“Dizziness can be due to underlying causes that are related to your period,” says Tiffany Pham, DO, a board-certified OB/GYN in Houston, Texas, and medical advisor for Flo Health. (And just to be clear, we’re talking about that faint, lightheaded sensation that can leave you feeling like you might pass out. This is a little different than vertigo, or feeling like the room is spinning, which can stem from inner ear or neurological issues.)

While most causes of pre-period dizziness are harmless, it can sometimes point to an underlying health condition that needs treating. Either way, figuring out the root cause of your woozy spells can help you return to more stable footing. Here’s a look at the top causes of dizziness before your period, and what to do about each.

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1. PMS

If that lightheaded, faint feeling tends to pop up before your period, it could be related to PMS, or premenstrual syndrome.

“[PMS] can include a variety of symptoms in the days leading up to your period, including mood symptoms, abdominal bloating, pelvic pain or cramping, dizziness, fatigue, headaches, breast tenderness, skin changes, or changes in your appetite,” says Dr. Pham.

PMS happens, as you might’ve guessed, thanks to fluctuations in hormones like progesterone, which can affect your levels of feel-good neurotransmitters like serotonin. Being stressed out tends to exacerbate the problem and make symptoms worse, notes the National Library of Medicine.

What to do

PMS typically goes away once your period begins and, although annoying, its symptoms are not harmful. But if your PMS symptoms are severe or disrupt your daily life, reach out to your OB/GYN or primary-care doctor. They can help you come up with a plan to make your cycles feel smoother.

“PMS can include a variety of symptoms in the days leading up to your period, including mood symptoms, bloating, fatigue, and dizziness.”—Tiffany Pham, DO, OB/GYN

2. Menstrual migraines

PMS can also trigger a migraine in the days leading up to your period (which, again, is all thanks to hormone fluctuations). Sometimes that can give people vertigo—a queasy, dizzy sensation where you feel like the room is spinning and it’s hard to balance, says Dr. Pham.

What to do

If migraines are causing your dizziness, talk to your doctor about migraine treatment options. You may be able to take an over-the-counter pain reliever like Excedrin or Advil (ibuprofen), use an ice pack, and/or sleep it off. But if those options don’t work, you may need a specific migraine medication, which your doctor can prescribe.

3. Dysmenorrhea (aka painful periods)

Most people will have mild cramping for a day or two during their periods, something that experts call dysmenorrhea. But for some, this pain can reach the level where you actually feel dizzy, says Kiarra King, MD, an OB/GYN in Chicago and women’s health medical advisor to Oura.

If your pain is severe enough to make you dizzy, or keeps you from your normal daily activities, an underlying condition could be to blame. Conditions like endometriosis, uterine fibroids, and pelvic inflammatory disease can all cause your uterus to contract abnormally, often resulting in extreme pain, according to Johns Hopkins Medicine.

What to do

If your cramping is severe, talk to your OB/GYN. They can run tests (like pelvic exams, blood work, or ultrasounds, to name a few) to rule out any underlying conditions causing your pain. From there, they can come up with a specific treatment plan to help relieve your pain. In the meantime, taking an NSAID (non-steroidal, anti-inflammatory drug) like ibuprofen, or using a heating pad, can help relieve cramping.

4. Anemia

Over time, very heavy periods (where you lose a lot of blood) can cause iron-deficiency anemia, which can make you feel weak and dizzy, and even cause heart palpitations or shortness of breath, notes the Mayo Clinic.

Other common symptoms of iron-deficiency anemia include:

• Fatigue
• Weakness
• Pale skin
• Cold hands and feet
• Headache
• Sore, inflamed tongue
• Brittle nails
• Poor appetite

What to do

If you think you might have anemia, your doctor can order a blood test to find out. If you do, “you can consider taking iron supplements to help boost your blood iron count,” says Dr. Pham. You can also try eating more foods rich in iron like spinach, eggs, red meat, and fortified cereal. Some people also try taking hormonal birth control pills, because they can reduce future blood loss by making your periods lighter, she adds.

5. Rapid, heavy blood loss

This isn’t common, but losing a large amount of blood from a very heavy flow—think, soaking through more than two pads or tampons in an hour, says Dr. King—could cause a rapid drop in blood pressure, making you feel dizzy.

Some potential causes of heavy vaginal bleeding include the following, per the Cleveland Clinic:

• Hormone imbalances (like from a thyroid disorder or PCOS)
• Uterine fibroids
• Infection
• An IUD
• Ectopic pregnancy (in most cases, though, it’s more likely to result in heavy internal bleeding)
• Miscarriage
• Certain bleeding disorders

What to do

“If you’re having rapid blood loss, you’ll want to call your doctor,” says Dr. King. “You may need to be checked out quickly,” to make sure nothing more serious is going on.

6. Toxic shock syndrome (TSS)

TSS is a rare but life-threatening bacterial infection marked by dizziness, sudden high fever, confusion, vomiting, and a rash on your palms or soles of your feet. Anyone can get it (including people assigned male at birth and kids), but it’s tied to tampon use because tampons can potentially cause bacteria to get trapped in your vagina and enter your cervix and uterus, where it can spread to your bloodstream, per the Cleveland Clinic.

What to do

TSS is not common, but if you do feel any of the corresponding side effects, and use tampons often, call your doctor and go to the ER as soon as possible.

You can protect yourself from TSS by changing your tampon at least every eight hours and using tampons with the lightest absorbency for your flow, which reduces the risk for harmful bacteria growth, per the Cleveland Clinic.

Non-period related causes of dizziness

Sometimes dizziness you notice before or during your period isn’t actually related to your cycle, says Dr. King. Some common culprits include:

• Dehydration: Along with feeling dizzy, you might also have a dry mouth, dry skin, dark-colored urine, or feel sluggish or fatigued, according to the National Institutes of Health.
• Low blood sugar: Your blood sugar might drop below the healthy range if you’ve gone too long without eating, especially if you have diabetes. Low blood sugar can make you dizzy, shaky, and irritable. You might feel like your heart is racing or like you can’t think clearly, per the National Institute of Diabetes and Digestive and Kidney Diseases.
• Orthostatic hypotension: This is a type of low blood pressure that happens when standing or sitting up from lying down, says the Mayo Clinic. You might briefly get dizzy, faint, or have blurry vision when you get out of a chair or out of bed, for instance.

Ways to prevent period-related dizziness

Keeping period-related dizziness at bay depends on what’s causing it, says Dr. Pham. Dizziness caused by PMS, dysmenorrhea, or heavy periods can often be managed with hormonal birth control pills. Same goes for period-related migraines, which can also be treated with prescription migraine meds, she adds. If the problem stems from anemia, supplemental iron can correct your deficiency and help you feel better.

Trying to focus on basic self-care—like eating balanced meals and snacks, drinking plenty of water, and getting enough sleep—will also help lower your chances of non-period causes of dizziness like dehydration or low blood sugar, says Dr. King.

What to do when you feel dizzy

First and foremost: Don’t try to push through it, because you could end up falling and getting hurt. If possible, slowly lower yourself into a seated position or find a place to lie down, says Dr. Pham. If you’re not able to sit, at least grab on to something to help you feel steadier. Once the dizzy feeling goes away, get up slowly and carefully, she adds.

This also means, if you need a rest day to sleep off that woozy feeling, take it.

Could dizziness before your period mean you’re pregnant?

Maybe, but only if your period never actually came. While dizziness isn’t a super common early pregnancy symptom, it can affect some people. “This can be due to hormonal changes that lead to a lowering of blood pressure, particularly in the first trimester,” says Dr. Pham.

Other clues that you could be pregnant? Bloating, fatigue, peeing more than usual, nausea, vomiting, mood swings, and tender or swollen breasts, notes Planned Parenthood. But don’t rely on your symptoms alone: If you think you might be pregnant, take a pregnancy test to get a definitive answer, says Dr. King.

When to see a doctor

More often than not, that woozy feeling before your period is due to the normal hormone fluctuations that happen at that time of the month.

But if dizziness before or during your period keeps you from living your day to day, let your doctor know. Dr. King recommends using a period tracker to keep tabs on your cycle and your symptoms, which can help you and your doctor narrow down what might be going on.

And of course, if you have severe symptoms like muscle weakness, very heavy bleeding, or signs of TSS, call your doctor and go to the ER as soon as possible.

—medically reviewed by Andrea Braden, MD, OB/GYN