Morning nausea can be caused by pregnancy, an empty stomach, acid reflux, or anxiety.
Common causes
- Pregnancy: nausea often starts around week 6.
- Hunger and low blood sugar.
- Acid reflux.
- Anxiety.
- Hormone changes during your cycle.
- Medicines on an empty stomach.
Pregnancy check
If you missed a period, take a pregnancy test.
What helps
Eat a plain cracker before getting up, avoid greasy foods and sip ginger tea.
See a doctor
If nausea persists or you can’t keep fluids down.
Hormones in the morning
After many hours without eating, blood sugar is low and stomach acid has built up. The hormone cortisol peaks in the early morning and can add to nausea.
Pregnancy
Nausea on waking is the classic early sign of pregnancy, usually starting between weeks 4 and 6 after the last period. It is related to rising hCG and estrogen. About 70% to 80% of pregnant women have nausea or vomiting.
Cycle and hormonal causes
- Premenstrual syndrome, with nausea in the days before a period.
- Starting or changing birth control pills.
- Polycystic ovary syndrome.
- Menopause hormone changes.
Other causes
- Acid reflux or gastritis.
- Migraines.
- Anxiety and panic.
- Low blood sugar, especially in diabetes.
- Sleep apnea, causing poor oxygen at night.
- Medications taken without food.
- Dehydration after drinking alcohol.
- Gallbladder disease.
When to test
If your period is late and there is nausea, a home urine pregnancy test is accurate from the first day of the missed period, with sensitivity above 99% when used correctly. Testing in the morning with first urine gives the most concentrated sample.
Relief
- Eat dry crackers or toast before rising slowly.
- Eat small, frequent meals.
- Avoid greasy and spicy foods.
- Drink fluids in small sips.
- Try ginger and vitamin B6, which ACOG lists as options in pregnancy.
See a doctor if
Vomiting is persistent and you cannot keep fluids down, you have severe abdominal pain, weight loss, fever, vomiting blood or severe headache. Seek emergency care for one sided lower belly pain with bleeding or fainting, which can signal ectopic pregnancy.
Hormonal and pregnancy links
Morning nausea in women can result from pregnancy hormones, mainly human chorionic gonadotropin (hCG) and rising estrogen and progesterone, with up to 70 to 80 percent of pregnant women reporting nausea, usually beginning around week 6. Hormonal changes before a period, starting or changing hormonal birth control, and polycystic ovary syndrome can also cause nausea. Taking a home pregnancy test is useful if a period is a week late, and morning urine has the highest hCG level. Hyperemesis gravidarum, severe vomiting with weight loss and dehydration, affects about 0.3 to 3 percent of pregnancies.
Self care and medical advice
Small frequent meals, ginger, vitamin B6 (10 to 25 mg, up to three times daily, as ACOG describes) and getting out of bed slowly help during pregnancy. Avoid skipping meals, strong smells and lying down right after eating. See a doctor if nausea persists beyond a few weeks without a clear cause, if you cannot keep fluids down, or if you have severe abdominal pain, fever or dizziness. Do not take new medicines for nausea during pregnancy without asking a clinician.
Based on data from ACOG and the NIH
