Are Falls More Common in Midlife?

I am approaching menopause, after five months without my period (I used to have very regular monthly cycles until two or three years ago). In addition to the typical symptoms, I have started having repeated falls. These began with light tumbles as I tripped while walking, then three bad falls (a missed step on the staircase, slipping on the bathroom floor) that resulted in visits to the emergency room. Is falling a typical symptom of this time of life, and what can I do?

—Anonymous

I am sorry to hear you have been falling! Falls can be very scary. Unfortunately, there is not a lot of data regarding falls in midlife. One study from the 1980s surveyed 2,000 men and 2,000 women in Oxford, England, in an effort to see if falls increase with age. The response rates were surprisingly high for a mail survey (83% of women and 72% of men responded). The authors found that in women, but not men, the risk of falling started to increase around age 45 and peaked between 55 and 59 before dropping again, reaching a nadir between the ages of 70 and 74. Both men and women have increased risk of falling in very old age.

The authors note that the increase in falls corresponds to the perimenopausal years, but the connection between perimenopause and increased falls is not well understood. Despite there having been calls for further study back then, I wasn’t able to find any other published data connecting perimenopause to an increased risk of falling. Certainly fatigue, moving around the house in the dark on sleepless nights, and palpitations might all contribute.

Because the connection between perimenopause and fall risk is poorly understood, it is not clear how best to manage this risk. However, given the frequency of your falls and the fact that they are becoming increasingly more injurious, I would urge you to follow up with your primary care physician. They can perform some testing and, if needed, recommend seeing a specialist such as a neurologist or physiatrist. The falls themselves are unsettling, and they increase your risk for injury. Taking a closer look to see if there is another cause of your falls or ways they might be prevented could spare you from more harm in the future.

The upshot: An association between perimenopause and falls was described in one study, but the connection is not well studied. It is important to work with your doctor to look for other causes for your falls that might help you prevent future falls and injury.