Menopause and benign paroxysmal positional vertigo

Abstract

Objective: This study was designed to examine the age and sex distribution and the effects of menopause in a large cohort of participants diagnosed with benign paroxysmal positional vertigo (BPPV).

Methods: We analyzed 1,377 BPPV patients and surveyed 935 women from this group-all diagnosed at the Boys Town National Research Hospital in the last decade.

Results: A detailed age and sex distribution analysis of BPPV onset showed that aging had a profound impact on BPPV occurrence in both sexes, and that perimenopausal women were especially susceptible to BPPV (3.2:1 female-to-male ratio). The latter is a novel finding and was confirmed by a direct survey of female BPPV patients (168 participated). In addition, there was a pronounced female preponderance (6.8:1 female-to-male ratio) in BPPV in the teenage group despite its low prevalence in this age group.

Conclusions: Data suggest that hormonal fluctuations (especially during menopause) may increase the tendency to develop BPPV.

Figure 1

Otoconia movements in BPPV. (Left) During night rest, otoconia fall from the utricular macula into the semicircular canal (arrow). (Right) During sitting up, movement of otoconia in the canal causes abnormal endolymph motion and vertigo.