A missed menstrual period is often the first recognizable sign of a possible pregnancy, but there are other signs and symptoms of early pregnancy as well. Some subtle signs appear in the first week, and more may be apparent in the weeks before your first missed period.
Keep in mind that not all women have all symptoms or experience them in the same way. Some of the most common first trimester pregnancy symptoms are discussed in the following slides.
The first sign many women recognize as an early sign of pregnancy is a missed menstrual period (amenorrhea). Some women may experience lighter-than-normal periods, and they may also have spotting that can occur 1 to 2 weeks following conception.
A missed menstrual period can be caused by other conditions aside from pregnancy, so it is not always a definitive sign.
Breast enlargement, tenderness, or pain similar to premenstrual symptoms can occur early in pregnancy. The breasts may feel full or heavy, and the area around the nipple (areola) may darken. A dark line called the linea nigra that runs from the middle of the abdomen to the pubic area may appear. You may notice tenderness or swelling in your breasts in the first or second week after you conceive.
"Morning sickness" is nausea and vomiting that typically come in the morning in early pregnancy. This usually happens between weeks two and eight of pregnancy. It's somewhat a misnomer because the nausea and vomiting can actually happen at any time. It's thought that changes in levels of estrogen may play a role in developing nausea.
Another early pregnancy sign may be food cravings or aversions. Women may have an unusual urge to eat a particular food, even one she previously did not like, or she may be completely repulsed by a food she used to love. This is common, and usually the food aversions fade at the end of the first trimester.
The extra progesterone in a woman's body during pregnancy may cause her to feel fatigued and tired, and her need for naps increases. By the second trimester, energy levels usually rise again.
The rise in progesterone during pregnancy can also cause abdominal bloating, fullness, and gas. The weight gain in the first trimester is usually minimal, but swelling and fluid retention may make you feel as if you have gained more than the typical one pound per month.
The urge to urinate more frequently starts about six weeks into pregnancy, thanks to the hormone human chorionic gonadotrophin (hCG), which causes increased blood flow to the pelvic area and can stimulate the urge to urinate. Later in pregnancy, the urge to urinate may be increased by the growing baby in the enlarging uterus putting pressure on the bladder.
Many women hoping to become pregnant will chart their basal body temperature (the lowest body temperature in a 24-hour period, usually first thing in the morning after waking). The basal body temperature usually rises around ovulation and lasts until the next menstrual period. If the basal body temperature stays high for longer than that, this may indicate pregnancy.
During the first trimester, the skin on your forehead, bridge of your nose, upper lip, or cheekbones may darken. This is often referred to as the "mask of pregnancy," and the medical term is melasma or chloasma. It is more common in darker skinned women and those with a family history of melasma.
Rapid changes in hormone levels during pregnancy may be responsible for mood swings and feelings of stress. Newly pregnant women may feel emotional, anxious, or depressed, and have crying spells. Mood swings may be worst in the first trimester, easing up somewhat in the second, and coming back as the pregnancy nears the end in the third trimester.
Headaches are common in early pregnancy. They may be caused by the surge of hormonal changes that begin soon after conception. Or they may be sinus headaches brought on by nasal congestion, which may also be a symptom of early pregnancy.
About 15% to 25% of pregnant women experience light bleeding or spotting in early pregnancy. This symptom can begin as soon as one week after conception. You may also experience light bleeding following a pelvic exam, Pap test, or after sex. This is common and usually not concerning, although if bleeding occurs later in pregnancy it can be serious.
Thin, milky, vaginal discharge is normal throughout pregnancy, and it may occur every day that you are pregnant. This is called "leukorrhea," and it is caused by the extra estrogen your body is now producing. This discharge may be white or clear, and it may have a mild odor or none at all, all of which is normal. This is a necessary side effect of pregnancy, so there is no medical treatment for leukorrhea. However, it may be distressing for some women. Panty liners can help. But avoid tampons, which may cause infections.
Many pregnant women become constipated. Possibly more than 35% of pregnant women develop this discomfort according to some experts. This may be due to the hormonal changes that pregnancy causes, including an increase in progesterone.
If you have constipation, your doctor may tell you to drink more fluids, eat more fiber, and get enough exercise to move things along. But if these safe remedies don't work, with a doctor's guidance you may find other helpful treatments that are safe during pregnancy, such as certain types of laxatives. Do not take any medication while pregnant without your doctor's recommendation.
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- The American College of Obstetricians and Gynecologists: "Bleeding during pregnancy."
- American Pregnancy Association: "Vaginal discharge during pregnancy."
- Canadian Family Physician: "Treating constipation during pregnancy."
- Lamaze International: "Discharge during pregnancy: What’s normal?"
- NICHD: "What are some common signs of pregnancy?"
- Stanford Children's Health: "Headaches in Early Pregnancy."
- UpToDate: "Clinical Manifestations and Diagnosis of Early Pregnancy."