Recurring Dizziness During Pregnancy: Causes and Solutions

Recurrent dizziness

Hello, Dr.
Jiang.
During my second pregnancy, I experienced several episodes of dizziness.
A few times while I was out, I suddenly felt like everything was spinning (similar to the sensation of a hangover, or like spinning around ten times and then trying to walk forward).
At that time, I thought it was due to iron deficiency during pregnancy, so I supplemented with an appropriate amount of iron, but it didn't help at all.
Once, it was more severe; while squatting to wash my hair, as soon as I tilted my head down to rinse, I started to feel dizzy, and my vision went completely black.
I couldn't even stay squatting and felt like I was about to faint, so I quickly grabbed onto something to stand up.
Staying still for a few seconds helped, but when I tried to move my head, I would feel dizzy again.
Later that night, when I was trying to put my first child to sleep, I just lay down and adjusted my sleeping position, and as soon as I moved my head slightly, I felt extremely dizzy.
If I stayed still, I wouldn't feel dizzy, but any movement would trigger it again.
Eventually, it got so bad that I had to go to the emergency room in the middle of the night for a dizziness injection.
Blood tests showed everything was normal.
Now, I experience these episodes every few months; whenever I lie down, if I move my head even slightly, I start to feel dizzy for about five seconds, but sitting up alleviates the dizziness.
Therefore, during severe dizziness, I tend to sleep sitting up.
I have visited an ear, nose, and throat specialist several times, and while my ears were checked and found to be mostly fine, the dizziness continues to occur periodically, lasting for 2 to 3 days each time, and then it resolves, only to repeat every few months.
Additionally, I previously experienced sharp pain in my ears and chest while flying, which made it difficult to breathe.

Xigua, 30~39 year old female. Ask Date: 2016/01/09

Dr. Jiang Junyi reply Neurology

Hello, based on your description, your symptoms are similar to Benign Paroxysmal Positional Vertigo (BPPV).
This condition is characterized by brief episodes of dizziness that are related to changes in head position, such as bending over, leaning back, lying down, getting up, rolling over, or suddenly turning your head.
These episodes may be accompanied by symptoms such as nausea, vomiting, palpitations, cold sweats, and feelings of weakness.
The exact cause is often unknown, but it can be related to inflammation, degeneration, or head trauma that leads to the displacement of otoliths in the inner ear's vestibular system, which then enter the semicircular canals.
When the head position changes, the movement of the otoliths within the semicircular canals alters the neural signals from the inner ear, resulting in vertigo.
BPPV is more common in women.
Treatment options include the Epley maneuver, which uses changes in head and body position along with gravity to reposition the displaced otoliths back into the vestibule of the inner ear.
It is advisable for you to consult an otolaryngologist followed by a neurologist to discuss examination and treatment options.
Wishing you good health and peace.

Reply Date: 2016/01/09

More Info

Experiencing recurring dizziness during pregnancy can be quite distressing, and it’s important to understand the potential causes and solutions. Dizziness in pregnant women can stem from various factors, including hormonal changes, blood volume fluctuations, and positional changes. Here’s a comprehensive look at the possible causes of your dizziness and some recommended solutions.

Possible Causes of Dizziness During Pregnancy
1. Hormonal Changes: During pregnancy, the body undergoes significant hormonal shifts, particularly with increased levels of progesterone. This hormone can cause blood vessels to relax and widen, leading to lower blood pressure and, consequently, dizziness.

2. Blood Volume Changes: Pregnancy increases blood volume significantly to support the growing fetus. However, this can sometimes lead to a temporary drop in blood pressure, especially when changing positions (like standing up quickly), which can cause dizziness.

3. Iron Deficiency Anemia: Although you mentioned taking iron supplements, it’s essential to ensure that your iron levels are adequate. Anemia can lead to fatigue and dizziness. Regular blood tests can help monitor your hemoglobin levels.

4. Dehydration: Pregnant women need to stay well-hydrated. Dehydration can lead to dizziness and should be addressed by increasing fluid intake.

5. Positional Dizziness: The way you position your body can also affect blood flow. For instance, lying flat on your back can compress the vena cava (the large vein that carries blood back to the heart), especially in later pregnancy, leading to dizziness.

6. Vestibular Issues: Since you have seen an ENT specialist and had normal results, it’s less likely that an inner ear issue is the cause. However, vestibular disorders can sometimes manifest as dizziness, especially if there’s a history of motion sickness or previous ear issues.

7. Anxiety and Stress: Pregnancy can be a time of heightened anxiety, which can also contribute to feelings of dizziness or lightheadedness.

Recommended Solutions
1. Regular Check-ups: Continue to have regular prenatal check-ups to monitor your health and the health of your baby. Discuss your dizziness with your healthcare provider, who may recommend further tests if necessary.

2. Hydration and Nutrition: Ensure you are drinking plenty of fluids and eating a balanced diet rich in iron, vitamins, and minerals. Foods high in iron include lean meats, beans, spinach, and fortified cereals.

3. Positioning: Be mindful of how you change positions. When getting up from a sitting or lying position, do so slowly to allow your body to adjust. If you feel dizzy, sit down until the sensation passes.

4. Rest: If you experience dizziness, resting in a comfortable position can help alleviate symptoms. Avoid sudden movements and try to maintain a stable posture.

5. Physical Activity: Gentle exercises, such as walking or prenatal yoga, can improve circulation and overall well-being. However, consult your healthcare provider before starting any new exercise regimen.

6. Stress Management: Engage in relaxation techniques such as deep breathing, meditation, or prenatal massage to help reduce anxiety and stress levels.

7. Emergency Situations: If you experience severe dizziness, especially if accompanied by other symptoms like chest pain, shortness of breath, or severe headache, seek immediate medical attention.

Conclusion
While recurring dizziness during pregnancy can be concerning, understanding the potential causes and implementing some lifestyle changes can help manage the symptoms. Always keep an open line of communication with your healthcare provider about your experiences, as they can provide personalized advice and support tailored to your specific situation. Remember, your health and the health of your baby are paramount, and addressing these concerns proactively is essential for a healthy pregnancy.

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