Vestibular Disorders and Hormonal Dysregulations: State of the Art and Clinical Perspectives

Abstract

The interaction between endocrine and vestibular systems remains poorly documented so far, despite numerous observations in humans and animals revealing direct links between the two systems. For example, dizziness or vestibular instabilities often accompany the menstrual cycle and are highly associated with the pre-menopause period, while sex hormones, together with their specific receptors, are expressed at key places of the vestibular sensory network. Similarly, other hormones may be associated with vestibular disorders either as causal/inductive factors or as correlates of the pathology. This review was carried out according to the PRISMA method, covering the last two decades and using the MEDLINE and COCHRANE databases in order to identify studies associating the terms vestibular system and/or vestibular pathologies and hormones. Our literature search identified 646 articles, 67 of which referred directly to vestibular dysfunction associated with hormonal variations. While we noted specific hormonal profiles depending on the pathology considered, very few clinical studies attempted to establish a direct link between the expression of the vestibular syndrome and the level of circulating hormones. This review also proposes different approaches to shed new light on the link between hormones and vestibular disorders, and to improve both the diagnosis and the therapeutic management of dizzy patients.

Balance in Transition: Unraveling the Link Between Menopause and Vertigo

“…Vertigo is a complex and multifaceted phenomenon that significantly impacts the quality of life for many individuals [ 1 ]. While the etiology of vertigo is diverse, emerging evidence suggests a potential link between the onset of menopause and an increased susceptibility to vestibular disturbances [ 2 ]. Menopause, a natural biological process marking the end of a woman's reproductive years, is characterized by hormonal fluctuations, most notably a decline in estrogen levels [ 3 ].…”

“…Beyond its well-established association with reproductive physiology, estrogen is increasingly recognized for its modulatory roles in various physiological systems, including those governing neurosensory function. One intriguing dimension of this interplay is the emergence of vertigo, a distressing vestibular symptom characterized by a distorted sense of motion and spatial orientation [ 2 - 4 ]. The vestibular system, comprising the inner ear structures and complex neural networks, plays a central role in maintaining equilibrium and spatial orientation [ 5 ].…”

“…The vestibular system, comprising the inner ear structures and complex neural networks, plays a central role in maintaining equilibrium and spatial orientation [ 5 ]. Recent investigations have unveiled a potential link between the hormonal fluctuations accompanying menopause and the manifestation of vertigo symptoms [ 2 , 6 ]. Understanding the nuanced relationship between hormonal dynamics and vestibular function during this pivotal life stage is not only of academic interest but also holds substantial clinical relevance [ 7 ].…”

“…The complex interplay between hormones and the vestibular system is an intriguing avenue of research that has gained momentum in recent years [ 2 ]. Understanding the relationship between menopause and vertigo holds significant clinical implications, as it may shed light on novel diagnostic and therapeutic approaches for managing vestibular disorders in postmenopausal women [ 2 ].…”

“…The complex interplay between hormones and the vestibular system is an intriguing avenue of research that has gained momentum in recent years [ 2 ]. Understanding the relationship between menopause and vertigo holds significant clinical implications, as it may shed light on novel diagnostic and therapeutic approaches for managing vestibular disorders in postmenopausal women [ 2 ]. This article reviews the current scientific literature, explores the hormonal intricacies of menopause, and investigates the potential mechanisms through which hormonal fluctuations may contribute to the development or exacerbation of vertigo symptoms.…”