Causes of dizziness

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Of all the causes of dizziness in women high levels of estrogen is one of the most common. The estrogen in the premenstruum causes water to be retained affecting the fluid in the ear and therefore balance. Dizziness is the sensation of spinning. In some instances nausea, vomiting, difficulty standing and walking may occur. Lying down makes no difference to the feeling, objects still appear to spin.

Some of the terms used are...

  • vertigo
  • dizziness
  • giddiness
  • lightheaded
  • spinning

A few of the more common causes of dizziness are...

  • an infection such as herpes
  • benign paroxysmal positional vertigo, or BPPV
  • drugs
  • strokes
  • multiple sclerosis
  • Meniere's disease
  • acoustic neuroma
  • labyrinthitis
  • brain trauma
  • migraines
  • acute brainstem disorders
  • change in blood pressure
  • fluid retention

Some of the symptoms associated with dizziness are...

  • hearing loss
  • tinnitus
  • pressure in one or both ears
  • loss of balance
  • water retention
  • nausea
  • vomiting
  • slurred speech
  • double vision
  • nystagmus (rapid involuntary movements of the eyes)
  • pre-syncope (lightheaded or feeling faint)
  • syncope (loss of consciousness or fainting)

The causes of dizziness are numerous. If it arises from the inner ear the medical term is otologic vertigo. One common cause is benign paroxysmal positional vertigo (BPPV). It's caused by changes in the position of the head which results in calcium crystals in the utricle being dislodged. BPPV can be treated by the Epley manoeuvre.

A severe form is Meniere's disease, sometimes accompanied by hearing loss, tinnitus and pressure in one or both ears. Other causes are superior canal dehiscence syndrome and labyrinthitis.

There is some evidence of a positive correlation between stress and Meniere's disease. Higher levels of cortisol and prolactin have been found. Progesterone suppresses prolactin and is a potent anxiolytic as it activates the GABA receptor sites, GABA is one of the most calming neurotransmitters, see Anxiety.

Women with Meniere's disease can experience an exacerbation of symptoms in the late luteal phase, with progesterone withdrawal.

Labyrinthitis, which is inflammation of the labyrinth or inner ear, is one of the causes of dizziness. Progesterone is an excellent anti-inflammatory, so too is vitamin D, taurine and a number of other amino acids, see Inflammation.

A lack of magnesium can cause dizziness, plus ataxia (loss of full control of bodily movements), nystagmus, athctoid, and choreiform movement.

Dizziness can arise from the balance centre in the brain, in which case it's neurological, and is usually milder. Symptoms are slurred speech, double vision or nystagmus. Brain pathology can cause an off-balance sensation.

Dizziness can occur in patients with acute brainstem disorders. Ondansetron, a 5- HT3 antagonist, can ameliorate dizziness and nausea in these cases.

Pre-syncope and syncope do not originate in the ear, or in the brain, but are usually caused by low blood pressure. It normally occurs when standing too quickly from a lying or sitting position.

One of the least acknowledged causes of dizziness is water retention. This most often occurs during the few days prior to bleeding during the monthly cycle in a woman. Up to one third of women who have PMS suffer from dizziness during the premenstruum.

It also frequently occurs in women in Peri-menopause who are nearing Menopause.

The cause is from progesterone withdrawal during the few days prior to bleeding, leaving oestrogen the dominant hormone. Peri-menopause is a time of dropping progesterone levels, as anovulatory cycles become more frequent.

Oestrogen is an excitatory, inflammatory hormone causing water retention. This can affect the fluid in the ear and therefore balance.

Progesterone is an excellent diuretic, now given to Traumatic Brain Injury victims to prevent oedema forming.

The hormone aldosterone also causes oedema. Progesterone has a high affinity to the aldosterone receptor sites, so inhibits it's action. It also suppresses oestrogen.

Pregnancy can also be one of the causes of dizziness. If it's also accompanied by weight gain, a rise in blood pressure and protein in the urine there's a possibility that preeclampsia could occur. The progesterone should be increased substantially, see Conception and Pregnancy problems.

A sharp drop in blood glucose can be one of the causes of dizziness. Although progesterone can help stabilise blood glucose, it's essential to avoid all sweet foods and drink, see Insulin Resistance and Nutrition.

Natural treatment of dizziness

Women should use between 100-200mg/day progesterone, men between 10-100mg/day. If there is a severe problem more may be required.

It's best to rub the progesterone cream around the ears and neck. Although progesterone travels rapidly around the body, if applied directly to the problem area it works far quicker.

For more information see the page on How to use progesterone cream.

Before using progesterone it's essential to read the page on Oestrogen Dominance first.

If prolactin is high, take the amino acid tyrosine, precursor to dopamine. Stress drops dopamine levels, which allows prolactin to rise. The rate limiting step in dopamine synthesis is the enzyme tyrosine hydroxylase. Insufficient levels of vitamin D inhibit tyrosine hydroxylase, resulting in a disturbance in the dopamine pathway.

If a magnesium deficiency is suspected consider taking it. Magnesium is the most important co-factor for vitamin D, considering taking vitamin D too, it's essential for dopamine synthesis.

A vitamin D test is essential, see the following websites for more information on testing, test kits etc...


Birmingham Hospital

The blood level should be between 70-100ng/ml or 175-250nmol/L, and not the 30ng/ml or 75nmol/L most laboratories and doctors use as a cut off point for adequate levels. The minimum daily dose should be 5000iu's per day, or more if levels are very low. Although the latest research indicates it should be 10,000iu's per day, see here.

If inflammation is present consider taking antioxidants and anti-inflammatory nutrients, above all vitamin D. Suggestions are given on the Inflammation and Insulin Resistance pages.

Useful websites relating to the causes of dizziness...

Dizziness, Giddiness and Feeling Faint 

Benign Paroxysmal Positional Vertigo 

Meniere's disease 

Acoustic Neuroma 


References for causes of dizziness...

Otolaryngol Clin North Am. 2010 Oct;43(5):1029-40
Premenstrual exacerbation of Meniere's disease revisited

Am Fam Physician. 2010 Aug 15;82(4):361-8, 369
Dizziness: a diagnostic approach

Ray Peat Ph.D. 2009
Water: swelling, tension, pain, fatigue, aging

Ray Peat Ph.D. 2009
Multiple sclerosis, protein, fats, and progesterone

Allergy. 2008 Jun;63(6):735-41
Oestrogen-dependent hereditary angio-oedema with normal C1 inhibitor: description of six new cases and review of pathogenic mechanisms and treatment

Emory University Press release 02 October 2006
Progesterone Shows Promise as Treatment for Traumatic Brain Injury

Otol Neurotol. 2005 Jan;26(1):74-81
Pathophysiology of Meniere's syndrome: are symptoms caused by endolymphatic hydrops?

Brain Research Bulletin Volume 66, Issue 1, 15 July 2005, Pages 1-8
Stress hormones in Mnire's disease and acoustic neuroma

Nurs Res. 2001 Sep-Oct;50(5):286-92
Changes in Meniere's disease responses as a function of the menstrual cycle

Journal of Bone and Mineral Research Volume 13, Issue 4, pages 749 758, April 1998
Magnesium Deficiency: A Cause of Heterogenous Disease in Humans

Experimental Neurology 138, 246251 (1996) Article No. 0063
Progesterone Rapidly Decreases Brain Edema: Treatment Delayed up to 24 Hours Is Still Effective

Arch Otolaryngol Head Neck Surg. 1992 Jan;118(1):74-8
The exacerbation of symptoms in Menire's disease during the premenstrual period

Journal of Endocrinology (1984) 102, 295-303
Progesterone interaction with eosinophils and with responses already induced by oestrogen in the uterus

J Endocrinol. 1983 Oct;99(1):123-30
Oestrogen levels in the blood, not in the uterus, determine uterine eosinophilia and oedema

To find out more about progesterone therapy in general and how it benefits health issues other than the causes of dizziness, please click here.

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