Dizziness and menopause: what you need to know

Although dizziness, or vertigo, is a common symptom of menopause, the underlying mechanism is not precisely known. Fluctuations in oestrogen and progesterone levels are believed to cause dizziness and accompanying nausea. 

The hormones oestrogen and progesterone play a role in many important bodily functions, including the cardiovascular system. Hormonal changes can lead to fluctuations in blood pressure, which can make you feel dizzy and lightheaded. Shifting oestrogen and progesterone levels also affect blood circulation in the inner ear. This, too, can cause dizziness. 

Hormonal changes can also trigger a variety of menopausal symptoms, such as hot flashes, sleep problems and mood swings. 

Many menopausal women experience symptoms such as dizziness or lightheadedness. It’s a common and normal complaint. During perimenopause, the symptoms are often most severe, because this is when your hormone levels fluctuate more erratically. 

The symptoms vary from one person to the next. Some women may feel like they are on a merry-go-round. Others report having wobbly legs, nausea or brain fog. And some even experience temporary vision problems. 

The good news is that once balance is gradually restored after your last period, symptoms such as dizziness, brain fog and nausea will disappear altogether, or at least diminish. 

Dizziness can also result from other factors. For example, hot flashes can cause dizziness, because you lose electrolytes when you sweat, causing an electrolyte imbalance. This imbalance can affect blood pressure and trigger dizziness or make it worse.  

Shifting hormones around menopause can also affect blood sugar levels and make it more difficult to keep them stable. Fluctuations in blood sugar can cause dizziness and lightheadedness.  

During perimenopause, periods can become heavy, closer together or last longer – all of which can make you feel dizzy. In addition, women go through many changes during this stage of life, triggering feelings of insecurity, stress or and sleep problems. This, too, can lead to tension, anxiety, breathing problems and dizziness. 

There are things you can do to manage lightheadedness and dizziness, such as watching your iron levels and resting more often. Here are some more tips: 

• Keep a dizziness diary. Write down when and under what circumstances you feel dizzy. This helps to identify the cause of your dizzy spells and decide on a strategy to deal with them.  
• Reduce stress. Stress may intensify dizziness. Try to do relaxation exercises every day and make sure you get enough quality sleep. Find ways to improve the quality of your sleep.  
• Stabilise your blood sugar. Eat a balanced diet with lots of fruit and vegetables (fibre!) and make sure your meals contain enough protein, healthy fats and slow-acting carbohydrates. Avoid processed foods, alcohol, smoking and too much caffeine.  
• Drink plenty of water to prevent electrolyte imbalance. This is especially important if you suffer from hot flashes or night sweats.  
• Make sure you get enough iron. Heavy blood loss month after month can lead to iron deficiency (low iron levels) and nausea. You can also consider taking a supplement. 
• Exercise on a regular basis. Regular exercise and strength training helps strengthen muscles and improve balance. Exercise also helps to sleep more soundly and reduce hot flashes and stress. 
• Consider hormone therapy. Is dizziness keeping you from your daily activities and are dietary and lifestyle adjustments not enough to reduce your symptoms? Then you could consider hormone therapy. Talk to a doctor about HRT options.