Menopause, Dizziness and Changing Balance.
It’s been over a decade now, since I began to consider that dizziness in our midlife years, might be a symptom of menopause.
The more health-screening forms I received from women on my programmes, the more I realised that over 50% of them were ticking the box that asked them if they ever felt dizzy or had balance issues.
To me, their screening forms, told my story as well.
It was in my early 50s that I was experiencing frequent dizziness. Not only at altitude when I was skiing, but also when I was participating in my beloved step exercise classes. With increasing concern about tripping over the old Reebok step, I gave up doing those classes.
Like many women, I never considered that dizziness and balance problems might be a symptom of menopause.
It was the same for Wendy from Australia – a master trainer for Les Mills step classes. That’s her below doing the job she loves!
From many of your emails to me over the years and from the number of health screening forms that I get to look at, I know that those of you who have been active over the years, have had to curtail some of your activities during menopause.
Not only do you feel exhausted, but some of your exercise pursuits also cause dizziness. This includes getting up and down from the floor,when you are at the gym and doing certain exercises. You then start to lose confidence in the workouts that you’ve been undertaking for years.
If this is the case, or you are feeling dizzy even without the exercise, then read on!
Changing oestrogen levels and Otoconia
The connection between menopause, vertigo (dizziness) and oestrogen changes is an intriguing one.
Which is why I want to thank the researchers at the Boys Town National Research Hospital in Omaha, USA. It was this research that led me towards understanding a condition called OTOCONIA (Ogun et al, 2014).
This helped me understand why there is the connection between our changing oestrogen levels, our biological ageing and dizziness and balance problems as we go into post-menopause.
Otoconia are bio-crystals which are made from protein and calcium molecules.
The highest scores for reporting of vertigo (dizziness) problems in the Nebraska study, [dizziness is medically known as Benign Paroxysmal Positional Vertigo (BPPV)], were reported in women aged between 10-19 years and 40-52 years who reported that they were either in menopause (peri-menopause) or out the other side (post-menopause).
Nearly 50% of the women in the older age group in the Nebraska study, reported that they experienced their first dizziness and balance episodes after menopause and, even more surprising, 22% of those who have had their ovaries removed and 32% of women who had a hysterectomy, reported increasing vertigo episodes.
BPPV occurs when head position changes (lying down, looking up, or turning over in bed) causing short, recurrent vertigo spells.
BPPV is a result of these tiny crystals in your inner ear being out of place.
The crystals make you sensitive to gravity and help you to keep your balance when oestrogen levels are optimal, as in your pre-menopause years. However, declining oestrogen levels, low calcium intake and hair loss in your ear canal occuring as women move through menopause, can cause these tiny bio-crystals to get out of place.
Normally, a jelly-like membrane in your ear keeps the crystals where they belong.
This is because your sense of balance relies on a finely tuned system that coordinates sensory information (from nerves throughout your body) and visual information to help you determine the position of your body relative to your surroundings.
The role of oestrogen in all of this, is to ‘couple’ or help this jelly-like protein substance to adhere and therefore, help to provide a mechanic force to the sensory hair cells in the ear canal.
This process is essential for us to sense linear acceleration and gravity for the purpose of maintaining our balance.
This is why balance exercises are important to over-ride the changes to the ear canal during menopause and in the Rebuild My Fitness programme and my Beyond Menopause programme, I have these exercises for you.
Check these blood-markers during menopause.
A few years ago I wouldn’t have been able to do the skiing and hiking that I can now enjoy. My knees, feet and muscles ached continuously and I was so tired and had frequent dizzy spells.
I never gave iron, ferritin or Vitamin D a thought. But if these blood markers are low, then your menopause symptoms, including dizziness and brain-fog, may become worse.
Conversely if you are in Post-menopause and therefore, not menstruating any more, your iron and ferritin levels may be high. This can impact dizziness and blood pressure changes too.
It is well known in sport and exercise science that female runners are at higher risk of low iron levels. This is known as Exercise-Induced Anaemia.
For women in menopause who exercise regularly, the same changes to iron and ferritin (the storage from of iron) can also occur.
Low iron impacts negatively on your sleep quality and duration. Then, when you aren’t sleeping, your temperature, hot flushes, night sweats and your ability to recover from your exercise can also suffer.
Understanding that declining oestrogen levels during menopause also change iron and ferritin (stored iron) levels, is important for those of you who feel tired, unwell or you can’t tolerate exercise without becoming breathless easily.
Low iron or ferritin levels may also increase feelings of anxiety and not coping. Just as some of you are finding now that you are in perimenopause or menopause.
This is also why your nutrition is important. My focus is always on the Mediterranean Diet, which is well-evidenced for women’s health and ageing. For women who have low iron or low Vitamin D, there are specific changes to their diet that they can follow from the information in the MyMT™ Food Guides, which are specific to the stage of menopause they are in.
Persistent tiredness, feelings of lethargy, dizziness, upper respiratory tract infections and of course, not sleeping are well known symptoms of over-training syndrome, but so too are night sweats, hot flushes and a temperature regulation system, that is out of balance.
It’s the same for female athletes.
That’s why I’m so impressed with Cheryl and her daughter from New Zealand, who hiked to Everest Base Camp. If there is a hike that is going to test your fitness, health and your resilience, then it is hiking at altitude. How amazing they were to achieve this together and as Cheryl mentioned to me,
“I never wavered from the goal of reaching Everest Base Camp, even though others were having an easier time of it. The takeaway from it all is to trust your body to not fail … it won’t if given the right mindset and you have the right knowledge, which I had from doing your programme.”
Improving her understanding of the role that menopause plays in her fitness was integral to Cheryl’s success and you can read her story HERE when you get a chance.
Knowing also that there are essential nutrients that she needs in order to look after her joints and muscles as well as recover-well, was an important sharing of information I had with her in the programme.
Freedom from menopause symptoms and poor health as you age is yours to choose.
With the myriad of symptoms I was experiencing a few years ago as well as the weight gain, I’m so pleased that as part of my own menopause journey, I chose to focus on turning my symptoms around and to look ahead to my healthy ageing.
Doing this, alongside understanding what and how to change specific lifestyle factors, reduce inflammation and boost my ageing immune system, helped me retain my self-identity as well.
It is well known in sports psychology that we suffer most when we believe that we have no control over our lives. But with the understanding of what is going on with our changing physiology during menopause we can take back control.
For numerous women in my coaching group, this means slowly removing themselves from the thoughts and beliefs that keep them in their current lifestyle routines and habits. Afterall, as their body is changing hormonally, then it’s important to change with it.
Through this, we can support our growth and wellness at this time of life. If you are feeling out of control, I hope you can join one of my 12 week programmes sometime. My passion is for you to live your best peri-to post-menopause life free of symptom chaos.
Dr Wendy Sweet (PhD)/ MyMT™ Founder/ Member: Australasian Society of Lifestyle Medicine
References:
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Dunsky A. The Effect of Balance and Coordination Exercises on Quality of Life in Older Adults: A Mini-Review. Front Aging Neurosci. 2019 Nov 15;11:318. doi:
Kaitha S, Bashir M, Ali T. Iron deficiency anemia in inflammatory bowel disease. World J Gastrointest Pathophysiol. 2015 Aug 15;6(3):62-72. doi: 10.3389/fnagi.2019.00318. 10.4291/wjgp.v6.i3.62.
Miller EM. The reproductive ecology of iron in women. Am J Phys Anthropol. 2016 Jan;159(Suppl 61):S172-95. doi: 10.1002/ajpa.22907.
Ogun OA, Janky KL, Cohn ES, Büki B, Lundberg YW. Gender-based comorbidity in benign paroxysmal positional vertigo. PLoS One. 2014 Sep 4;9(9):e105546. doi: 10.1371/journal.pone.0105546.
Sincan, G., Sincan, S., & Bayrak, M. (2022). The effects of iron deficiency anemia on sleep and life qualities. Annals of Medical Research, 29(2), 108–112. Retrieved from https://www.annalsmedres.org/index.php/aomr/article/view/4054
Terauchi M, Odai T, Hirose A, Kato K, Akiyoshi M, Masuda M, Tsunoda R, Fushiki H, Miyasaka N. Dizziness in peri- and postmenopausal women is associated with anxiety: a cross-sectional study. Biopsychosoc Med. 2018 Dec 12;12:21.
