Cramps, bloating, headaches, irritability… and now dizziness? Aunt Flo can bring unwelcome symptoms that make you feel crummy. Lightheadedness during your period isn’t one to ignore.

Here’s how to figure out what’s going on and when you should check in with your doctor about your symptoms.

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Girl posing in studio Guille Faingold/Stocksy United

Feeling light-headed when you have your period has a number of possible causes. Narrowing down where your dizziness could be coming from will help you figure out what to do about it.

A really heavy flow

According to the Centers for Disease Control and Prevention, if your dizziness is accompanied by lots of blood, you might have menorrhagia. That’s what doctors call heavy menstrual bleeding.

Check for these symptoms:

  • Your period lasts longer than 7 days.
  • You bleed through one or more tampons or pads in less than 2 hours.
  • You pass blood clots the size of a quarter.

Menorrhagia is super common. According to the American College of Obstetricians and Gynecologists, about 33 percent of vagina owners get help for these symptoms at some point in their lives.

Sometimes it can be the result of an underlying medical concern, like fibroids, bleeding disorders like von Willebrand disease, endometriosis, adenomyosis, hormonal imbalances like polycystic ovary syndrome (PCOS) and hypothyroidism, or cancer. It could also be caused by your IUD.

Heavy blood loss of any kind can make you feel light-headed because your brain is sensitive to even the smallest changes in the oxygen levels of your blood. Menorrhagia can also lead to anemia.

Anemia

According to the National Heart, Lung, and Blood Institute, anemia is when your body doesn’t have enough healthy red blood cells to carry oxygen from your lungs to the rest of your body.

There are lots of different kinds and causes of anemia, but one common one (especially during your period) is iron-deficiency anemia.

During a typical period, you don’t lose enough blood to cause an iron deficiency. But if you have very heavy periods, you just might. Donating blood frequently, taking certain medications, or not getting enough iron and vitamins in your diet can also cause it.

Other symptoms of iron-deficiency anemia include:

  • shortness of breath
  • headaches
  • irregular heart rate
  • fatigue
  • paler skin than usual

Super painful cramps

You get cramps during your period because your uterus contracts to shed your uterine lining. Sometimes those cramps are mild, but other times they can be pretty severe or debilitating. This is called dysmenorrhea.

If your cramps are causing you enough pain, they can make you feel temporarily light-headed. In fact, one study found that dizziness is the second most common symptom of painful periods.

Intense cramps can also cause:

  • nausea
  • fatigue
  • diarrhea
  • bloating
  • vomiting
  • headaches

Your hormones

According to an old 1987 research review, prostaglandins are hormones that regulate processes in your body, including your menstrual cycle. They’re produced in your endometrium (aka the lining of your uterus) right before and just as your period starts.

It is possible to produce too many prostaglandins during your period, which can make you feel dizzy, light-headed, or even faint. This is because these hormones can cause your blood vessels to dilate significantly.

Excess prostaglandins can also cause other symptoms too, including:

  • headaches
  • more severe or painful cramps

Toxic shock syndrome (TSS)

TSS is a rare and serious disease that may occur if you leave a tampon in for too long — and one of the earliest signs of TSS is lightheadedness. Other symptoms include:

  • high fever and chills
  • sore throat
  • eye inflammation
  • nausea and vomiting
  • headaches
  • hypotension (low blood pressure)
  • sunburn-like rash, usually on the palms of your hands and soles of your feet
  • seizures

Premenstrual dysphoric disorder (PMDD)

According to the Office of Women’s Health, PMDD is a severe form of PMS. If you have it, your periods are probably so severe that they interfere with your daily activities. The causes of PMDD are unknown. The symptoms include:

  • lightheadedness or dizziness
  • irritability
  • tension or anxiety
  • extreme sadness, despair or thoughts of suicide
  • trouble thinking and focusing
  • mood swings
  • fatigue
  • food cravings
  • difficulty sleeping
  • extreme cramps, bloating, and breast tenderness

You’re hungry or dehydrated

According to an old 2008 research review, when you get your period, the fluctuations in your hormones can make you more likely to get dehydrated, which, in turn, can make you feel light-headed.

This is because periods can cause edema (otherwise known as swelling). Your body reacts to this in the same way it reacts to dehydration. With edema, fluids seep out of your bloodstream and into body tissues.

Some people also eat or drink less because of their menstrual cramps (especially if the cramps make them nauseous). Skipping calories your body needs can make you feel dizzy.

Low blood sugar

Usually, people’s blood sugar levels are raised before and during their period.

But for some people, fluctuating hormones — specifically estrogen, which makes you more sensitive to insulin — can cause hypoglycemia. That’s another word for low blood sugar. Low blood sugar can make you feel light-headed or faint.

This is more common in people with diabetes, though it can happen to anyone.

Period-related migraines

According to the National Headache Foundation, people who experience migraines are also 60 percent more likely to experience menstrual migraines. Estrogen is the main culprit causing these kinds of migraines.

Like any migraine, period-related ones generally cause one-sided throbbing headaches, which can make you feel light-headed.

Something totally unrelated to your period

Just because you feel light-headed at the same time as your period doesn’t mean that your period caused it. It’s possible that the timing is just coincidental.

According to an old 2009 research review, other possible causes could include:

  • motion sickness
  • balance disorders
  • Ménière’s disease, which affects the inner ear, according to the National Institute on Deafness and Other Communication Disorders
  • certain over-the-counter and prescription drugs for high blood pressure, asthma, breathing concerns, pain, and mental health conditions
  • low blood pressure
  • heart health conditions
  • strokes
  • brain tumors or lesions

Well… that depends. Lightheadedness can have any number of causes, and each requires different treatment to help you feel better.

Your best step is to talk with your doctor if your lightheadedness is concerning you. They alone can tell you what to do.

Medical treatments

Depending on the underlying cause, medical treatments could include:

  • nonsteroidal anti-inflammatory drugs (NSAIDS), particularly if cramps, prostaglandins, period-related migraines, or PMDD are the reason you feel dizzy
  • iron supplements, especially for anemia
  • clotting medications like Desmopressin nasal spray
  • metformin, for PCOS or diabetes
  • surgery for things like endometriosis or fibroids
  • physical therapy
  • birth control pills and antidepressants, especially for PMDD

Home remedies

If you feel light-headed during your period, the best thing to do is lay down until the feeling passes. You can also try:

  • taking over-the-counter pain relievers
  • using a heating pad or hot water bottle, especially if your painful cramps are bad
  • making sure you’re drinking enough water and eating regularly
  • avoiding caffeine and alcohol, which both make dehydration worse

However, if lightheadedness is happening to you a lot, there’s no replacement for talking with your doctor. (Seriously.)

Not to sound like a broken record, but the answer depends on what’s really causing your lightheadedness. There’s no sure-fire way to avoid it.

That said, there are some habits you can adopt that might help you generally feel better, like:

  • getting enough sleep
  • drinking plenty of water
  • avoiding too much caffeine or alcohol
  • avoiding skipping meals, especially when Aunt Flo is in town
  • eating nutritious foods, especially those that are rich in irons and vitamin C

You can also take steps to prevent toxic shock syndrome.

  • Never leave your tampon in longer than 8 hours.
  • Avoid the super absorbent ones, and just change tampons more often.

Before your period. Lightheadedness is actually pretty common, and it’s usually caused by the hormonal changes leading up to your period. It could also be caused by anemia, low blood pressure, PMDD, or pregnancy.

After your period. Lightheadedness could still be caused by anemia because your body hasn’t had a chance to make more red blood cells after a heavy flow. Your body could also just be exhausted from what it just went through.

If you suspect toxic shock syndrome, call your doctor ASAP. This is a serious condition and requires medical intervention immediately.

If you only feel lightheadedness once in a while or if it doesn’t last more than a couple of seconds, you’re probably OK. But always call your doctor if you’re worried.

You’ll also want to call a medical professional if your:

  • period lasts more than 7 days
  • bleeding is so heavy, you need to change your pad every hour
  • cycle is off unexpectedly
  • symptoms include, severe dehydration or low blood pressure, including confusion, fainting or loss of consciousness, blurred vision, seizures, or inability to catch your breath

Feeling light-headed can be pretty unnerving, especially if it happens a lot or lasts a long time. It can also be a symptom that something else is going on, so it’s a good idea for you to mention it to your doc. They can help you figure out what’s happening and treat it.