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Key Takeaways
- 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.
- Early pregnancy and starting birth control pills can also cause nausea.
Experiencing nausea before your period is usually a normal response to hormonal changes associated with PMS. Yet, if these symptoms are joined by extreme pain or unusual bleeding, it might be worth investigating other possible causes such as endometriosis or uterine fibroids.
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1. Premenstrual Syndrome
Nausea is common during the onset of premenstrual syndrome (PMS), which some people describe as “period flu.” Nausea and other symptoms of PMS commonly occur one to two weeks before the start of each menstrual 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 the endometrium, will start to break down and release inflammatory compounds known as prostaglandins.
During menstruation, prostaglandins stimulate uterine contractions to shed the endometrial lining, producing a period. These contractions can cause menstrual cramps, 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).
2. New Birth Control
Spotting or bleeding between periods, known as breakthrough bleeding, can occur with any birth control pill, especially in the first few months. This uterine inflammation can trigger prostaglandin release and cause nausea.
3. Adenomyosis
Adenomyosis occurs 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.
4. 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.
5. Endometriosis
Endometriosis is a chronic condition where tissue similar to the endometrium grows 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.
6. 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 untreated sexually transmitted infection (STI), leading to pelvic pain, fever, vaginal discharge, pain with urination, and pain with sex. Nausea and vomiting are also common.
7. 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, and vomiting.
8. Early Pregnancy
Early pregnancy and PMS can both cause breast tenderness, fatigue, and nausea. The difference is that with early pregnancy, these and other morning sickness symptoms typically start around week six of gestation. As such, morning sickness is recognized by the absence of a period, while PMS occurs with a period.
The one way to know for sure is to take a pregnancy test.
9. Gastrointestinal Conditions
Irritable bowel syndrome (IBS) is a common gastrointestinal condition that can cause nausea along with other symptoms such as diarrhea, constipation, bloating, and abdominal pain. If you have IBS, you may experience a worsening of symptoms around the time of your period.
How to Deal With Nausea During Periods
Dealing with nausea during PMS can be challenging. It may be helpful to write down when your symptoms occur and what you were doing at the time (things you ate or drank, for example) so you can identify triggers.
Some of the things that may help manage or prevent period-related nausea include the following:
A Note on Gender and Sex Terminology
Verywell Health acknowledges that sex and gender are related concepts, but they are not the same. To accurately reflect our sources, this article uses terms like “female” and “women” as the sources use them.
When to Call a Healthcare Provider
It can sometimes be hard to tell if nausea during periods is normal or abnormal. Thus, it is important to see a healthcare provider if symptoms are severe or accompanied by other symptoms, like severe pelvic pain, fainting, vomiting, or abnormal vaginal discharge. Untreated, some medical conditions can lead to potentially severe complications.
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 transvaginal ultrasound or a biopsy to obtain a sample of endometrial tissue.