Sip, Scroll, and Learn (Midlife Edition)

I thought I understood dizziness until I experienced real vertigo.

One minute I was fine. The next, the room was spinning so violently that I had to crawl into bed, where I stayed until the following morning. Moving my head even a few centimetres sent me into another wave of spinning, nausea, and the sincere belief that I might never roll over in bed again.

Thankfully, my children were there to help. Even so, it was one of the most frightening and physically miserable experiences I have ever had.

What surprised me later was learning that vertigo and balance problems can sometimes become more noticeable during midlife. Hormones may be part of the conversation, but they are rarely the only possibility.

First, Is It Really Vertigo?

We often use dizziness and vertigo interchangeably, but they are not quite the same.

Vertigo usually feels as though you or the room is spinning, tilting, or moving when everything is actually still. Lightheadedness, feeling faint, or becoming unsteady when you stand can point toward other issues, including dehydration, blood-pressure changes, low blood sugar, anemia, medications, or heart-related concerns.

Knowing which sensation you are experiencing provides an important first clue.

Where Hormones May Fit In

Your inner ear contains a finely tuned balance system that constantly communicates with your brain, eyes, muscles, and joints. Researchers have identified estrogen receptors within the inner ear and are exploring how hormonal changes may influence balance, calcium metabolism, and vestibular function.¹

This offers a possible explanation for why some women report more dizziness or vertigo during perimenopause and after menopause. The evidence is still developing, however, and menopause should not become the automatic explanation for every spinning sensation.

I like to think of hormones as one instrument in the orchestra. They may change the sound, but they are not necessarily playing the entire concert.

Looking Beyond Hormones

One of the most common causes of true vertigo is benign paroxysmal positional vertigo, better known as BPPV. It tends to cause brief but intense spinning after rolling over in bed, looking upward, bending down, or turning the head.

BPPV happens when tiny calcium crystals in the inner ear move into an area where they do not belong. A trained healthcare professional or vestibular therapist can usually identify it through positional testing and may treat it with a canalith-repositioning procedure such as the Epley manoeuvre.²

Vestibular migraine is another possibility. It can cause vertigo, motion sensitivity, nausea, light sensitivity, or a rocking sensation, sometimes without a typical migraine headache. Sleep disruption, stress, irregular meals, caffeine changes, and fluctuating hormones may all influence the migraine threshold.³

Vertigo accompanied by hearing loss, ringing, or pressure in one ear may suggest an inner-ear condition such as Ménière’s disease. A recent viral illness, medication side effects, blood-pressure changes, thyroid conditions, and neurological problems can also enter the picture.

This is where a holistic approach becomes valuable. Instead of assuming every episode has the same cause, we look at the pattern surrounding it.

What Can You Do When It Happens?

If the room begins spinning, sit or lie down somewhere safe and keep your eyes on one stationary object. Move slowly, avoid driving, and ask someone to stay nearby if the episode is severe.

Sip water if you can do so safely, particularly if you have been sweating, travelling, exercising, or experiencing frequent hot flashes. Hydration may help lightheadedness, but it will not reposition inner-ear crystals or treat every cause of vertigo.

Avoid attempting random head manoeuvres from social media when you do not know what kind of vertigo you have or which ear is involved. The correct manoeuvre can be very effective for confirmed BPPV, while the wrong one may leave you feeling considerably worse. I speak from experience when I say the room does not need additional encouragement. 😄

Supporting Yourself Between Episodes

Consistent sleep, regular protein-rich meals, adequate fluids, gentle movement, and stress regulation create a steadier foundation for the nervous system. These habits are especially helpful when vestibular migraine, blood-sugar fluctuations, dehydration, or nervous-system overload may be contributing.

Nutrient status deserves individual consideration too. Research has connected vitamin D deficiency with recurrent BPPV, and supplementation may reduce recurrences in people who have confirmed BPPV and low vitamin D levels.⁴ That is a reason to test and correct a deficiency with professional guidance, rather than taking a high dose “just in case.”

Depending on the symptoms, a healthcare practitioner may also consider iron, vitamin B12, thyroid function, glucose regulation, blood pressure, medications, and other possible contributors. Testing is most useful when it answers a clear question created by your symptoms and health history.

When Vertigo Requires Urgent Care

Seek emergency help if vertigo appears with facial drooping, weakness or numbness on one side, difficulty speaking, sudden vision changes, a severe unexplained headache, confusion, fainting, or an inability to walk. These can be warning signs of stroke or another urgent neurological problem.⁵

New hearing loss, repeated vomiting, chest pain, an irregular heartbeat, or vertigo that is severe, persistent, or repeatedly returning also deserves prompt evaluation.

One Last Thought

Vertigo can make you lose confidence in your body very quickly. After my episode, every small moment of imbalance made me wonder whether the room was about to take off again.

Learning what may be contributing can replace some of that fear with a sense of preparedness. Hormones may influence the picture, but the inner ear, migraine pathways, nutrients, hydration, sleep, stress, medications, and metabolic health may all provide valuable clues.

The goal is not to blame menopause or chase every possible imbalance.

It is to understand your pattern, support the areas that need attention, and know when it is time to ask for help.

Wishing you health and happiness,

Martine