Nausea During Periods: What Is Normal and What Is Not (2024)

Nausea during periods is common with premenstrual syndrome (PMS) along with mood swings, cramps, bloating, and tender breasts. It occurs when hormonal changes during menstrual cycles trigger the release of inflammatory compounds called prostaglandins. These chemicals not only induce nausea but also cause menstrual cramps.

Less commonly, nausea during periods may be due to serious medical conditions like endometriosis, adenomyosis, and pelvic inflammatory disease. Left untreated, these can lead to potentially severe complications.

It can sometimes be hard to tell if nausea during periods is "normal" or "abnormal." This is why it is important to see a healthcare provider if symptoms are severe or accompanied by heavy menstrual bleeding or pain.

What Causes of Nausea During Periods?

Nausea is common during the onset of PMS, which some people describe as "period flu." Nausea and other symptoms of PMS commonly occur one to two weeks before the start of eachmenstrual period and resolve around the time that menstrual bleeding begins.

PMS is thought to be due to fluctuations in hormone levels during the menstrual cycle. This includes estrogen which triggers ovulation (the release of an egg from the ovaries) and progesterone which prepares the uterus for implantation of the fertilized egg.

If fertilization doesn't occur, the lining of the uterus, called endometrium, will start to break down and release inflammatory compounds known as prostaglandins.

During menstruation, the primary function of prostaglandins is to stimulate uterine contractions to help shed the endometrial lining, thus producing a period. The contractions, in turn, can cause menstrual cramps, otherwise known as dysmenorrhea.

As prostaglandin levels increase, they can also affect the brain, causing symptoms like anxiety, depression, mood swings, insomnia, and a loss of sex drive.

Prostaglandins can also provoke nausea by activating a part of the brain called the brainstem which regulates nausea and emesis (vomiting).

Other Causes of Nausea During Periods

The same mechanisms that give rise to nausea during PMS—hormonal fluctuations, prostaglandin production, and endometrial disturbances—can give rise to nausea independent of PMS. These conditions interfere with the normal menstrual cycle, albeit in different ways.

New Birth Control

Spotting or bleeding between periods (called breakthrough bleeding) can occur with any birth control pill, especially during the first few months of use. The inflammation of the uterus, in turn, can stimulate the release of prostaglandins and the onset of nausea.

Adenomyosis

Adenomyosis is when endometrial tissues grow into the muscular wall of the uterus. This enlarges the uterus, causing heavy menstrual bleeding (menorrhagia) and pain. In addition to nausea, adenomyosis can cause cramping, pain during sex, and a feeling of bloating, fullness, or heaviness.

Uterine Fibroids

Uterine fibroids are benign growths that develop in the uterus or endometrium. A person can have one or many, ranging from as small as a pea to as large as a football.

Certain types are more likely to trigger nausea than others, including intramural fibroids which can affect menstrual cycles and induce heavy menstrual bleeding.

Endometriosis

Endometriosis is a chronic condition where tissue similar to theendometriumgrows outside the uterus. Endometriosis can affect the ovaries and fallopian tubes and invade nearby organs, including the bowel and bladder.

Endometriosis can cause heavy bleeding or pain during sex or when urinating or having a bowel movement. Nausea, constipation, and cramping are also common.

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is an inflammatory infection that affects the uterus, ovaries, and fallopian tubes. It is often caused by an untreatedsexually transmitted infection (STI), leading to pelvic pain, fever, vagin*l discharge, pain with urination, and pain with sex. Nausea and vomiting are also common.

Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a condition in which multiple cysts develop on the ovaries. This can disrupt the balance of hormones leading to irregular periods, acne,excessive facial or body hair, male-pattern baldness, weight gain, and insomnia.The disruption of hormones can also cause nausea, stomach pain, andvomiting.

How to Deal With Nausea During Periods

Dealing with nausea during PMS can be challenging, but there are several things you can do to better cope when symptoms are severe:

• Drink plenty of water and eat a bland diet.
• Take a warm bath or put a heating pad on your stomach or lower back.
• Sip ginger, peppermint, or fennel tea.
• Suck on a ginger candy or sip a flat ginger ale.
• Practice meditation, progressive muscle relaxation (PMR), or deep breathing exercises.
• Take a walk out in the fresh air.
• Take an over-the-counter (OTC) anti-nausea drug like Pepto-Bismol (bismuth subsalicylate)
• Take an OTC nonsteroidal anti-inflammatory drug (NSAID) like Advil (ibuprofen) to reduce inflammation and prostaglandin levels.

When to Call a Healthcare Provider

It is time to call a healthcare provider if your period nausea is consistent or you have other symptoms, like severe pelvic pain, fainting, vomiting, or abnormal vagin*l discharge.

To determine the underlying cause, a healthcare provider will start by running blood work and performing a pelvic exam. Based on the likely causes, additional tests may be ordered, including a transvagin*l ultrasound or a biopsy to obtain a sample of endometrial tissue.

Summary

Some nausea before and during your period is considered a normal PMS symptom. If nausea is coupled with heavy bleeding, severe cramps, fainting, or abnormal discharge, there may be an underlying condition at play, like endometriosis or pelvic inflammatory disease.

Starting birth control pills can also cause nausea coupled with breakthrough bleeding. Nausea may also be a sign of early pregnancy, which can be confirmed with a pregnancy test.