For many of us, perimenopause is already a struggle — dealing with symptoms like sleep struggles, skin issues, mood swings, weight gain, and irregular periods is no easy task. Another indicator of perimenopause you might not be aware of? Nausea.
That’s right, the sudden feeling that you’re going to upchuck your breakfast can be a telltale sign you’re entering into this phase of your life. Let’s dive into the connection between nausea and perimenopause, and how to manage it.
Perimenopause 101: What you need to know
Perimenopause is the time leading up to menopause, which is when your periods stop permanently and you can no longer get pregnant, according to the Office on Women’s Health. While perimenopause begins and ends at a different age for everyone, it usually starts in your mid- to late 40s and lasts about four years.
During perimenopause, your levels of estrogen (a hormone that supports sexual and reproductive development) and progesterone (a hormone that supports menstruation and pregnancy) fluctuate, eventually leading to very low levels of each in your body.
Because of this, you may experience symptoms like irregular periods, periods that are lighter or heavier than usual, hot flashes, insomnia, night sweats, weight gain, low libido, and heightened anxiety, according to the Cleveland Clinic.
So, what does nausea have to do with perimenopause?
1. Fluctuating hormones
Fluctuating levels of estrogen and progesterone that occur during perimenopause can cause nausea. For instance, a small 2009 study of 90 women published in Women's Health Issues, investigates how fluctuations in reproductive hormones throughout the menstrual cycle affect susceptibility to nausea.
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While the study focuses on the menstrual cycle of women 18 to 22 years old rather than perimenopause specifically, its findings on estrogen and progesterone offer insights into why nausea often increases during hormonal transitions.
The research highlights that sensitivity to nausea changes as levels of estrogen and progesterone fluctuate, as they do in perimenopause. Progesterone is noted for its impact on gastrointestinal (GI) motility (how quickly food moves through the digestive tract), and can cause GI distress.
Progesterone can cause slower GI motility, according to a 2022 review in Physiological Research. Slow GI motility, called gastroparesis, can lead to feeling nauseous, according to the Mayo Clinic.
Additionally, when the Women’s Health Issues study participants were in the days leading up to and during menstruation, they reported significantly greater symptoms of nausea compared to other phases. This is a period marked by low levels of estrogen and progesterone, which also happens during perimenopause.
2. Anxiety
Another potential reason for nausea during perimenopause has to do with the anxiety you may feel during this phase of your life. Perimenopause can cause anxiety for two main reasons, according to Johns Hopkins Medicine: physical factors and hormonal factors.
Let’s start with the physical factors. During perimenopause, your body is changing in ways you may have never experienced before, and figuring out how to cope can cause feelings of unease and anxiety to crop up.
Now onto the hormonal factors. When estrogen and progesterone levels drop during perimenopause, your levels of serotonin — a hormone that stabilizes your mood and contributes to feelings of happiness — also decline, according to Johns Hopkins Medicine. This can heighten feelings of anxiety. What’s more, the stress hormone called cortisol also increases as you age, which can contribute to anxiousness as well.
Anxiety can cause stomach discomfort and make you feel like you’re about to throw up. According to a 2021 research article in Immune Network, there’s a connection between your brain and your gut through the central nervous system (your body’s control and processing center). Psychological stress can negatively impact GI motility, which, as we mentioned above, can lead to nausea.
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Strategies to relieve your nausea
If perimenopausal nausea’s got you feeling down, there are plenty of ways to manage it. Here’s how.
1. Try deep breathing exercises
According to a small 2026 randomized controlled trial of 85 people in the Canadian Journal of Gastroenterology and Hepatology, diaphragmatic breathing may improve feelings of nausea. In another 2020 randomized controlled trial in Complementary Therapies in Clinical Practice, researchers found that deep breathing exercises reduced chemotherapy-induced nausea in those with breast cancer.
Why does deep breathing work so well? It stimulates the vagus nerve (which transmits signals between your brain, heart, and digestive system), which can help reduce nausea and vomiting, according to a 2026 systematic review and meta-analysis in the Journal of Acupuncture Research.
Here’s how to practice diaphragmatic breathing: Take a deep breath in through your nose so your stomach expands. Then, exhale slowly through your mouth. Repeat for as long as you need.
2. Eat ginger
Ginger encourages gastric emptying, and can relieve nausea, according to Johns Hopkins Medicine. It does so by stimulating stomach contractions, which forces food into the small intestine faster, relieving GI symptoms (like nausea), per a randomized controlled trial in European Journal of Gastroenterology & Hepatology.
You can consume ginger in many forms, according to Harvard Health Publishing, including powder, supplements, tea, or fresh ginger. To prevent nausea, it’s recommended to consume 1 to 1.5 grams (1,000 to 1,500 mg) of ginger, typically divided into smaller doses throughout the day.
3. Use aromatherapy
Aromatherapy, which uses essential oils (natural plant extracts) as a way to improve your physical and emotional well-being, can also be used as a strategy to prevent nausea. According to a 2024 review of 11 studies in the Tzu Chi Medical Journal, smelling oils that contain ginger, lavender, or peppermint may manage nausea in postoperative settings.
4. Suck on peppermint candy
Sucking on peppermint candy or chewing peppermint flavored gum can help alleviate mild nausea by relaxing stomach muscles and reducing stomach contractions. Additionally, in a small randomized controlled trial with 105 participants in Explore: The Journal of Science & Healing, researchers found that sucking on ice cubes containing peppermint extract could also help reduce nausea and vomiting.
5. Take medication
In some circumstances, you may want to look into medication that reduces nausea. Some examples of medications include Granisetron (Kytril), Ondansetron (Zofran), and Palonosetron (Aloxi), which have all been FDA-approved to treat nausea and vomiting. However, it’s important to speak with your doctor before taking any of these medications, as they may recommend something different depending on your individual circumstances.
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