4.5 Review

Influence of sex hormones on vestibular disorders

Journal

CURRENT OPINION IN NEUROLOGY
Volume 35, Issue 1, Pages 135-141

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/WCO.0000000000001019

Keywords

gender dimorphism; gonadal hormones; sex hormones; sex-specific synaptic plasticity; vestibular disorders

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This review summarizes the higher prevalence of vestibular disorders in women and discusses the effects of sex hormones on various vestibular conditions. Recent studies have found a direct link between abnormal gonadal hormone levels and vestibular dysfunction. For example, benign paroxysmal positional vertigo may be linked to the rapid decrease in estrogen levels in menopausal women. Hormonal therapeutic intervention studies have advanced our understanding of hormonal influences in Meniere's disease. The review also highlights potential mechanisms involving vestibular migraine, Mal de Debarquement syndrome, and gonadal hormones. Overall, the review concludes that a multifaceted approach is needed for the clinical assessment of female vestibular patients, involving auditory and vestibular medicine physicians, gynecologists and/or endocrinologists, along with hormonal profile evaluations.
Purpose of review Vestibular disorders are gender distributed with a higher prevalence in women. Although research has increased in this field, the mechanisms underlying this unbalance is unclear. This review summarises recent advances in this research sphere, and briefly discusses sex hormone effects on various vestibular conditions and highlights some recent theories. Recent findings Recent work has identified a direct link between aberrant gonadal hormone levels and vestibular dysfunction. Benign paroxysmal positional vertigo research suggests that the disorder may be linked to the rapid decrease in oestrogen, observed in menopausal women, which disrupts otoconial metabolism within the inner ear. A successful hormonal therapeutic intervention study has advanced our knowledge of hormonal influences in the inner ear in Meniere's disease. Also, several studies have focused on potential mechanisms involved in the interaction between Vestibular Migraine, Mal de Debarquement Syndrome, and gonadal hormones. In females, gonadal hormones and sex-specific synaptic plasticity may play a significant role in the underlying pathophysiology of peripheral and central vestibular disorders. Overall, this review concludes that clinical assessment of female vestibular patients requires a multifaceted approach which includes auditory and vestibular medicine physicians, gynaecologists and/or endocrinologists, in conjunction with hormonal profile evaluations.

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