School of Science, Campbelltown Campus, Western Sydney University, NSW, Australia.
iHearWell Inc, Chagrin falls, Ohio, USA.
Curr Opin Neurol. 2022 Feb 1;35(1):135-141. doi: 10.1097/WCO.0000000000001019.
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 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 Ménière'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.
前庭障碍呈性别分布，女性患病率更高。尽管该领域的研究有所增加，但这种不平衡的机制尚不清楚。本综述总结了该研究领域的最新进展，简要讨论了性激素对各种前庭疾病的影响，并强调了一些最新理论。
最近的研究工作已经确定了异常性腺激素水平与前庭功能障碍之间的直接联系。良性阵发性位置性眩晕研究表明，该疾病可能与绝经后妇女体内雌激素水平的快速下降有关，这种下降破坏了内耳中的耳石代谢。一项成功的激素治疗干预研究提高了我们对内耳中梅尼埃病中激素影响的认识。此外，一些研究还集中在前庭性偏头痛、晕动病综合征和性腺激素之间相互作用涉及的潜在机制上。
在女性中，性腺激素和性别特异性突触可塑性可能在周围和中枢前庭障碍的潜在病理生理学中起重要作用。总的来说，本综述得出结论，对女性前庭患者的临床评估需要采用多方面的方法，包括耳鼻喉科医生、妇科医生和/或内分泌科医生，以及激素谱评估。
