Can Perimenopause Cause Dizziness? What to Know

Key Takeaways:

• Dizziness is a pretty common (albeit lesser-known) symptom of perimenopause.

• Hormonal shifts can contribute to perimenopause dizziness by affecting the inner ear, cardiovascular system, metabolism, and sleep.

• Hormone replacement therapy (HRT) and nonhormonal treatments may help manage factors that can cause dizziness during perimenopause.

• Lifestyle changes to prevent dizziness include lowering stress, getting good-quality sleep, and staying hydrated.
  

You’re likely familiar with perimenopause symptoms like an irregular menstrual cycle, hot flashes, vaginal dryness, and mood changes. But perimenopause can also cause other, less common symptoms.

One of these lesser-known symptoms is dizziness or lightheadedness. Why can perimenopause cause dizziness? Many factors can contribute to dizziness during perimenopause.

If you’re in perimenopause and have found yourself Googling ”menopause feeling sick and dizzy,” we’ve got you. Keep reading to find out what causes dizziness during perimenopause and the steps you can take to manage it.

Dizziness or lightheadedness can be a potential symptom of perimenopause. While dizziness may not come to mind when you think of perimenopause, it’s not all that uncommon.

A study looked at 471 women in the perimenopausal or postmenopausal stage. It found that 35.7 percent had dizziness at least once a week.

Other health conditions associated with dizziness or vertigo are also commonly reported during menopause. A couple of examples include benign paroxysmal positional vertigo (BPPV) and vestibular migraine.

Perimenopause (aka the menopause transition) is a time of shifting hormone levels. During perimenopause, the levels of estrogen and progesterone made by your ovaries start to drop.

These hormonal changes can have numerous effects on your body. And some of these effects can increase the likelihood of feeling dizzy:

• Inner-ear issues

• Cardiovascular changes

• Metabolic shifts

• Sleep problems

• Anxiety and stress

• Migraine

• Hot flashes

Let’s explore the various underlying causes of perimenopause dizziness now.

Inner-Ear Issues

Your vestibular system is the part of your body that helps you maintain balance and orientation with your surroundings. It’s in your inner ear.

Researchers have found estrogen receptors within the vestibular system, implying that estrogen is involved in regulating balance in some way.

So, changes in estrogen levels could impact balance, leading to feelings of dizziness, lightheadedness, or being off-balance (disequilibrium).

Perimenopause and Benign Paroxysmal Positional Vertigo

Some research suggests that perimenopausal women are more susceptible to BPPV — and that this increased risk could be due to hormonal changes.

BPPV is a type of vertigo that happens when you change the position of your head. The risk of BPPV increases with age, and it’s also more common in women than men.

Also, low estrogen levels have been linked to Meniere’s disease in women during perimenopause. Meniere’s disease is another inner-ear disorder that can cause dizziness, tinnitus, and hearing loss.

Cardiovascular Changes

Menopause is associated with multiple cardiovascular changes that can increase your risk for heart disease. Many of these changes are linked to changes in estrogen and progesterone.

Some cardiovascular changes that begin during perimenopause may boost your risk of dizziness.

For instance, up to 40 percent of women in perimenopause experience heart palpitations. These are heartbeats that feel rapid or irregular (also known as arrhythmia). Dizziness can also sometimes happen with heart palpitations.

Low Estrogen and Hypertension

Decreases in estrogen can potentially affect the elasticity of arteries, causing them to become stiffer. Arterial stiffness is associated with high blood pressure (hypertension).

Researchers have linked dizziness to hypertension in older adults. This association is particularly noticeable in older women.

Metabolic Shifts

Metabolic shifts might increase the likelihood of dizziness during perimenopause. This includes how blood sugar (glucose) — your body’s main energy source — is used.

Estrogen affects how glucose is used in your body. Because of this, hormonal fluctuations that happen during perimenopause may lead to changes in blood sugar levels.

Changes in blood sugar, whether it’s too low or too high, can lead to dizziness. One small study also linked low estrogen levels to changes in blood sugar.

→ Learn more: Low Estrogen Guide

Sleep Problems

Sleep problems are very common during perimenopause. These can include:

• Trouble falling asleep

• Night sweats

• Waking up frequently at night

• Waking up too early in the morning

Sleep disturbances may be caused by hormonal changes. They’re also related to other menopause symptoms, like hot flashes, increased urination, mood changes, or stress.

Poor sleep can have many negative effects on the body. Researchers have found that one of these effects is dizziness.

→ Read: What Is Sleep Debt? How to Catch Up on Sleep

Anxiety and Stress

Perimenopausal women have a higher risk of mental health conditions like anxiety disorders and panic attacks. Potential causes of anxiety during this time include:

• Hormone changes

• Poor sleep

• Stress

• Other perimenopausal symptoms

Anxiety disorders are often associated with feelings of fear, nervousness, or restlessness that impact daily life and well-being. But they can also lead to physical symptoms, including:

• Dizziness

• Heart palpitations

• Hot flushes

Compared to women who haven’t gone through menopause, perimenopausal women report higher levels of stress. One study linked stress to chronic dizziness in women.

→ Learn more: Can Menopause Cause Anxiety?

Migraine

If you have migraine, the hormone fluctuations in perimenopause could come with more frequent episodes. The good news is migraine frequency usually decreases after menopause as hormone levels stabilize.

Vestibular migraine is a specific type of migraine associated with feelings of dizziness and vertigo. Research suggests vestibular migraine may be a critical cause of dizziness in women during perimenopause.

Hot Flashes

Vasomotor symptoms, which include hot flashes and night sweats, are among the most common symptoms of perimenopause. They impact up to 75 percent of women during the perimenopausal stage of life.

Hot flashes are caused by changes in estrogen. They’re mainly associated with a sudden hot feeling that typically leads to increased sweating. But hot flashes can also be accompanied by other symptoms, like dizziness, racing heart, or anxiety.

If dizziness during perimenopause is throwing you for a loop, know that there are ways to manage it, including treatments and lifestyle changes.

Treatments for Perimenopause Dizziness

Generally speaking, perimenopause dizziness can be managed by addressing its potential causes.

Many contributing factors for perimenopause dizziness are rooted in hormonal changes that happen during this transitional time. So, addressing hormonal fluctuations may help.

Hormone Replacement Therapy

If you frequently have dizziness and other perimenopausal symptoms, your healthcare provider might recommend hormone replacement therapy (HRT).

HRT works by replacing missing estrogen. Some HRT regimens also include progesterone.

There are two main types of HRT:

• Systemic HRT. This form of HRT acts throughout your body to reduce perimenopause symptoms. It’s given by mouth or through a skin patch.

• Local HRT. This treatment contains low-dose estrogen to address vaginal or urinary symptoms of perimenopause. It’s applied to the vagina as a cream, ring, or insert.

Research suggests that systemic HRT may prevent inner-ear changes associated with low estrogen. This could reduce the risk of conditions like BPPV.

Systemic HRT can also address several factors contributing to perimenopause dizziness. For example, it can reduce the frequency of vasomotor symptoms like hot flashes by about 75 percent. Studies also suggest HRT can help improve mood and sleep quality.

Systemic HRT has some possible risks and side effects, such as an increased risk of blood clots (with oral estrogen supplementation) and breast cancer (specifically with long-term combination estrogen and synthetic progestin). It’s important to discuss these with your healthcare provider before getting started.

Nonhormonal Treatments

If you can’t or choose not to take HRT, nonhormonal treatment options may help address some causes of menopause dizziness.

These include:

• Brisdelle^® (paroxetine) and Veozah^® (fezolinetant). These are FDA-approved to treat moderate-to-severe hot flashes and night sweats.

• Talk therapy. This includes cognitive behavioral therapy (CBT), which can help you develop strategies to cope with mood changes, sleep problems, and other bothersome symptoms of menopause.

• Psychiatric medications. For instance, selective serotonin reuptake inhibitors (SSRIs) can be used to address anxiety.

• Working with an ENT (ears, nose, throat) specialist or audiologist. This might help if you have BPPV.

Lifestyle Changes for Perimenopause Dizziness

A few lifestyle changes can help you better manage dizziness during perimenopause.

These include:

• Identifying activities and ways to reduce stress levels

• Taking steps to improve your sleep hygiene to get better-quality sleep at night

• Drinking enough fluids, as dehydration can contribute to feeling dizzy

• Avoiding smoking, alcohol, and caffeine, which can all lead to dizziness

• Eating a healthy diet and not skipping meals

If you do get dizzy, sit or lie down until the feeling goes away. When you’re ready to get up again, do so slowly.

If you’re in perimenopause and experiencing frequent dizzy spells, you’re certainly not alone. Though dizziness isn’t the most well-known symptom, it’s absolutely something you can experience during this time.

But you don’t just have to grin and bear it. There are several treatments and lifestyle changes you can make to help manage or prevent dizziness during perimenopause.

Perimenopause dizziness is generally linked to hormonal fluctuations that can have various effects on your inner ear, blood flow, metabolism, and mood.

If you’re frequently experiencing dizziness, reach out to your healthcare provider. They can help determine what factors are contributing to your dizziness and recommend effective ways to address them.

Get answers to frequently asked questions about perimenopause and dizziness ahead.

Can menopause cause dizziness?

Yes. Dizziness is a potential symptom that may happen during the transition to menopause, called perimenopause.

How common is dizziness in perimenopause?

Dizziness during perimenopause is pretty common. In one study of women in menopause, over one-third of participants reported experiencing dizziness one or more times each week.

What could make you feel dizzy during perimenopause?

Dizziness during perimenopause can often be chalked up to the effects of hormonal changes that happen during this time. These changes can lead to dizziness by impacting the inner ear, cardiovascular system, metabolism, sleep, mood, and more.

What treatments can help with perimenopause dizziness?

Hormone replacement therapy may help address many factors that play into perimenopause dizziness. If HRT isn’t an option, nonhormonal medications, talk therapy, or healthy lifestyle changes may be beneficial.

What lifestyle changes help with dizziness?

Lifestyle changes that help reduce dizziness in general include things like lowering stress, getting enough sleep, drinking plenty of water, eating a healthy diet, and avoiding things like smoking, alcohol, and caffeine.

Does perimenopausal dizziness go away?

It’s possible that perimenopause dizziness may lessen or go away after menopause when your hormone levels stabilize.

When should you see a healthcare provider for dizziness?

Seek medical advice from a healthcare provider for dizziness that worries you, interferes with your quality of life, or keeps coming back. Also, seek immediate medical attention if dizziness happens with symptoms like chest pain, difficulty hearing or speaking, vision changes, numbness, weakness, or fainting. These could be signs of a more serious inner-ear, cardiovascular, or nervous system problem.