Unexplained Vertigo Symptoms
A 37-year-old female with a history of Polycystic Ovary Syndrome (PCOS), currently classified as prediabetic due to her condition, is experiencing ongoing episodes of vertigo without a clear origin. She is on Metformin for management of her prediabetes. Approximately a month ago, she awoke to intermittent sensations of vertigo that progressively intensified. After several days, she sought help at an urgent care facility where she was prescribed prednisone and was advised to continue her regimen of Claritin and Flonase. Unfortunately, the prednisone only alleviated her symptoms marginally, leading to tightness in her neck and chest instead. Although she experienced some minor improvement post-treatment, spells of vertigo persisted, accompanied by episodes of heart palpitations and feelings of overheating. This is not the first occurrence of similar symptoms; five years prior, she suffered from vertigo for an extended period. At that time, medical investigations including a brain MRI yielded normal results, and blood tests were also clear. An ENT specialist noted her temporal mandibular joint (TMJ) issues but found no significant concerns. Eventually, her symptoms subsided on their own over a span of a few months. Recently, days before the onset of her current vertigo, she had a dental appointment, which raises her suspicions that a flare-up of her TMJ might be affecting her inner ear. In the past, chiropractic treatments have provided some relief, and she has returned to her chiropractor three times within the last month, though she remains uncertain about the effectiveness of these sessions. The episodes of vertigo are triggering anxiety symptoms in her, and she is also contemplating whether these recent fluctuations in her health could be attributed to perimenopause. For the last five years, she has faced various hormonal challenges, night sweats, and heightened anxiety, with the situation appearing to escalate recently. Her primary care physician suspects an issue with her inner ear, while her chiropractor suggests the potential involvement of upper cervical issues. She is faced with a decision: should she wait it out or advocate for further testing? Is there a possibility that this discomfort is a remnant of a previous viral infection? Compounding her situation is a growing concern about health-related anxiety that may be exacerbating her symptoms!
Answers (1)

6/23/2025, 2:10:48 PM
OpenHealth AI
It's understandable to feel concerned about ongoing vertigo, especially with your history of PCOS, anxiety, and potential hormonal fluctuations. The combination of these factors, along with your past experiences, can make it challenging to navigate your current symptoms.
Main Points:
The vertigo you're experiencing could stem from a few different sources, including possible TMJ issues, inner ear problems, or even anxiety. Given your complex health background, it’s essential to prioritize addressing these vertigo episodes and their impact on your overall well-being.
Explanation:
Vertigo can be caused by issues in the inner ear (like benign paroxysmal positional vertigo or vestibular disorders), tension related to TMJ, anxiety, or changes due to hormonal shifts. Since you experienced a previous episode of vertigo that resolved on its own, it's possible that stress, muscle tension from TMJ, or hormonal factors are contributing to your current symptoms. The side effects from medications, such as prednisone, can also complicate your experience.
Next Steps:
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Keep a Symptom Diary: Track when the vertigo occurs, its duration, and any associated symptoms (like heart palpitations or feelings of overheating). This can help identify triggers and patterns, which may provide insights for your healthcare providers.
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Assess TMJ and Tension: Since you suspect TMJ may be related, consider gentle jaw exercises to relieve tension. Heat therapy (like a warm compress) may help relax your muscles. If you notice that jaw clenching or teeth grinding correlates with vertigo episodes, practicing stress management techniques could be beneficial.
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Focus on Hydration and Nutrition: Ensuring you're well-hydrated and maintaining a balanced diet can support your body’s overall functioning and may help reduce symptoms. Monitor your blood sugar levels, as fluctuations can also contribute to feelings of dizziness.
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Explore Anxiety Management: Since your anxiety appears to exacerbate your symptoms, consider implementing stress-reducing activities like meditation, yoga, or deep-breathing exercises. These can help create a calming environment that may reduce vertigo frequency and intensity.
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Communicate with Healthcare Providers: Given your persistent symptoms, it may be worth discussing further testing with your primary care physician if symptoms do not improve. This could include a more detailed assessment of your inner ear function, or even evaluation for vestibular migraine, which can sometimes present similarly.
Monitoring your symptoms and actively managing stress and TMJ could bring relief. Please be aware that it's okay to advocate for yourself and seek more information as needed. Let me know if you need more details!
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