Perimenopause Nausea: Why It Happens and How to Find Relief

If you’re often bothered by an upset stomach and feelings of queasiness, your first thought may not necessarily be “perimenopause.” But perimenopause nausea is actually one possible symptom (among many) of the transition to menopause.

Perimenopause nausea is queasiness or stomach upset caused by hormonal fluctuations during the transition to menopause. This symptom affects many people due to declining estrogen and progesterone levels, which regulate digestion and gut health.

What causes perimenopause nausea, and how can you find relief when you’re feeling nauseous? Read on to find out.

Does Perimenopause Cause Nausea?

The short answer is: yes, perimenopause can cause nausea. Perimenopause nausea is a recognized perimenopause symptom, even if it may not be as well-known as others.

The evidence shows that people experience an uptick in gastrointestinal symptoms during perimenopause, including [1]:

• Nausea
• Bloating
• Indigestion
• Constipation
• Diarrhea
• Vomiting
• Gassiness
• Stomach cramps
• Heartburn
• Acid reflux

Many of these gastrointestinal symptoms can also worsen perimenopause nausea.

Why does perimenopause cause nausea?

Like so many other aspects of perimenopause, perimenopause nausea is related to your changing reproductive hormones and the wide-ranging impacts those changes have all throughout your body.

Low levels of estrogen and progesterone, like those you have in perimenopause, are thought to contribute to nausea and other gastrointestinal symptoms [1]. (Side note: this helps explain why many experience stomach trouble around their period, as reproductive hormone levels also fall pre-period.)

Perimenopause also features fluctuating hormone levels. These fluctuations appear to play a role in perimenopause nausea, too, since both estrogen and progesterone help regulate gut health, including in these two key areas:

• Digestion: Estrogen and progesterone are involved in gastric motility – that is, how your muscles move food through the digestive tract as your body digests. Perimenopause hormone fluctuations slow gastric motility which slows digestion, leading to stomach trouble like nausea, indigestion, constipation, and changes in bowel habits [2].

• Gut microbiome: The gut microbiome, the ecosystem of friendly microorganisms that populate your gut, plays a crucial role in overall health. Perimenopause hormone fluctuations change the makeup of your gut microbiome, potentially triggering gastrointestinal problems like nausea, indigestion, and bloating as your body adjusts [3].

Can other perimenopause symptoms make nausea worse?

Perimenopause hormone fluctuations lead to lots of other symptoms, too, many of which can also cause perimenopause nausea or make nausea worse:

• Stress: Increased stress and increased cortisol (the stress hormone) slow digestion, which can lead to issues like perimenopause nausea, diarrhea, constipation, gassiness, and bloating [4,5].

• Anxiety: For many perimenopausal people, perimenopause anxiety is accompanied by waves of nausea and other belly issues.

• Emotional symptoms: Emotional distress can impact eating habits and appetite. You may eat more highly processed foods and foods high in fats and sugar, or you may skip meals entirely – often recipes for an upset stomach and perimenopause nausea.

• Hot flashes (vasomotor symptoms): These sudden rushes of burning heat leave many people feeling queasy [6]. Plus, easing an upset stomach is harder when your body temperature is unpredictable.

• Trouble sleeping: Difficulty sleeping can alter your gut microbiome, increase inflammation, and impact gut function, which can lead to gastrointestinal symptoms like nausea, bloating, and gas [7,8].

Can perimenopause medication cause perimenopause nausea?

Yes, medications commonly prescribed to manage perimenopause symptoms can cause nausea.

Common side effects of perimenopause treatments like hormonal replacement therapy (HRT), hormonal birth control, and antidepressants include:

• Nausea
• Vomiting
• Stomach cramps
• Bloating

Signs perimenopause nausea might be a red flag

Perimenopause nausea generally isn’t cause for concern on its own, but it shouldn’t significantly disrupt your daily life. Talk to your doctor if you have severe nausea or nausea that doesn’t go away.

In some cases, perimenopause nausea could point to an underlying condition that requires treatment. Seek medical help if you also have:

• Abdominal pain
• Frequent or heavy vaginal bleeding
• Bloody stool
• Frequent vomiting
• Extreme weakness
• High fever
• Shortness of breath

How to find relief from perimenopause nausea

When a wave of perimenopause nausea hits and you need immediate relief, try these anti-nausea strategies to calm the queasiness:

• Recline with your upper body elevated (like lying back on a couch)
• Loosen any tight clothing around your waist or belly
• Open a window or sit in front of a fan
• Apply a cool compress to your neck
• Breathe slowly and deeply
• Take small sips of cool water
• Slowly sip ginger tea or peppermint tea
• Wear acupressure bracelets (these activate an acupressure point thought to alleviate nausea)
• Distract yourself (try a TV show, movie, or audiobook)

Managing perimenopause nausea over time can also provide relief. Long-term management strategies for perimenopause nausea involve a combination of lifestyle strategies, natural remedies, and medication on a case-by-case basis.

Lifestyle strategies for perimenopause nausea relief

Adapting your lifestyle can help you control perimenopause nausea and other perimenopause symptoms:

• Build your perimenopause diet: Dietary and nutritional needs can change in perimenopause. Try making changes to your diet and tracking your nausea symptoms. Eat a balanced diet (fruits, veggies, lean proteins, whole grains), limit alcohol, and cut back on highly processed, fried, high-fat, high-sugar, and very spicy foods.

• Modify daily meal and hydration habits: Try eating smaller, more frequent meals, like snack-size meals six to eight times a day [9]. Drink plenty of water, as dehydration can cause nausea.

• Optimize your sleep: Restorative sleep helps your body recharge and reset. Build healthy sleep habits with a regular sleep schedule, a relaxing bedtime routine, and a cool, dark, and quiet sleep environment for maximum coziness.

• Exercise regularly: Regular exercise supports digestion, metabolism, a healthy gut microbiome, and sleep to help you manage perimenopause nausea [10]. Aim for around 45 to 60 minutes of exercise, three times a week.

Natural remedies for perimenopause nausea relief

Ginger

Ginger improves gastric motility and supports digestion. An effective treatment for morning sickness, motion sickness, and other queasiness causes, ginger may also help perimenopause nausea [11].

To alleviate perimenopause nausea, try slowly sipping ginger tea. You can also try eating crystallized ginger or using a ginger essential oil. Ginger is also available as an herbal supplement, but always talk to your doctor before using supplements.

Peppermint

Peppermint can help relieve stomach cramps, bloating, and gas to ease perimenopause nausea [12].

Peppermint tea is a great option for perimenopause nausea relief. You can also use peppermint essential oil, peppermint-flavored chews or lozenges, or peppermint herbal supplements (but again, always consult with your doctor about supplement use).

Breathing techniques

Deep breathing techniques like belly breathing (also called diaphragmatic breathing and abdominal breathing) can reduce nausea and vomiting [13]. Breathing and meditation techniques can also help soothe stress, anxiety, and other emotional symptoms, which may help you manage perimenopause nausea over time.

When perimenopause nausea is making you queasy, try belly breathing until nausea subsides. Breathe in slowly and deeply through your nose, hold for three seconds, then exhale through pursed lips. 

Medication for perimenopause nausea

Depending on your situation, your doctor may recommend medication for perimenopause nausea. Options include anti-nausea medication (antiemetics), and general perimenopause medication like HRT, hormonal birth control, and certain antidepressants. Always take medication under your doctor’s supervision and guidance.

Perimenopause nausea can also be a medication side effect, though. If your medication is causing nausea, talk to your doctor to determine the best path forward. That may include adjusting your dose, finding strategies for dealing with side effects, or stopping the medication.

Perimenopause nausea: The bottom line

Perimenopause nausea is a recognized symptom of perimenopause, often caused by changing hormone levels and other perimenopause symptoms.

For immediate relief from perimenopause nausea, loosen tight clothing, get fresh air, breathe deeply, and slowly sip ginger or peppermint tea. To manage perimenopause nausea and other perimenopause symptoms long term, consider adapting your diet and eating habits, prioritizing sleep, and exercising regularly.

Perimenopause nausea can feel hard to overcome, but with support, you can move toward nausea-free days.

Frequently Asked Questions About Perimenopause Nausea

Does perimenopause cause nausea?

Yes, perimenopause commonly causes nausea due to declining estrogen and progesterone levels, which affect digestion and gut health.

What other perimenopause symptoms make nausea worse?

Hot flashes, anxiety, stress, poor sleep, and emotional distress can all trigger or worsen perimenopause nausea.

Does hormone replacement therapy cause nausea?

Nausea is a common side effect of HRT, hormonal birth control, and antidepressants used to manage perimenopause symptoms. Talk to your doctor if medication-related nausea persists.

How do you get rid of perimenopause nausea?

For immediate relief, try deep breathing, cool compresses, ginger or peppermint tea, and fresh air. Long-term strategies include dietary changes, regular exercise, and better sleep habits.

When should I see a doctor about perimenopause nausea?

Seek medical help if your nausea is severe, persistent, or accompanied by abdominal pain, heavy bleeding, bloody stool, frequent vomiting, high fever, or shortness of breath.

How long does perimenopause nausea last?

Perimenopause nausea duration varies by individual. It may come and go throughout perimenopause as hormone levels fluctuate, typically lasting until you reach menopause.