Patient: I had unprotected sex about a month ago but I am on the pill, I have just had my period, but for the last 3 nights I have been waking up in the middle of the night feeling really sick, could i be pregnant?
Doctor: First of all, let me remind you that the pill is >99% effective if used perfectly, meaning, taking the pill on the sa me time everyday (e.g. 9pm everyday). This is because most pills exert their effect within 24 hours +/- 2-5 hours (again, this depends on the brand). If you have been doing this and you just had your period, then there is a low possibility of being pregnant. The term “really sick” is too broad for me. Did you mean nauseated? Or feels like vomiting? Or feverish? Signs and symptoms of early pregnancy include nausea and vomiting but this usually happens in the morning. However, it is also possible you are having reflux symptoms (upward flow of acid from the stomach to the esophagus and may reach the mouth, hence may feel nauseated [?], acid taste in the mouth, some feels chest tightness). The reason for this is acid from the stomach can easily slide upward when lying down than when standing or sitting up (laws of gravity). More importantly, peak acid secretion of the stomach happens at night that’s why some people wake up in the middle of the night because of reflux symptoms. Common factors associated with increased acid production (which may result to reflux) are smoking, stress, too much caffeine, among others. You may try over-the-counter antacids (e.g. Maalox, also safe in pregnancy, to help with these symptoms). Also, you may use 2-3 pillows at night to elevate your head (lesser chances of reflux). These are merely suggestions. If you want to be sure if you are pregnant or not, you may do a home pregnancy test. Do this early in the morning (first morning urine upon waking up) because the urine is most concentrated at this time. I would still suggest for you to see a doctor just to be sure your symptoms have no underlying serious condition. I do hope I have answered your question. Take care always.