Attribution: Image by Freepik
Medically Reviewed by Andrea Caamano, Director of Medical Affairs, The HRT Club
Menopause is often associated with hot flashes, night sweats, and mood swings — but what about that sudden dizzy spell or the room spinning for no apparent reason? If you’ve been feeling off balance during perimenopause or menopause, you’re not imagining it. Dizziness and vertigo can, in fact, be part of the menopausal experience.
While these symptoms aren’t as widely talked about as others, they’re surprisingly common. A recent study published in Cureus (Castillo-Bustamante et al., 2024) sheds light on the connection between menopause and balance disturbances — and importantly, how hormone replacement therapy (HRT) might help.
Why Menopause Can Leave You Feeling Dizzy
Dizziness during menopause can manifest in different ways — a spinning sensation (vertigo), feeling lightheaded or unsteady, or even like you might faint. According to the study, these symptoms may be linked to the sharp decline in estrogen and other hormones that occur during this stage of life.
Estrogen isn’t just about reproductive health; it also plays a key role in neurological and sensory function. In the inner ear and the central nervous system — both critical parts of the body’s balance system — estrogen helps maintain stability and communication between nerve cells. When estrogen levels drop, these systems can get thrown off-kilter, quite literally.
What’s especially interesting from the study is that vestibular symptoms (like vertigo) were reported more frequently in women transitioning through menopause than in premenopausal women. This suggests a strong hormonal link — one that’s often overlooked in the exam room.
Enter: Hormone Replacement Therapy (HRT)
So, where does HRT fit into all of this?
HRT is typically prescribed to ease classic menopausal symptoms like hot flashes, vaginal dryness, and mood swings — but it may also help with vestibular issues. By replenishing estrogen, HRT can help rebalance the systems affected by hormonal decline, including those involved in balance and spatial orientation.
The Cureus study points to a potential therapeutic role for HRT in reducing the frequency and severity of dizziness and vertigo in menopausal women. It’s not a universal fix — and it’s not the right choice for everyone — but for some, it can make a meaningful difference in quality of life.
What to Do If You’re Experiencing These Symptoms
If dizziness or vertigo is interfering with your daily life, talk to your doctor or find one here. It’s important to rule out other causes (like blood pressure changes, inner ear disorders, or medication side effects), but don’t be surprised if menopause is a contributing factor — especially if other hormonal symptoms are present too.
If hormone imbalance is suspected, your provider may discuss whether HRT could be appropriate for you. This usually involves a detailed medical history, bloodwork, and a conversation about risks and benefits. There are also non-hormonal options and lifestyle changes that can support vestibular health — like staying hydrated, managing stress, and avoiding sudden head movements that trigger symptoms.
The Bottom Line
Dizziness and vertigo aren’t just “in your head” — and they’re not just random. If you’re in your 40s or 50s and feeling off balance more often, menopause could be playing a role. Thankfully, options like HRT treatments offer hope, especially for women whose vestibular symptoms are making life harder than it needs to be.
Menopause may be a natural part of aging, but that doesn’t mean you have to suffer through it. Understanding the full range of symptoms — and knowing your treatment options — is key to navigating this stage with confidence and comfort.
Reference: Castillo-Bustamante M, et al. (2024). Balance in Transition: Unraveling the Link Between Menopause and Vertigo. Cureus, 16(4):e59277. https://doi.org/10.7759/cureus.59277
