‘Why Am I Nauseous in the Morning?’ 5 Overlooked Reasons Women Over 50 May Be Feeling Queasy When They Wake
Sneaky culprits like medication and gallbladder issues may be to blame
If you wake up feeling more than a bit queasy—and can’t blame a night out that was just a little too fun—you might be wondering, “Why am I nauseous in the morning?” Here, a leading gastroenterologist reveals the most likely suspects that can trigger nausea in midlife and beyond. Plus, he shares how simply eating breakfast can help tame this tummy tumult.
What is nausea?
Though we all know what it feels like, it’s worth clarifying what nausea actually is. “Generally speaking, it’s a symptom or sensation of upper-stomach distress,” says Anish Sheth, MD, board-certified gastroenterologist and Chief of Gastroenterology at Penn Medicine Princeton Medical Center.
“The best description of nausea is what you feel before you have to vomit—it doesn’t always progress to that point, but that uneasiness in the stomach, that disturbance, can eventually lead to it if it worsens.”
Woman's World Answers
Common symptoms of nausea include:
- A sour taste in your mouth
- Lack of appetite
- Sweating
- Stomach pain
- Retching or feeling like you’re about to vomit
And while we often blame our gut for this disturbance, nausea isn’t always caused by gastrointestinal issues, points out Dr. Sheth. “The classic example is if you’re on a cruise ship and have motion sickness, you feel nauseated. But in that case, there’s nothing wrong with your stomach; it’s just an inner ear issue. So the reason can be something outside the digestive system.”
Why am I nauseous in the morning? 3 key culprits
If you’ve already ruled out the morning sickness that often accompanies the first trimester of pregnancy, read on for Dr. Sheth’s three most likely causes:
Acid reflux
The most common reason for waking up in the morning with that nauseous, queasy feeling is acid-related, notes Dr. Sheth. “This can be acid reflux or what we call dyspepsia, which is the effect that acid can have on the stomach lining.”
When we go to sleep at night, hopefully our stomachs are empty, he explains. “But during that time, the stomach is still generating acid and enzymes. And for some people who have a ‘sensitive stomach,’ that unbuffered acid can cause stomach upset that can feel like acid reflux or nausea in the morning—like something is unsettled.”
The interesting thing about this type of nausea is that eating typically makes people feel better, Dr. Sheth continues. “So if you’re wondering, ‘How do I know if this is the cause?’ the pattern is usually pretty clear: You wake up feeling nauseous, go about your morning, then notice the symptoms start to subside after you eat. That’s because once the stomach is filled with food that isn’t acidic, it helps buffer and raise the stomach’s pH, settling things down.”
One stealthy cause of this acid-induced morning nausea? Intermittent fasting. “People may eat dinner at six or seven, then skip breakfast and end up with a 14- to 16-hour fast,” says Dr. Sheth. “Just keep in mind, your stomach is still doing its thing [churning acid on an empty stomach], and sometimes that can lead to nausea in the morning.” The good news is that once you eat something, this nausea triggered by stomach acid typically goes away.
Gallbladder trouble
Nausea can be a sign of gallbladder issues, notes Dr. Sheth. “This is sometimes accompanied by abdominal pain and is related to meals. Nausea wouldn’t necessarily manifest as soon as you wake up, but, if by mid-morning after breakfast, you feel nauseous—especially with some abdominal pain—that can be a sign of gallbladder issues.” If you’re experiencing these symptoms, talk to your doctor about getting your gallbladder checked.
Stomach ulcer or inflammation
A.M. tummy turbulence could also be explained by a stomach (peptic) ulcer or inflammation, Dr. Sheth reveals. “In contrast to the first scenario [acid refllux], where people feel better after eating in the morning, if the opposite is true—if nausea is worsened by meals—then that is more indicative of something wrong with your GI system, and could warrant further testing and treatment.”
Is morning nausea worse for women over 50?
Here’s your semi-satisfying answer: Yes, no and maybe. Certainly gallbladder issues are more common in this demographic, notes Dr. Sheth, which can lead to nausea any time of day, including in the morning. Here, he ticks off a few other factors more likely to affect women in this age group:
Hormonal replacement therapy (HRT)
“While it’s more common with oral contraceptives, HRT can lead to nausea,” says Dr. Sheth, as our body adjusts to the hormonal changes.
Certain medications
The list of potential suspects is long, to put it mildly. “There are probably 1,000 medicines out there that cause nausea,” confirms Dr. Sheth. “That’s why it’s always a good idea anytime you have a GI symptom to see if it coincides with taking a new medication.”
One type of potentially nausea-causing treatment specifically relevant to women over 50, however, is selective serotonin reuptake inhibitors (SSRIs).
“A lot of women will use SSRIs to manage menopausal symptoms,” Dr. Sheth explains. “These medications—the Prozacs and Zolofts of the world—certainly can cause nausea.” He adds that people taking blood pressure drugs may also experience symptoms.
The bottom line on morning nausea
Typically, if you wake up with a queasy tummy and eating something helps you feel settled, there’s likely nothing to worry about.
Persistent nausea, however, especially the kind that gets worse with eating, may justify a trip to your healthcare professional for medical attention, notes Dr. Sheth. “The simple tests that will be considered are an ultrasound of the gallbladder and an upper endoscopy.”
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