Can menopause cause nausea?

Not feeling well for no apparent reason? Nausea, or feeling as if you could vomit, is pretty common, and a bunch of factors could be causing it. For example, you might occasionally feel nauseous after eating certain foods or if you have a stomach bug.

But if you’re somewhere between your late 30s and 50s, and your cycle-tracking app shows that your periods have been irregular lately, you might be curious to know if nausea can be a perimenopause symptom. And it turns out your tummy trouble can be hormone related, so it might be a relief to know there are plenty of ways to manage it. 

Here, obstetrician and gynecologist Dr. Angela Jones, New Jersey, US, shares everything you need to know about perimenopause or menopause nausea. But if you have any questions or concerns, always reach out to a health care professional for advice.

Key takeaways

• Research is limited, but nausea is a possible symptom of perimenopause (which is the lead-up to your final period plus one year afterward). Doctors think the main cause of this type of nausea is shifting hormones, particularly your estrogen levels, which are in flux around menopause. 
• Nausea isn’t always caused by perimenopausal hormonal changes. Sometimes it can be a side effect of hormone therapy, or HT (previously called hormone replacement therapy, or HRT). 
• Hot flashes — or more specifically, the anxiety you can feel as a result — may also make you feel nauseous. 
• You can generally ease nausea with some lifestyle and dietary changes, but in some cases your doctor may prescribe medications. Chat with them if you need help.

Is nausea a common menopausal symptom?

While nausea isn’t the most common symptom during the transition through menopause, it’s certainly possible that it can happen. “Nausea may or may not be common in perimenopause and menopause, as what each woman experiences will be specific to her,” explains Dr. Jones. To understand why menopause might make you feel queasy, it helps if you know how it all works. 

You’ve probably heard of menopause before, so what’s perimenopause? The terms are often used interchangeably, but perimenopause refers to the years leading up to menopause and the year after your last period. “In the most literal sense, perimenopause means around menopause,” explains Dr. Jones.

Perimenopause can begin anywhere between your late 30s and 50s, but it most often happens in your 40s. During this time, your hormones shift up and down in preparation for them to eventually wind down completely. “On average, perimenopause lasts about four years,” says Dr. Jones. “It’s the transition period to menopause, when a woman [doesn’t] get her periods any longer.” 

Once your menstrual cycle stops altogether (which usually happens between the ages of 45 and 55), you’ll have gone through menopause. “By definition, it’s an entire year without a period,” says Dr. Jones. “Once menopause is reached, a woman no longer has reproductive capacity. After menopause is reached, you become postmenopausal.”

You might already be familiar with other signs of perimenopause, such as hot flashes, night sweats, and mood swings. Generally, these things happen during the run-up to menopause and in the years after the last period because your body is getting used to lower hormone levels. And it’s thought that nausea, although less common, could also be caused by hormonal changes.

It can be useful to keep track of your symptoms when you’re going through perimenopause, especially if you ever want to see a doctor about them. A cycle-tracking app like Flo can help with that, allowing you to log symptoms like headaches, brain fog, and vaginal dryness alongside your periods (which are, by definition, irregular during perimenopause). Download Flo now to start keeping a log of what you’re experiencing.

Why does nausea happen during perimenopause?

Just like other more widely known perimenopause symptoms like irregular periods, nausea in the transition through menopause is thought to be caused by changing hormone levels. “Estrogen is one such hormone,” says Dr. Jones. While no two people have the exact same symptoms, it’s possible that a change in hormone production might make you feel a bit nauseous. “If estrogen is elevated, nausea may be experienced,” she adds.

Unpredictable hormones can also mess with the way your body absorbs food. “[Increased] adrenaline levels caused by high cortisol levels and decreased estrogen levels as seen in [peri]menopause can impact the digestive system, leading to nausea,” explains Dr. Jones.

But it’s also possible that nausea might not be caused by perimenopause itself. It may be due to anxiety resulting from hot flashes, as this is a feeling some people get when having a hot flash. 

There’s also a chance that hormone therapy, which is often used to treat certain perimenopause symptoms, can make you feel nauseous. Usually, this only lasts a few weeks while your body adapts to its new hormone levels. 

Whatever the cause of your nausea, if it’s ongoing and you’re finding it difficult to manage, schedule an appointment with your doctor, who should be able to help.

Other reasons you may be experiencing nausea

It’s also very possible that you might be feeling nauseous for reasons other than perimenopause. That’s why it’s always a good idea to get checked out by your doctor, because it could flag that something is going on inside, as Dr. Jones explains.

“Possible reasons [for nausea] include certain gastrointestinal conditions such as gastritis [an inflamed stomach lining], gastroparesis [where the stomach muscles don’t move food through properly], or ulcers [where stomach acid burns through your stomach lining],” she says.

“Pain, food poisoning, indigestion, infections, migraines, and pregnancy are a few other common reasons one might experience nausea,” she adds. If you’re at all worried, then speak to your doctor. They can offer personalized advice and run some tests, if necessary.

How to treat nausea in the transition through menopause

If nausea or any other perimenopause symptom is bothering you, don’t assume you should just live with it. In fact, there are a number of treatment options available to help you feel like yourself again. 

Treatment for hormone-related nausea usually involves a mix of lifestyle and diet changes, but in some cases your doctor may suggest medications to help with symptoms.

Take care of yourself with lifestyle changes

Doing your best to lead a healthy lifestyle is a good idea at any age. But one thing that may be suggested for perimenopausal symptoms is to make a few tweaks to your lifestyle. 

“There are quite a few lifestyle changes to help prevent nausea in menopause and perimenopause,” says Dr. Jones. She suggests the following:

• Know your triggers: Lots of things have been found to make perimenopause symptoms worse, but everyone’s experience is different. “Triggers such as alcohol, caffeine, and spicy foods can trigger hot flashes,” says Dr. Jones. Try to learn yours and avoid anything that sets you off. 
• Avoid smoking: Medical studies have repeatedly found that smoking increases the chance of having severe hot flashes. And research also shows that quitting cigarettes can help ease other perimenopause symptoms, so there’s another health reason to quit. 
• Drink more water: Nausea can be a sign of dehydration, which happens when you don’t drink enough water. Our bodies are made up of 60% water, but dropping estrogen levels during perimenopause can affect your sense of thirst, meaning we drink less. The amount of fluids you’ll need to consume (from eating as well as drinking) will be different from person to person, and your doctor may be able to help guide you on what you should be aiming for. As a starting point, a very general recommended amount is about 11.5 cups (2.7 liters) per day.
• Keep cool: If hot flashes are making you feel nauseous, maintaining a comfortable temperature may help. “Wear light clothing or dress in layers,” says Dr. Jones. That way, you can easily remove items if a hot flash comes on. Carrying a portable fan is a good way to help you level out your temperature on the move, too. 
• Keep stress in check: Lots of us are juggling different life stresses by the time we reach perimenopause, such as caring for aging parents, working demanding jobs, parenting, or all of the above. But stress has been found to impact perimenopause symptoms. “Try to maintain low stress levels,” says Dr. Jones. “This can be achieved via finding activities that relax you.” This might be a regular yoga class or spending time outdoors.
• Get moving: Anything that gets your heart rate up and strengthens your muscles can help with tricky perimenopause symptoms. “Exercise regularly,” says Dr. Jones. “This can serve as a stress reliever as well.” Whether it’s walking, yoga, swimming, or whatever you’re physically able to do, try to find something you enjoy, and it won’t feel like a chore.
• Manage your weight: On average, women gain about 1.5 kg (just over 3 lb) per year during perimenopause. This is normal, but research has found a link between how much you weigh and how often you get hot flashes. So, if you feel you want to, managing your weight could be one way to try to minimize hot flashes and the nausea that may result. 

Dietary changes

Eating certain foods and avoiding others may help to relieve symptoms of nausea. In the short term, it’s a good idea to avoid fried, greasy foods or anything that triggers feelings of nausea. Stick to bland foods such as plain toast. Chewing slowly and eating smaller meals more often may also help. You can also try sipping ginger ale or mint tea, drinking cold water, and avoiding doing anything too energetic soon after eating.

Medication

If your nausea is linked to other perimenopause symptoms, your doctor might recommend medication to help. “You treat menopausal nausea by identifying the cause,” explains Dr. Jones. “If it is due to hot flashes, one might consider some sort of hormone therapy that includes estrogen [if it’s suitable to take]. You might consider an anti-nausea medication as well.” 

Some selective serotonin reuptake inhibitors (SSRIs), which are usually taken to help treat mental health issues such as depression and anxiety, have also been found to reduce perimenopause symptoms like hot flashes and night sweats. This could be an option if you don’t want to take HT (or can’t for medical reasons) but need help managing your symptoms during perimenopause or beyond.

It’s worth noting that in some people, SSRIs can cause nausea as a side effect, which means they may not be suitable options. But your doctor may be able to help you explore other options if this is the case.