Written by Marie Ellis
Reviewed by Sammie Gill
Unfortunately, it’s not unusual to feel bloated, tired and nauseous.
For instance, nearly 1 in 5 people experience bloating each week, and it’s twice as common in females, compared with males.
Often, simple strategies can help. But these symptoms sometimes signal an underlying health condition.
In this article, we’ll outline why you might feel bloated, sick and tired. We’ll also describe ways to ease the discomfort and when to visit a doctor.
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Strategies to try
First, here are some general techniques for reducing bloating. All of these are are worth a try:
- Eat smaller meals.
- Eat more slowly.
- Limit salt.
- Limit carbonated drinks.
- Keep active.
- Slowly add more fibre to your diet.
- Avoid chewing gum.
We’ll expand on some of these later on. You can also explore more ways to get rid of bloating here.
Causes in females
Here, we’ll look at some female-specific causes of bloating, fatigue and nausea. Then, we’ll move to more general causes.
1. Premenstrual syndrome
Premenstrual syndrome (PMS) is common in the weeks before your period. Symptoms vary widely, but they can include bloating, tiredness and nausea.
In fact, the authors of a review suggest that ‘abdominal bloating and excessive fatigue’ are the most common physical symptoms of PMS.
What to do: Some of the strategies above might help ease bloating from PMS. You could also try a heat pad or hot water bottle, abdominal massage, and gentle exercise, such as yoga or swimming.
But if your symptoms are significantly affecting your life, speak with a doctor or pharmacist about other options.
For instance, pain medications and the contraceptive pill can relieve symptoms of PMS, including bloating, for some people.
2. Endometriosis
Endometriosis is a long-term (chronic) condition. It occurs when cells similar to those of the uterine lining grow in other parts of the body.
Endometriosis affects around 1 in 10 females of reproductive age globally. Some of the most common symptoms of endometriosis are:
- painful periods
- abdominal pain
- pain during sex
- painful bowel movements
Symptoms can also include bloating, fatigue and nausea.
What to do: Medicines and surgery can help reduce the symptoms of endometriosis. If you think you might have it, visit your doctor to explore the treatment options.
While there’s no diet designed to manage endometriosis, it’s important to prioritise plant foods, such as whole grains, nuts, seeds, fruits, vegetables and legumes.
This is because plants contain anti-inflammatory compounds, such as polyphenols.
Studies also suggest that vitamin D could support endometriosis management. In the United Kingdom, guidelines recommend that everyone take 10 micrograms of vitamin D every day, particularly during winter months (October to March).
3. Fibroids
Fibroids are growths that form in the uterus. They’re not cancerous, and they occur in up to 70% of females across their lifetime.
Black women are significantly more likely to have fibroids, compared with other women.
Not everyone with fibroids has symptoms. For those who do, the most common symptom is heavy bleeding, which can lead to anaemia and fatigue. Some people also experience bloating.
Some medicines and nonsurgical procedures can relieve symptoms, and surgery is also an option. Often, symptoms improve or disappear during the menopause.
What to do: Speak with a doctor if you’re concerned that your bloating and fatigue might be related to fibroids.
If you’ve already received a diagnosis, some of the strategies above may help reduce bloating, alongside your current treatments.
4. Ovarian cancer
This section focuses on cancer, but it’s important to remember that bloating is extremely common, and most causes are everyday issues relating to constipation or diet. These we explore below.
In the UK, ovarian cancer accounts for 4% of all cancer cases in females. It’s most common in people aged 75–79.
Symptoms tend to be relatively subtle, but they can include abdominal or pelvic bloating.
Other symptoms can include:
- pain or tenderness around your abdomen
- reduced appetite
- feeling full soon after eating
- needing to pee more often, or urgently feeling the need
- vaginal bleeding after the menopause
- back pain
- unexplained weight loss
What to do: If you’ve had persistent bloating for 2 weeks or more, visit your doctor, who can investigate the cause of your symptoms.
General causes
Now we’ll move on to causes of bloating, nausea and tiredness that can affect anyone.
5. How and what you eat
Often, bloating is caused by what or how you eat.
For instance, eating too quickly can cause gas. You’re likely to swallow more air, which can build up in your gut.
Similarly, eating too much can cause bloating, as can carbonated drinks and foods high in salt.
What to do: Try reducing your portion size, eating more slowly and chewing your food well. It’s also a good idea to reduce your intake of fizzy drinks and salty foods.
6. Irritable bowel syndrome
Irritable bowel syndrome (IBS) is a common condition that affects the gut. Symptoms include:
- stomach cramps
- bloating
- nausea
- diarrhoea
- constipation
- excess wind
While anyone can have IBS, it’s more common in females.
Females with IBS are more likely to report nausea and bloating than males, and the symptoms may worsen in line with your menstrual cycle.
Females with this condition are also more likely to report insomnia and fatigue.
Because the causes of IBS are highly varied, treatments also vary. Reducing stress and making dietary changes can help. Your doctor might also prescribe a certain diet, such as the low-FODMAP diet.
What to do: If you think you might have IBS, speak with your doctor for advice.
7. Food intolerances
If you have trouble digesting a specific food or ingredient, experts call this a food intolerance. Symptoms can include bloating, nausea and fatigue.
While food intolerances can affect anyone, they are more common in females than males.
Because we eat hundreds or thousands of compounds every day, it can be challenging to get to the bottom of food intolerances.
But some of the most common food intolerances are caused by:
- products containing sulfites, such as processed meats
- salicylates, which are in many fruits and vegetables
- FODMAPs, a type of carbohydrate in a wide range of foods
- biogenic amines (such as histamine), which occur in fermented foods, alcoholic drinks and some fruits and vegetables
- lactose, a sugar in cow's milk and dairy products, including yoghurts and cheeses
What to do: If your bloating occurs only occasionally, try keeping a food and symptom diary. This can help you spot patterns and, over time, identify what’s triggering your symptoms.
There are no specific treatments for food intolerances, but removing the trigger and replacing it with suitable alternatives generally resolves the issue.
If you think you have a food intolerance, speak with a registered dietitian for guidance and support.
8. Constipation
If you don’t poo very often – fewer than 3 times a week – or you find it difficult or painful to poo, you might be constipated.
It’s a common cause of bloating, and it can also make you feel sick.
Females are twice as likely as males to experience constipation. Scientists don’t know precisely why, but food may move more slowly through the gut at certain stages of the menstrual cycle due to the influence of sex hormones.
Also, women generally have longer intestines than men, and this could play a role.
What to do: To relieve constipation, some lifestyle and behaviour changes can help, including the strategies at the top of this article, like eating more fibre.
Plants are rich in fibre, so start adding more fruits and vegetables to your diet. It’s a good idea to begin gradually over a few weeks to give your gut time to adapt.
Fibre feeds your gut bacteria, which is a good thing. But as these bacteria digest fibre, they produce gas, which can increase bloating.
Meanwhile, make sure you drink enough water and exercise regularly. Both approaches help keep things moving.
It’s also important to listen to your body – when you feel the urge, go to the loo, don’t hold it in.
Constipation can be linked to certain medications, as well as anxiety and depression. Speak with a doctor if you think any of these might be a trigger.
Although over-the-counter medicines can help keep you regular, it’s important to identify the cause of constipation.
9. Coeliac disease
Coeliac disease is caused by an autoimmune reaction to gluten.
It affects almost 1 in 100 people in Europe, and globally, the rate is around 50% higher in females than males.
Symptoms of coeliac disease can include:
- bloating
- nausea
- fatigue
- vomiting
- diarrhoea
- constipation
- gas
- abdominal pain
These symptoms overlap with those of other gut conditions, such as IBS. It's important to understand the root cause.
What to do: There’s no cure for coeliac disease, but a strict, life-long gluten-free diet is very important for your long-term health.
Doctors can diagnose coeliac disease using a blood test, so make an appointment if you’re concerned.
10. Stress
Everyone experiences stress, but some evidence suggests that females experience more stress than males.
For some people, stress can produce physical symptoms, including:
- constipation
- insomnia and fatigue
- nausea, indigestion and heartburn
- changes to your menstrual cycles
- blurred vision
- trouble breathing
What to do: Tackling stress is challenging, but there are some techniques to try, such as:
- meditation
- yoga
- deep breathing exercises
- journaling
- massage
- regular exercise
- connecting with family and friends
- reducing your alcohol intake, if you drink
- getting enough sleep
- counselling or other talking therapies
If you think your stress levels are affecting your quality of life, and nothing seems to help, speak with your doctor.
What else?
Other conditions and circumstances can cause bloating, fatigue and nausea, including:
- Sleep deprivation: This can make gut symptoms feel worse.
- Gastroenteritis: This common infection causes nausea and vomiting.
- Food poisoning: This often causes bloating, stomach cramps, nausea and gut pain.
- Small intestinal bacterial overgrowth (SIBO): This involves too many bacteria gathering in the small intestine. Bloating and nausea are common symptoms, and people with SIBO also report fatigue.
- Gastroparesis: This involves food staying in your stomach for too long. Bloating and nausea are two common symptoms.
When to seek help
If you’re concerned about any symptoms, visit your doctor.
The following signs and symptoms are more likely to suggest a more serious condition:
- unexplained or rapid weight loss
- difficulty swallowing or pain when you swallow
- large quantities of diarrhoea or diarrhoea at night
- persistent or severe abdominal pain
- blood in your urine or poo
- significant changes in the colour or frequency of your poo
- loss of appetite or feeling full quickly
Summary
Bloating, nausea and tiredness are incredibly common. Most of the time, they pass on their own, but less often, they can signal a more serious condition.
For fleeting symptoms, try drinking more water, gradually adding more fibre to your diet, and reducing your intake of salty and highly processed foods. It’s also important to stay active.
If you’ve tried some of our suggestions and your symptoms haven’t improved, or if you’re experiencing any of the warning signs, make sure to visit your doctor as soon as you can.
To learn more about the science behind gut health, visit Symprove’s Gut Hub.
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