Dizziness & Vertigo in Perimenopause

by Magnolia on February 7, 2013

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I used to think that dizziness and vertigo in perimenopause were obscure symptoms. But I don’t think that anymore.  In fact, in the past 15 years, I’ve changed my mind about a lot of things regarding perimenopause.

Much of that is simply due to the fact that until you walk a mile in those shoes, as they say, you really don’t know half as much about something as you might think you do.

Before I went through perimenopause, I thought it was going to be nothing more than a few hot flashes and night sweats, and that eventually I would no longer get my menstrual cycles. But that was before I went through it.

I’ve since learned that the symptoms of perimenopause is actually a very long and distinguished list.  I’ve also learned that getting help for those symptoms is not always straight forward and easy either. This is due in large part in my opinion, to the fact that when a woman is going through perimenopause, it’s not just her estrogen and progesterone levels which are out of balance.

It’s everything.

Her adrenal glands can become fatigued and depleted.  Her brain neurotransmitters such as serotonin and dopamine can also become out of balance, and she can suffer from some sort of thyroid dysfunction as well.  In short, everything pretty much goes to hell in a hand basket.

A lot of symptoms of perimenopause are the result of the perimenopause butterfly effect

In my last post I told you about an E-How article that I ran across recently which stated that dizziness and vertigo are two symptoms of hypothyroidism. The fact that I found it on E-How notwithstanding, I was completely fascinated by this for two reasons.

One, many women suffer from hypothyroidism during perimenopause.  Two, a lot of women also experience dizziness and vertigo during perimenopause, and are usually told that it’s everything except perimenopause. Why is that?

I think it’s the perimenopause  butterfly effect.  What begins as simple hormone imbalance during the onset of perimenopause, ends with  a long list of whack-a-doodle symptoms which can be attributed to a variety of causes.  I also think this befuddles the average physician who doesn’t know where to begin – with the chicken or the egg?

I asked BodyLogicMD if they had any insight into this topic.  But, I’m sorry to say with all due respect to Dr. Petruzzelli¹.  The answer I received was a garden variety canned medical response which I’ve heard a million times:   

Vertigo is the term classically used to describe a feeling of moving when you are not moving. Traditionally, most people describe feeling as if they are spinning. Cases of vertigo are classically linked to issues with the inner ear problem because it is responsible for balance and equilibrium.

Lightheadedness or dizziness more accurately describe a feeling like you are going to “pass out” or faint. This may be due to a number of causes, including low blood pressure, anemia, dehydration, fatigue, anxiety, stress, a cold, the flu, medication (such as sleep medication, anti-anxiety medication, antihistamines, etc.) and alcohol.

Perimenopause and menopause does not usually cause vertigo or lightheadedness. However, a feeling of dizziness may be associated with hot flashes, especially if hot flashes cause stress or anxiety.

If you are experiencing vertigo, I recommend seeing in an ENT (ears, nose and throat doctor) for investigation of the inner ear. Sometimes seeing a chiropractor can be helpful too. Dizziness may be remedied with simple measures, such as avoiding medications that may make you dizzy, staying hydrated, getting enough sleep and eating at regular intervals.

This is not to say that Dr. Petruzelli’s answer has no merit. All of the potential causes she points to are plausible explanations for dizziness and vertigo.  I mean, who hasn’t jumped up too quickly from a chair, experienced a sudden drop in blood pressure and nearly passed out?  It’s common.  Staying hydrated, getting enough sleep, and eating at regular intervals is also good advice for everyone.

But, it doesn’t adequately address the issue.

I’m not suggesting it is perimenopause  which is the cause of vertigo and dizziness.  As I said, I think it’s a butterfly effect that begins with perimenopause, but ends with a secondary issue like hypothyroidism which does  cause vertigo and dizziness.

I started this post with the intention of telling you about a book I bought recently entitled, The Thyroid Solution: A Revolutionary Mind-Body Program That Will Help You, by Dr. Ridha Arem, M.D.  But as I often do, I got a bit sidetracked.

I will need to finish this discussion in another post. There’s a lot of good information in this book which I think is relevant, and supports my hunch that perimenopause, dizziness and vertigo, and hypothyroidism are interconnected.


¹Anita Petruzzelli, MD is the Medical Director of the Connecticut-area practice she shares with Dr. Elizabeth Galan. She focuses on empowering her patients to take care of their body and embrace a healthy lifestyle to help them achieve optimal health through structured fitness programs, nutritional guidance and hormonal balance using natural bioidentical hormone replacement therapy. She helps both men and women resolve the symptoms of menopause and andropause including weight gain, sexual dysfunction, declining energy levels, depression and stress. Inspired by the Women’s Health Initiative (WHI) study, Petruzzelli wanted to offer her patients alternative treatments to traditional hormone replacement therapy.

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{ 2 comments… read them below or add one }

Julie Martineau May 2, 2014 at 3:21 pm

Hello ladies,
I came across this blog during my many, and I mean many hours of research on menopause. A week ago today I received a phone call from the doctors office that said I am in menopause! So, for a week I have been mourning my younger self lol. I have some questions that I hope someone can help me with. Also, I have some bit of information on vertigo that I hope will help everyone that has not been given a clear reason why. First a bit of background on me. I turned 45 years old in February. I believe I have been having perimenopause symptoms probably for a good 3 1/2 years. However, my test results showed that I was not in perimenopause in December of 2012. I was so frustrated that there was not a clear reason why I was suffering from so many different symptoms. So here we are a year and half later. I go to see the doctor because of more severe symptoms. I thought I was having hot flashes for the last many years but I was wrong! They were warm flashes. I could swear at night that I have caught on fire! And not a couple of times but like 7 or 8 times. There is no sleep. My doctor tells me that we need to check my female hormone. I told him we already did that a year and a half ago but ok I’m willing to pay for yet another test that I think is a waste of time since I was sure that it could not have changed in that amount of time. well, it did and he was surprised at the numbers on my test, they were so high compared to the previous ones. He told me I was in full on menopause. So my questions are, is it normal to only be in perimenopause for 1 1/2 years then be seriously into menopause, just like that! And could my first test have been wrong? Im curious because I believe I have been having serious symptoms for many years before that….

So, now to the vertigo. I woke up one day and was dizzy. Dizzy like motion sickness with nausea. It was so often that I saw many different specialists and went through testing for menieres disease . Very unpleasant. I also has a CT scan that showed no fluid behind my inner ear but inflammation. So still no answer for me. Finally I think maybe it is allergies that is causing the inflammation. I made an appointment with the ear, nose, and throat specialist to see what he thinks. He tells me that just recently they are discovering that the drug that is used to treat asthma is helping people with unexplained vertigo. At this point I was willing to try anything to stop throwing up all of the time because of the vertigo. The drug is called (Singular). It is a beautiful little 10mg square pill that has changed my life.
If i skip a couple of days of not taking it I will start to feel dizzy and nauseous though so I’m excited to have found this blog about vertigo and menopause. I have only been on the hormone Estrace for three days and hope if my vertigo is related to my lack of estrogen I will be able to stop taking the Singular. I know this was a long story long instead of short. Sorry about that. I hope someone can answer my questions as they come up as I am new to Menopause, sheesh, I don’t even like saying the word! I also hope that the information regarding Singular and vertigo will help everyone that is suffering from unexplained vertigo

Thanks ladies, Im trying to wrap my head around this, its hard.


Me in NC August 16, 2014 at 3:28 am

I can’t answer your questions, but I do have some myself 😀 Have you ever suffered from migraines? ” Dizzy like motion sickness with nausea” is what I get with my normal migraines, and menstrual migraines are just much heavier on the dizzy and nausea. I get visual disturbances in each type, and the menstrual ones are just heavy on a dizzy-blurred-vision kind of eye symptom. I do find that estrogen (well, soy used as a substitute that fits the same receptors) helps my menstrual nausea, dizziness, and migraine cluster of symptoms.

Antihistamines help many of my migraines, too, apparently because any swelling near those blood vessels and nerves triggers many of my migraines. Maybe it helps other dizziness for similar inflammation-near-nerves reasons? I don’t know, but I don’t mind taking them to lesson the problems. My nose and sinuses usually hurt then, too (not always), so it’s nice to cut that down!

Hormones can cause inflammation in the body similar to allergies, so it’s worth a shot, I think, for folks out there searching for help. I found that the antihistamines were less helpful for menstrual migraines than the estrogen-receptor issue, so maybe you can get off the Singulair! I’m bound to have allergies anyway during my period, so I do both.


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