Can perimenopause cause nausea

What actually is nausea? 

Nausea is the term most people use when they feel like they are feeling sick or are going to vomit. Some people describe nausea as a queasy feeling in their stomach, an uncomfortable feeling of pressure, a churning, a ‘wave’ of sickness…either way, if you’ve experienced it, you’re unlikely to forget the feeling. 

Whether actually followed by vomiting or not, nausea is an unpleasant feeling that can be hard to ignore. 

The actual feeling of nausea is your body’s way of saying ‘something’s not quite right here’. It can be triggered by emotions, infections, balance problems, digestive issues, strong smells, medications, alcohol and of course…your hormones. 

Can perimenopause cause nausea?

Nausea can definitely be a symptom of perimenopause¹. During perimenopause (the time in women’s lives before menopause), the amount of hormones produced by your ovaries changes, leading to a reduction in oestrogen levels and fluctuating levels of progesterone – which are the 2 main female hormones. 

There are a few reasons why these hormone changes can make you feel sick in perimenopause:

• We all have a ‘vomiting centre’ in part of the brain called the medulla. The medulla responds to various signals and causes the feeling of nausea. It can be triggered by substances in the blood and in the gut, such as our hormones. 

• One of the chemicals that can stimulate the vomiting centre is called serotonin. Studies have shown that when oestrogen levels change, the amount of serotonin produced in the gut can go up² which can lead to women in perimenopause feeling sick. 

• To add to this, when progesterone levels fall, the way digestion works and the gut contracts changes (and usually slows down)³. This can lead to the feeling of being bloated and full, which ultimately leads to nausea. 

• Perimenopause can be a whole mind-body experience. As well as the physical symptoms that many women experience, it is also often an emotional or stressful time of women’s lives. When we are stressed, high levels of the stress hormone (cortisol) can affect gut contraction,, leaving you feeling bloated and generally pretty sick to the stomach.

• Dropping levels of oestrogen can lead to hot flashes, which can in themselves cause nausea.

So, does perimenopause cause nausea? Yes, it does, and fundamentally it is because there are lots of chemical and hormonal changes going on. 

It is also important to know that there are other medical issues that can cause nausea. Indigestion, allergies, infections and certain medications are also common culprits. If youare experiencing nausea, especially alongside weight loss and difficulty eating, speak to a doctor. 

How long does perimenopause nausea last?

The length of time that women suffer with nausea in perimenopause is variable. For some, it is a feature of the whole perimenopause transition (which can last up to 12 years in some cases). It can come and go at different times. However, don’t let that leave your stomach churning – there are lots of things you can do to help. 

How to relieve nausea during perimenopause

Hydrate!

If you are dehydrated, this might make the nausea worse. Drinking plenty of water helps keep the digestion moving. Try regular sips of a cool drink. 

Avoid the triggers

Often, stress, intense heat, caffeine and alcohol can trigger perimenopause nausea – try and stick away from these if possible. It may also help to stick to ‘bland’ foods and avoid foods that are spicy, greasy or very sweet.

Eating smaller meals

If you eat smaller meals more regularly, it can give you some perimenopause nausea relief as this keeps your blood sugar more stable. 

Drinking tea

Try ginger tea (or foods containing ginger, like ginger biscuits), or peppermint tea.

Stress

Take care of your stress levels – whether using exercise, being out in the fresh air, or trying some cognitive behaviour therapy (CBT), trying to remain cool and collected may help settle the nausea. 

Supplements

Magnesium supplements may help the gut contract well, which is particularly important if constipation is an issue for you⁴.

Although evidence is limited, a supplement that contains vitamin B6 (also called pyridoxine) , may be beneficial⁵. You can buy this in a pharmacy. 

Diet

Enriching your diet with products that are higher in soy may help with nausea along with several other common perimenopause symptoms. This is not recommended if you have had breast cancer. 

Increasing your fibre intake and using a probiotic may help to keep your gut running smoothly and improve the good bacteria in your gut during perimenopause.

Medication

There are some anti-sickness medications that can be prescribed, which may help if you are still struggling. These may help with symptoms in the short term but doctors don’t recommend them for long term use⁶.

• Promethazine (a type of sedating antihistamine) can be useful, particularly if perimenopause nausea at night is an issue for you⁷.
• Metoclopramide, which helps the gut to empty more quickly⁶.
• Cyclizine, which is another type of antihistamine that is thought to block the nausea signals that the brain receives⁶.

Can HRT cause nausea? 

Unfortunately, whilst hormone replacement therapy (HRT) is intended to replace the oestrogen and progesterone that decline in perimenopause (and therefore help treat a lot of the symptoms that women suffer from), HRT related nausea can be a problem for some. Talk to your doctor if you think this is causing you an issue; sometimes a dose adjustment can help. 

Nausea is thought to be more of a problem when HRT is given as a tablet⁸. If nausea is an issue for you but you would like to remain on the medication, consider whether you could try a gel or a patch⁸. Your doctor can give you some advice on this, or you can check out The Lowdown reviews

Whilst nausea can be an issue in perimenopause, it can come and go. There are lots of small adjustments you can make to help yourself feel better. Remember that if you are not sure whether that nasty sick-feeling is due to your hormones, or could be something else, speak to your doctor for more advice.