including feeling faint, unsteady, or light-headed. Vertigo, a specific type of dizziness, is the sensation that either you or your surroundings are spinning, often leading to balance issues and nausea. Both can vary in intensity and frequency, but even mild episodes can be disruptive.
Why Do Symptoms Such As Vertigo and Dizziness Occur in The Perimenopause?
The hormonal fluctuations of perimenopause, particularly in oestrogen and progesterone, are believed to play a significant role in causing dizziness and vertigo. These hormones influence various systems in the body, including the vestibular system, which controls balance.
Some specific causes linked to perimenopause include:
Hormonal Imbalances
Fluctuating oestrogen levels can affect blood flow to the brain and inner ear, where balance is regulated. Sudden drops in oestrogen may trigger dizziness or vertigo episodes.
Migraines
Perimenopause is associated with an increased frequency or severity of migraines in some women, often accompanied by dizziness or vertigo as a symptom.
Sleep Disruptions
Insomnia and poor-quality sleep are common in perimenopause, leading to fatigue and a heightened risk of feeling light-headed during the day.
Anxiety and Stress
Hormonal changes can exacerbate anxiety, which may trigger hyperventilation or a sense of dizziness during panic episodes.
Inner Ear Disorders
Some women may develop vestibular disorders, such as benign paroxysmal positional vertigo (BPPV), during this time. While not directly caused by perimenopause, these conditions can be influenced by hormonal shifts.
Blood Pressure Changes
Hormonal fluctuations may lead to changes in blood pressure, causing orthostatic hypotension—a drop in blood pressure upon standing, leading to light-headedness.
How to Manage Vertigo and Dizziness
Managing these symptoms often requires a multifaceted approach that addresses underlying causes:
Consider Hormone Replacement Therapy (HRT)
For many women, regulated, body-identical HRT can stabilise hormonal fluctuations, reducing dizziness and vertigo. Consultation with a menopause specialist is essential to determine if HRT is appropriate.
Lifestyle Adjustments
Stay Hydrated: Dehydration can worsen dizziness, so aim to drink plenty of water.
Maintain Balanced Nutrition: Ensure a diet rich in essential nutrients like magnesium and vitamin D, which support nerve and muscle function.
Exercise Regularly: Gentle activities such as yoga, tai chi, or walking can improve balance and overall health.
Vestibular Rehabilitation Therapy (VRT)
For those experiencing persistent vertigo, VRT—a type of physiotherapy designed to retrain the balance system—can be highly effective.
Address Sleep Issues
Establishing good sleep hygiene and seeking help for sleep disturbances, such as cognitive behavioural therapy (CBT), can reduce fatigue-related dizziness.
Manage Stress
Techniques such as mindfulness, meditation, or breathing exercises can help manage anxiety, a common trigger for dizziness.
Conclusion
Dizziness and vertigo can be challenging symptoms of perimenopause, but they are manageable with the right approach. By understanding the underlying causes and exploring tailored treatments—whether through lifestyle changes, therapeutic interventions, or HRT—women can find relief and regain confidence in their balance and well-being. We can help you with personalised advice and to ensure symptoms are appropriately addressed.
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