Have you been experiencing dizzy spells and are unsure why? Many women may not realize that vertigo, particularly a form known as BPPV (Benign Paroxysmal Positional Vertigo), can become more common during menopause. To help us understand why this happens, we spoke to Alison Linn, a seasoned osteopath with over 34 years of experience, who shares insights into the causes, symptoms, and management of vertigo in women aged 40 and above. 

What is menopausal vertigo, and why is it so common?  

There are many causes of vertigo, so it’s important to seek professional advice to rule out any serious health concerns. However, the most common form of vertigo—BPPV—starts to appear more frequently in women from the age of 40, peaking in their 60s, and then often declines again. This pattern closely follows the stages of menopause, where fluctuating and declining estrogen levels impact bodily functions like our biochemical pathways, bone density, and the vestibular system responsible for balance.

BPPV affects around 50% of individuals over the age of 65, with women being more susceptible than men, at a ratio of 3.2:1. Interestingly, research suggests that women on hormone replacement therapy (HRT) or estrogen-boosting products tend to experience fewer incidences of BPPV.

What are the main symptoms of vertigo in menopausal women?

Vertigo in the form of BPPV is characterised by sudden episodes of dizziness, particularly when you:

• Roll over in bed
• Look up (often called “Top Shelf Vertigo”)
• Bend over
• Get up from lying down
• Lie down

These dizzy spells can last anywhere from a few seconds to a minute or more, making everyday tasks more challenging.

What is the connection between hormonal changes and vertigo?

As we age, particularly during the menopause transition, the body experiences several hormonal shifts, with a significant drop in estrogen. This decline affects various systems in the body, including the vestibular labyrinth located in the temporal bone, the part of the skull that holds the external ear. This labyrinth is responsible for balance by detecting head movements and spatial orientation.

Within this vestibular system are otolith organs, which contain tiny calcium carbonate structures called otoconia. As these otoconia age, they can become dislodged from their usual positions and float into the inner ear canals (or reattach within them), disrupting balance and leading to BPPV. This is one of the most common causes of menopausal vertigo and can trigger dizziness, particularly when moving your head in certain ways, like rolling over in bed or looking up.

Estrogen also plays a key role in maintaining bone density and biochemical pathways, so its decline, combined with the ageing of otoconia, contributes to the development of this type of vertigo. Additionally, other factors, such as low Vitamin D levels, which are common in menopausal women, are linked to vertigo. That’s why it’s important to get adequate sunlight exposure, especially in the early morning or late afternoon, when it’s safer for your skin, to help maintain healthy Vitamin D levels.

Can lifestyle changes help manage vertigo during menopause?

Yes, lifestyle adjustments can make a significant difference. As mentioned, maintaining adequate Vitamin D levels through safe sunlight exposure is beneficial. A diet rich in fiber and healthy fats can also help. Interestingly, studies show that vertigo isn’t strongly linked to alcohol or smoking, but can be worsened by low-carb diets, stress, and excess weight.

It’s important to avoid certain physical activities that might aggravate vertigo, such as high-impact exercises, yoga, or swimming, which can delay recovery. However, regular exercise, when vertigo is not present, is encouraged as a preventative measure.

How is vertigo diagnosed and treated?

When BPPV is diagnosed, a healthcare professional, such as an osteopath, can perform specific maneuvers to help dislodge the loose otoconia and relieve symptoms quickly. While this treatment is often effective, 30% of women may experience a return of vertigo even after treatment.

Once treated, it's vital to adjust your sleeping position for a while, keeping your head propped up, and avoiding lying on the affected side. Your healthcare professional will guide you on after-treatment care.

Are there any supplements that can help with vertigo?

Yes, supplements can support balance and overall health. Vitamin D is essential for bone and balance health, while Magnesium can assist with muscle relaxation. Incorporating these into your diet can be beneficial for managing vertigo symptoms.

Why is menopausal vertigo often misunderstood?

Menopausal vertigo, particularly BPPV, is often overlooked or misdiagnosed as general dizziness or another health concern. It’s important for women to understand that this type of vertigo is linked to hormonal changes and that seeking proper diagnosis and treatment can significantly improve quality of life.

 

 

If you're looking for additional support, magnesium glycinate is known for its ability to relax muscles and is a key ingredient in our natural Sleep aid - helping you drift off into a deep restorative sleep.

For more from Alison Linn, read her detailed article uncovering the causes, symptoms, and effective treatments for frozen shoulder

Alison Linn,  BSc (Hons) Ost. Med Cert TCM & Acup (musculoskeletal) - runs her own clinic, Rozelle Osteopaths, in Sydney. In addition to osteopathy, she provides shockwave therapy, needling, traditional Chinese medicine (TCM), cupping, exercise prescription, craniosacral osteopathy, and visceral osteopathy.