Is There a Link Between HG and Menopause Symptoms?

I am a 37-year-old who had severe hyperemesis gravidarum during my one (and only) pregnancy 2.5 years ago. Are there any known or suspected links between having HG and having a rough time with menopause? I still have some lingering HG symptoms (smell sensitivity is the worst, and still some nausea and food aversion), and my periods have been kind of wild even this long after having my baby. I am just trying to gear myself up for experiencing yet another roller coaster.

—HG but not Wells

Hyperemesis gravidarum — severe nausea and vomiting in pregnancy — is a challenging diagnosis. Understandably, you would be concerned that it might be the gift that keeps on giving all the way into menopause. However, there is no evidence that having a history of HG has any effect on how a woman experiences the perimenopausal transition.

In the absence of any data, I think it is helpful to consider whether the reason there is no evidence is because there is no connection between HG and perimenopausal symptoms or because it hasn’t been studied. In this case, I suspect it is because there is no connection. While we are just beginning to understand what causes HG, we suspect that it is most likely related to the hormones of pregnancy and the body’s response to those hormones.

Perimenopause is almost the opposite of pregnancy when it comes to which hormone levels are high and what causes symptoms. In pregnancy, progesterone and human chorionic gonadotropin (hCG) levels are high. In perimenopause, there is little (if any) hCG in circulation, and progesterone levels are, in general, lower than during the reproductive years. Follicle-stimulating hormone, which may play a key role in perimenopausal symptoms, is high during perimenopause and undetectable in pregnancy.

Put another way, the hormonal milieu of pregnancy is very different from the hormonal milieu of perimenopause. As a result, there is no reason to think that your experience of one will bear any resemblance to your experience of the other. Good news if you had HG.

The takeaway: There is no evidence of a connection between hyperemesis gravidarum and the severity of perimenopausal symptoms. And because different hormones are at play in each process, there is no easy way to explain how they might be connected.