Dizziness during menopause may be related to hormone changes, but researchers don’t fully understand the connection.

Many people experience dizziness during menopause. In a Japanese study, about 36% of participants attending a menopause clinic reported feeling dizzy at least once a week.

Keep reading to learn what causes dizziness during menopause and how you can manage this symptom.

Although researchers don’t know the exact reasons for increases in dizziness during perimenopause and menopause, they have suggested some possible causes.

Blood sugar

Hormones play an important role in balancing your blood sugar levels. Hormone changes during menopause affect how your body responds to insulin. That makes it hard for your body to keep your blood sugar stable. Changes to blood sugar levels can make you dizzy.

If you have diabetes, hormone changes during menopause can make your blood sugar levels harder to manage. Talk to your diabetes care team about your treatment plan. In some cases, your doctor might suggest changes to your blood sugar testing schedule or your medications.

Changes inside the ear

Changes in estrogen, progesterone, and other hormones are known to affect your inner ears, which are critical to your sense of balance. Some people report changes in balance, sinuses, and hearing before menstruation. It’s possible that hormonal changes during menopause may also affect your ears.

As people age, they are more likely to experience a type of vertigo called benign paroxysmal positional vertigo (BPPV). This condition is especially common among females.

BPPV causes vertigo when a person moves their head, and the cause is usually unknown. However, some research indicates that changes in estrogen during menopause may be a contributing factor. Plus, a 2017 study found that hormone replacement therapy may reduce the incidence of BPPV among menopausal women.

Sleep problems

Many people find they have trouble sleeping during menopause. Sleep problems can leave you feeling tired and stressed out during the day.

What’s more, poor sleep quality may be linked to dizziness for some people. Long-term studies are needed to understand this relationship, and to learn if treating sleep problems can help reduce dizziness.

Hot flashes

Hot flashes — also known as vasomotor symptoms — may be associated with certain types of dizziness. In a 2014 study, women who experienced both hot flashes and vertigo (a spinning sensation) had more persistent vertigo. After 2 months, women without hot flashes were more likely to be vertigo-free.

Heart palpitations

Changes in your estrogen levels can affect your heart rate. This can cause palpitations, often described as feeling your heart skipping a beat, fluttering, or adding an extra beat. Heart palpitations can make some people feel dizzy.

When heart palpitations and dizziness happen at the same time, it could be caused by a heart problem or other medical emergency. If you have both of these symptoms, it’s best to be on the safe side and get medical attention right away.

Migraine

Migraine is associated with a variety of symptoms, and dizziness is a common one.

Many women report that hormone fluctuations can trigger the onset of migraine episodes. In the early stages of menopause, your levels of hormones such as estrogen can vary dramatically. For some people, this can lead to increased migraine activity and more severe symptoms.

Dizziness and other migraine symptoms will usually improve when your hormone levels stabilize after menopause.

Dizziness unrelated to menopause

Dizziness may be caused by things unrelated to menopause. Some of the more common causes include:

It’s a good idea to see your doctor if you regularly feel dizzy. They’ll likely ask a lot of questions to get an accurate picture of what you’re experiencing. Try describing the feeling without using the word “dizzy.” This gives your doctor more information about the possible cause of your dizziness.

It may help if you keep a symptom journal of what’s happening each time you get dizzy. You might notice a trend in situations that trigger dizziness.

Your doctor might check your blood pressure and pulse while you sit or stand in different positions. This is to see how your movement and stance affects your heart and blood flow.

Because so many bodily functions can be related to dizziness, your doctor might ask about other symptoms that happen alongside your dizzy spells such as earaches or dehydration.

Your doctor may refer you to a neurologist, cardiologist, or otolaryngologist. An otolaryngologist is a doctor who specializes in conditions of the ear, nose, and throat and is sometimes called an ear, nose, and throat doctor (ENT).

3 types of dizziness

When explaining your symptoms to your doctor, it’s important to describe the type of dizziness you’re experiencing. What we call “dizziness” can be described in several different ways:

  • Disequilibrium is when you feel unsteady on your feet. You may feel like you’re having problems with balance or coordination.
  • Vertigo is when you feel like the room is moving or spinning when it’s not. You also might feel like you are in motion when you aren’t actually moving. Recurring vertigo may be a sign of a problem with your inner ear, which controls your sense of balance.
  • Lightheadedness is when you feel like you may lose consciousness or faint. Standing up too quickly can make you feel lightheaded.

When to get emergency help

Sudden dizziness can be a sign of a medical emergency. Get medical help immediately if you have sudden dizziness and any of the following symptoms:

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You may be able to manage your symptoms with lifestyle changes:

  • Drink plenty of water to prevent dehydration. If you don’t like plain water, squeeze fresh fruit, like orange or lemon, into your water, or try herbal tea without caffeine.
  • Eat more frequently by having smaller meals and snacks throughout the day. This can help keep your blood sugar levels stable.
  • Try limiting foods high in sugar and salt. This dietary change can help manage certain causes of dizziness.
    • You may find it helpful to avoid processed foods or foods high in sugar, like soda, fruit juice, chips, and candy bars.
  • Consider quitting smoking and limiting caffeine and alcohol. These substances may make dizziness worse.
  • Stand up slowly after you’ve been sitting or lying down. This helps your blood pressure slowly acclimate to standing.
  • Look for ways to manage your daily stress. If you feel continually overwhelmed or anxious in your daily life, you may benefit from talking with a licensed counselor or therapist.

In some cases, medical treatment may be necessary. Because many different conditions can cause dizziness, treatment will depend on what’s causing you to feel dizzy.

Your doctor may recommend hormone replacement therapy to address symptoms associated with menopause. However, some forms of hormone replacement therapy can increase your risk for certain health conditions, like stroke, heart attack, and breast cancer. Work with your doctor to weigh the pros and cons of hormone replacement therapy.

Learn more about hormone replacement therapy and whether it may be right for you.

Dizziness can be a symptom of various conditions. Pay attention to what causes your dizziness and work with your doctor. With lifestyle changes or treatment, chances are good that you can see improvement and feel dizzy less often.