Description: Hormonal fluctuations significantly impact vestibular function across different life stages in women. This session explores how vestibular function is affected during menarche, pregnancy, and menopause, highlighting diagnostic insights using vHIT SHIMP, saccadometry, and ocular counter-roll (OCR). We will discuss how estrogen and progesterone influence vestibular pathways, leading to dizziness and balance dysfunctions. Attendees will gain practical knowledge on identifying vestibular disorders linked to hormonal changes and optimizing diagnostic accuracy using advanced vestibular assessments.

Outcome Objectives: By the end of this session, attendees will be able to:

- Analyze the effects of hormonal fluctuations on vestibular function during menarche, pregnancy, and menopause.
- Compare vHIT SHIMP, saccadometry, and OCR findings across these three hormonal stages.
- Interpret vestibular test results to differentiate between peripheral and central dysfunctions in hormonally influenced dizziness.
- Implement clinical strategies for assessing vestibular disorders in women experiencing hormonal transitions.

Structure of the Session (30 min):

- Introduction (5 min): Overview of hormonal influences on the vestibular system.
- Menarche & Vestibular Function (7 min): Early hormonal changes and their impact on balance.
- Pregnancy & Vestibular Adaptations (7 min): Hemodynamic and vestibular changes in gestation.
- Menopause & Vestibular Decline (7 min): Estrogen depletion and balance dysfunction.

Conclusion (4 min): Summary and final considerations.

Background & References:

MacDougall HG, McGarvie LA, Halmagyi GM, Rogers SJ, Manzari L, Burgess AM, Curthoys IS, Weber KP. A new saccadic indicator of peripheral vestibular function based on the video head impulse test. Neurology. 2016 Jul 26;87(4):410-8. doi: 10.1212/WNL.0000000000002827

Demian D, Petrak M, Zielinski G, Massingale S, Alexander A, Fuemmeler L, Lin CC. Clinical Saccadometry: Establishing Evaluative Standards Using a Simplified Video Oculography Protocol in the Adult Population. J Am Acad Audiol. 2023 Feb;34(1-02):19-27. doi: 10.1055/s-0043-1772582.

Castillo-Bustamante M, Del Cid Chua C, Vázquez M, Bello Dotel L, Baez Recalde M. Hormonas sexuales y alteraciones neurotológicas en Mujeres [Estrogen and neurotological diders in womenSexual hormones and neurotological disorders in women]. Rev Fac Cien Med Univ Nac Cordoba. 2020 Dec 19;77(4):351-355. Spanish. doi: 10.31053/1853.0605.v77.n4.29349

Castillo-Bustamante M, Çelebisoy N, Echavarria LG, Franco I, Valencia S, Gonzalez S, García A. Balance in Transition: Unraveling the Link Between Menopause and Vertigo. Cureus. 2024 Apr 29;16(4):e59277. doi: 10.7759/cureus.59277 Feng MY, Gu HH, Tian Q, Yang HL, Zhuang JH. Molecular Mediators of Estrogen Reduction-induced Otolith Shedding. Curr Med Sci. 2021 Aug;41(4):667-672. doi: 10.1007/s11596-021-2421-3

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