Dizziness

The NHS uses dizziness for a few different feelings: off-balance, giddy, light-headed or faint, or the spinning feeling called vertigo. Most of the time, it says, dizziness is not serious and passes on its own. Vertigo has causes of its own, mostly in the inner ear, and its own page: vertigo.

Here is the honest part. The NHS menopause pages do not list dizziness as a symptom in its own right. They mention it as one of the things a hot flush can bring on, along with sweating, palpitations and anxiety. So if your dizziness comes with flushes, that is the link the guidance makes. If it comes on its own, the other causes on this page matter more.

Light in the head when you get up too fast from the floor. Unsteady on your feet in a hot kitchen. A wave of heat, a racing heart, and then the wobble. Sometimes the room genuinely seems to spin.

Roshara's symptom score describes it as feeling light-headed, or as if the room is spinning.

Where dizziness comes with a hot flush, the NHS links the two directly. Where it does not, the NHS dizziness page lists causes that have nothing to do with the menopause and are worth ruling out: dehydration or heat exhaustion, stress or anxiety, an inner ear problem, low blood sugar in someone with diabetes, iron deficiency anaemia, a sudden drop in blood pressure when you stand or sit up, and the side effects of a new prescription medicine.

That list matters more for South Asian women. The British Menopause Society notes higher rates of diabetes, insulin resistance and high blood pressure among South Asian women during the menopause transition. A doctor checking your sugar and your blood pressure is not making a fuss. It is part of the answer.

The NHS dizziness page lists these for while you feel dizzy:

• Lie down until it passes, then get up slowly. Move slowly and carefully, and rest.
• Drink plenty of fluids, especially water. More on that in hydration.
• Avoid coffee, cigarettes and alcohol. The NHS names coffee; if your day runs on chai, chai and caffeine covers what the guidance says about tea.
• Do not bend down or stand up suddenly, and do not drive, climb a ladder or use machinery while you feel dizzy.

The NHS says to see a GP if you are worried, if the dizziness will not go away or keeps coming back, or if it comes with any of these: hearing loss or trouble speaking, ringing or other sounds in your ears, double or blurred vision, numbness or weakness in your face, arms or legs, changes to your pulse, fainting or collapsing, headaches, or feeling or being sick.

Some signs cannot wait for an appointment. The NHS stroke page lists sudden weakness or drooping on one side of the face, weakness or numbness in one arm or down one side of the body, slurred or confused speech, sudden loss of sight, and dizziness or falling over among the signs of a stroke. If dizziness comes with any of them, get emergency help at once, even if the symptoms stop.

If you faint, or your heart races with the dizziness, tell your doctor. Heart palpitations has more on that.

Two of the NHS's causes, dehydration and heat, meet on a summer fast. Add getting up from sajda many times over in taraweeh, and it is no surprise women ask about it. Questions about the fast itself belong with a qualified scholar. Questions about medicines and their timing in Ramadan belong with whoever prescribes them. Ramadan and fasting gathers what the guidance says.

At home, the risk is being told you are just tired, or not eating enough. Maybe so. Keeping a note of when it happens, standing up, mid-flush, on a fasting afternoon, gives your doctor something better than maybe.