Menopause may cause a person to feel sick and dizzy due to factors such as hormonal changes and fatigue, but dizziness can also result from an ear infection and other causes not related to menopause.

Menopause is the time when menstruation stops, and it is no longer possible to become pregnant. It is a natural transition that affects people with ovaries, usually during the midlife years.

It is not a disease or health condition, and it does not have symptoms as such. However, some physical and mental changes and features, including dizziness, are common around this time.

This article explains some potential causes of dizziness during menopause and the treatment options available.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Hormonal changes may cause dizziness during menopause.

In a 2018 Japanese study involving 471 females ages 40 to 65, 35.7% of participants experienced dizziness at least once a week.

The researchers considered that the following factors might play a role:

  • age
  • menopause status
  • body composition
  • cardiovascular factors
  • sleep patterns
  • symptoms of depression and anxiety
  • lifestyle characteristics

Take a look at some potential causes of dizziness related to menopause in more detail below.

Hormonal changes

Hormone levels fluctuate throughout a female’s life, but they start to change significantly during perimenopause. This transitional stage can begin when a person is in their 30s or 40s.

According to the Office on Women’s Health, perimenopause can last between 2 and 8 years but usually lasts around 4 years. Periods become irregular and eventually stop.

When a year passes since someone’s last period, menopause starts. The average age at which menopause occurs in the United States is 52 years.

However, some people may experience menopause early. This transition may occur at a younger age if a person has a health condition or has undergone surgery or other treatment that affects their hormones or ovaries.

During perimenopause, the ovaries start to produce less estrogen and progesterone. These hormones are responsible for maintaining the reproductive system, but they may also play a role in the functioning of other organs, including the brain, ear, and heart.

These changes can lead to dizziness by affecting the following:

The inner ear

Ear problems, such as inflammation or infection, can cause dizziness. A 2023 review highlights an association between the pre-menopause period and dizziness.

Benign paroxysmal positional vertigo (BPPV) can occur when something causes the displacement of otoconia, an organ of the inner ear comprising tiny crystals called otoliths.

A 2020 review concludes that the reduction of estrogen can disturb otoconial metabolism, which may increase the risk of BVVP, which can cause dizziness.

Learn more about the inner ear and how it works.

Metabolism

Metabolism is the process by which the body breaks down food into glucose and delivers it to the cells, where it provides energy. Estrogen helps maintain this process.

Estrogen plays a role in blood glucose availability. As glucose levels rise and fall, the body’s cells may not receive a steady supply of energy, which can lead to fatigue and dizziness.

A 2017 study supports this, finding that low estrogen levels after menopause can significantly affect the levels of glucose and insulin in the blood.

The heart

Hormonal changes during menopause can affect the cardiovascular system, and this can cause palpitations or an irregular heartbeat.

When someone has an irregular heartbeat, the heart does not pump blood effectively around the body, and the blood cannot deliver the usual amount of oxygen. This may make a person feel lightheaded or dizzy.

Aging

Menopause is different from aging, and people can experience it at different times. However, people often experience menopause between 45 and 58 years, when age-related changes may also be underway.

For example, the inner ear and other bodily systems may not work as well as they previously did. Various age-related factors can contribute to the dizziness that occurs around menopause.

For example, people going through the transition to menopause may experience increases in high blood pressure due to natural aging. In some cases, high blood pressure and medication to treat it can lead to dizziness.

Insomnia

Features of menopause, such as hot flashes and mood changes, can make it difficult to sleep well. People who do not get enough good quality sleep may be more likely to experience health conditions that cause dizziness.

In some cases, conditions that cause dizziness can also affect a person’s sleep quality. Anyone who experiences ongoing sleep problems and dizziness should see a doctor, as these symptoms may indicate an underlying condition.

Get some tips on sleeping better.

Hot flashes

Hot flashes affect up to 75% of people during perimenopause.

A hot flash is a feeling of heat that temporarily spreads across the face, neck, and upper body. Dizziness can occur at the same time, as well as:

If they happen at night, hot flashes can affect sleep quality, which may lead to fatigue and dizziness during the day.

Migraine

Many females with migraine say that they notice a link between migraine episodes and their menstrual cycle. People in perimenopause may experience more frequent migraine symptoms due to hormone disruption and more frequent periods.

Anxiety and stress

Anxiety and depression are common during menopause. Factors that may influence these mood changes include hormonal changes, midlife events, and concerns about issues such as aging, health, and taking care of elderly parents.

In some cases, anxiety can lead to panic attacks, which can involve palpitations and dizziness.

Researchers in Japan found that dizziness was common among women around the time of menopause. They also suggest a link between dizziness and anxiety.

Although they could not confirm that one factor caused the other, they suggested that treating anxiety might help to reduce dizziness.

Learn about anxiety treatments.

The following may help reduce the symptoms of dizziness due to menopause:

  • Stay hydrated: People can stay hydrated by drinking plenty of fluids, especially water.
  • Eat frequent small meals and snacks: This can help maintain blood sugar levels. People should opt for foods with complex carbohydrates, such as whole grains and vegetables, to maintain a steady supply of energy.
  • Establish a regular sleep schedule: This should involve a consistent bedtime and waking time. Regular exercise and healthful eating can also improve sleep.
  • Manage stress: Steps such as exercise, meditation, and yoga can help someone manage stress. Counseling may help people with severe or ongoing stress and anxiety. A healthful diet can also be beneficial.
  • Try balance exercises: Balance exercises may help to strengthen the muscles that support balance.
  • Keep a journal: Keeping a symptoms journal can help a person identify foods, activities, and medications that may trigger dizziness.
  • Seek medical help: Dizziness can occur due to health conditions. People should speak with a doctor if new symptoms occur or existing symptoms persist, get worse, or are severe.

Learn about more medications and treatments for dizziness.

Doctors can treat dizziness by addressing the underlying cause. For dizziness that results directly from menopause, lifestyle changes may help. For some people, however, hormone therapy may be appropriate.

Hormone therapy can help relieve various features of menopause. It provides supplemental estrogen or progesterone through oral medications or patches.

However, this treatment can lead to adverse side effects in some people, which may include dizziness. People can discuss with their doctor whether hormonal therapy is suitable for them.

People should seek medical help if dizziness worsens, persists, or affects daily activities. Various health conditions can lead to dizziness. A doctor can help identify whether the person has an underlying condition that needs additional treatment.

The individual may be able to help the doctor by saying whether they feel:

  • lightheaded
  • as though the ground is off balance or shifting
  • as though the surroundings are spinning

Dizziness is common during menopause, and some people will find that it improves as they move through the transition period.

However, people may also be more likely to experience dizziness as they age or if they develop a health condition.

A person should see a doctor if dizziness affects their quality of life or daily activities. It is also best to speak to a doctor if nausea, vomiting, or other symptoms accompany dizziness or if dizziness continues after menopause.