Created for Greatist by the experts at Healthline. Read more

Headaches, backaches, cramps… we know periods are a pain. But what about other symptoms like nausea? We associate nausea with pregnancy, but it’s also possible with your menstrual cycle when there’s no baby on board.

It’s annoying but not usually a big deal. Though sometimes, nausea in combination with other symptoms can signal a bigger period problem.

Check out these common causes of period nausea, and what you can do to get relief.

The hormones that fluctuate throughout the month impact your whole body, even in ways that don’t seem obvious.

Basically, your uterus and other abdominal organs are roommates who don’t always get along but have to share the same space. Here are some of the common reasons you might feel nauseated before or during your period.

Dysmenorrhea, a literal pain in your period

Dysmenorrhea — or as you may know it, “cramps from hell” — impacts 45 to 93 percent of women of reproductive age.

Uterine cramps occur during your period due to the production of prostaglandins. Prostaglandins are a hormone-like substances that cause the uterus to contract, resulting in abdominal pain that may be dull and continuous or throbbing and crampy.

Cramps can start a few days before your period and will fade a few days after you start bleeding. For some women they are mild, but they can be intense enough to affect daily activities.

It can get really tough to function when cramps are accompanied by these symptoms:

  • nausea
  • diarrhea
  • headache
  • dizziness

Dysmenorrhea is one of the most common causes of pelvic pain.

PMS (pretty much sucks)

More than 90 percent of women say they experience symptoms a week or 2 before their periods start. The list of potential PMS symptoms is a long one:

  • bloating and gas
  • constipation
  • diarrhea
  • changes in appetite
  • cramping
  • headache
  • backache
  • swollen or tender breasts
  • tiredness
  • irritability
  • sensitivity to sound and light
  • trouble concentrating
  • anxiety
  • sleeping too much or too little
  • mood swings
  • low libido

Cramping, pain, and gastrointestinal symptoms can also bring on nausea. Your individual experience with PMS will change over time and could range from barely noticeable to “OMFG make it stop!” But there are lots of ways to ease symptoms, so keep reading.

PMDD: PMS gone wild

How are all these women shrugging off their PMS symptoms while you’re crying in the corner or feeling like you have a fatal illness every month? Maybe it’s more than PMS.

Premenstrual dysphoric disorder (PMDD) is like PMS turned up to 11. Affecting 5 percent of women of reproductive age, PMDD causes severe emotional symptoms and is more common in women who already have anxiety or depression.

Like PMS, PMDD symptoms start a week or 2 before your period and stop a few days after your period starts. PMDD Symptoms include:

  • cramps
  • bloating
  • headaches
  • body aches
  • sadness, despair, thoughts of suicide
  • irritability and anger
  • mood swings
  • crying often
  • anxiety
  • panic attacks
  • trouble concentrating
  • low energy
  • food cravings or bingeing
  • no interest in regular activities
  • trouble sleeping
  • feeling out of control

While the pros don’t really know why premenstrual symptoms are so severe for some women, researchers theorize it has something to do with how sensitive you are to fluctuations in hormones and serotonin levels during your cycle.

You put my what WHERE? Rogue uterine lining explained (endometriosis)

The lining of your uterus — the part that grows and sheds during your menstrual cycle — is called the endometrium. Sometimes the same kind of tissue grows outside your uterus in other parts of the abdominal cavity. This condition is called endometriosis.

The out-of-place endometrium grows and bleeds just like your uterine lining, but has no way to exit the body, building up and causing swelling and pain.

It affects 7 to 10 percent of women, causing gastrointestinal symptoms like abdominal pain, bloating, nausea, constipation, vomiting, painful bowel movements, and diarrhea.

Endometriosis is a cause of secondary dysmenorrhea and chronic pelvic pain. Other symptoms include pain during sex, heavy periods, fatigue, and infertility.

Don’t ignore that infection: Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is inflammation of the upper genital tract (uterus, fallopian tubes, and ovaries) due to infection.

It’s diagnosed in women with pelvic pain when other possible causes — like ectopic pregnancy — are ruled out. PID is most often caused by one of two sexually transmitted infections: gonorrhea or chlamydia.

Between 10 and 15 percent of women with one of these infections will develop PID. If diagnosed early enough, the infection can be treated with antibiotics and long-term complications are avoided.

The longer PID goes untreated, the more like you are to have complications from scarring, adhesions, and blocked fallopian tubes. Those complications include ectopic pregnancy, infertility, and chronic pelvic pain.

You can have PID with no symptoms, but if you do have symptoms, they look like this:

  • nausea or vomiting
  • pelvic or abdominal pain
  • painful urination
  • abnormal vaginal bleeding
  • pain during sex
  • fever or chills
  • unusual vaginal discharge

If you have nausea before or during your period, and any of the above conditions sound like a match, call your healthcare provider. All of these causes of nausea are treatable, so you don’t have to suffer through every period.

Treatment will relieve your symptoms or at least take the edge off so you can get on with life. Also, let your doctor know if period symptoms like nausea, cramps, pain, and emotional symptoms are impacting your daily activities.

There are a number of medications that can help with PMS, PMDD, PID, and endometriosis. Once you have a diagnosis, your doctor will recommend appropriate treatment. Below are some of the options for treating these four menstrual monsters and their associated symptoms.

She said, he said, NSAIDs for pain relief

Nonsteroidal anti-inflammatory drugs (NSAIDs), the big name for those tiny over-the-counter (OTC) pills most commonly used for pains of all kinds.

If your nausea is related to the pain of cramps, headaches, and backache, NSAIDs can really help. You can find these examples on your drugstore shelves, no prescription needed:

  • ibuprofen (Advil, Motrin)
  • naproxen (Aleve)
  • aspirin

Taking one of these before your period starts may prevent or lessen period pain and nausea. NSAIDs prevent the production of prostaglandins, those little painful jerks.

Birth control and period control, for the win

Oral contraceptive pills may reduce symptoms of PMS, PMDD, and endometriosis. Birth control pills use synthetic hormones to control the hormones your body produces during your cycle and prevent pregnancy.

By metering hormone levels, the Pill can relieve conditions that are caused by fluctuations around the time of your period. But a word of warning: They sometimes may make things worse. Talk to your doctor about choosing the best option.

Treat your feels

While your nausea is likely linked to the pain and gastrointestinal symptoms of the conditions listed above, emotional symptoms are a major part of both PMS and PMDD.

Your doctor may prescribe anti-anxiety medications or antidepressants like selective serotonin reuptake inhibitors (SSRIs). It’s a mouthful, right? Simply put, SSRIs control the levels of serotonin in your brain, which can help with the emotional symptoms of PMS and PMDD.

These three SSRIs are approved by the Food and Drug Administration to treat PMDD:

  • sertraline (Zoloft)
  • fluoxetine (Prozac)
  • paroxetine HCI (Paxil)

Some SSRIs may cause nausea, so be sure to tell your doc that’s a side effect you want to avoid.

Antibiotics are anti-PID

If your doctor suspects PID is the cause of your discomfort, she will prescribe an antibiotic to treat the underlying infection.

Antibiotics can unfortunately cause their own gastrointestinal side effects, but it’s important to take the entire course of treatment to stop the infection and prevent serious long-term complications of PID.

While PMS, PMDD, endometriosis, and PID can be serious enough to require a doctor’s input, there are steps you can take at home to improve nausea and other symptoms. Try some of these tips for general health and more comfortable periods:

  • Beat stress. Try yoga, massage, journaling, or meditation.
  • Exercise. Getting regular activity all month long will make you feel better both physically and mentally.
  • Eat to feel better. Eating a variety of foods and avoiding excess sugar, salt, and caffeine in the 2 weeks before your period may reduce PMS symptoms. You probably know what foods help settle your stomach and make you feel better (maybe a little bananas, rice, applesauce, or toast?) Listen to your gut!
  • Get your Zzz’s. Sleeping about 8 hours each night has many health benefits, but most importantly, it can help you ditch the fatigue, anxiety, and depression that comes with your period.
  • Don’t smoke. Smoking makes PMS symptoms worse.

There’s also evidence these alternative treatments are good for nausea:

  • Fennel. One study shows it effectively reduced period nausea. Participants were given 30 milligrams of fennel every 4 hours around the start of their periods. Treatment continued for 3 months.
  • Ginger. Ginger is a traditional treatment for dysmenorrhea and other causes of nausea and vomiting. Researchers think it has an impact on the production of prostaglandins. Participants in this study took ginger capsules from 7 days before menstruation to 3 days after for 3 months. They experienced reduced nausea and other gastrointestinal symptoms.
  • Acupressure. Applying pressure to the Nei Guan (P6) point is believed to relieve nausea and upset stomach. Find your Nei Guan acupressure point three finger widths below your wrist on the inner forearm. Apply pressure between the two tendons in that spot and massage for 4 to 5 seconds for nausea relief.

Nausea is a pretty normal symptom on the wild ride through your monthly menstrual cycle. Period nausea is typically related to pain from cramps or disruptions in your gastrointestinal system.

You may be feeling barfy because of premenstrual syndrome, premenstrual dysphoric disorder, endometriosis, or pelvic inflammatory disease.

Because these conditions can cause other serious symptoms, it’s important to talk to your doctor about treatment, especially if nausea, pain, and emotional symptoms disrupt your daily life.

You can try home remedies for nausea and talk to your doctor about a diagnosis to get on the right medication for you.

If you suspect you have PMDD, and experience any thoughts of hurting yourself or others, call 911 immediately.