What to Know About Early Signs and Symptoms of Pregnancy
Picture of The Three Stages of Pregnancy
- Signs and symptoms of early pregnancy can occur before the missed period and be confused with those of premenstrual syndrome (PMS) or the approaching menstrual period. It is not possible to determine if you are pregnant (in the absence of having a menstrual period) until a pregnancy test is positive.
- Not all women will experience the same symptoms in early pregnancy or experience these symptoms to the same degree. The time when very early pregnancy symptoms and signs start is also different for every woman. Feelings of breast swelling, tenderness, or pain are also commonly associated with early pregnancy.
- A persistently elevated basal body temperature (the oral temperature measured first thing in the morning, upon arising from sleep) is another characteristic sign of early pregnancy. Nausea and vomiting, sometimes known as "morning sickness" typically begin in weeks 2-8 of pregnancy. Other possible early pregnancy symptoms are mood swings, fatigue, changes in skin pigmentation, frequent urination, and headache.
How Early Do Pregnancy Symptoms Start?
Most often the first sign of pregnancy is a missed menstrual period.
Women in the early stages of pregnancy may experience a number of different symptoms that may signal a pregnancy. While a missed menstrual period is often the characteristic sign of pregnancy, women who do not have regular menstrual cycles may not recognize that a menstrual period has been missed. In some cases, breast tenderness or other symptoms are the first sign of pregnancy. Still, other women may not experience any particular symptoms at all during early pregnancy and may not be aware of their condition.
A missed menstrual period is most often the first sign of pregnancy and is a common first-trimester symptom. Sometimes a woman who is pregnant may still experience some bleeding or spotting around the time of the expected period, typically 6-12 days after conception. When it occurs, this so-called "implantation bleeding" is generally not as heavy or long as a regular menstrual period. This small amount of bleeding that happens at the time of the expected menstrual period occurs because the fertilized egg attaches to the uterine wall. This is referred to as implantation bleeding.
Any bleeding during pregnancy is typically lighter than that observed during the regular menstrual period. However, if a woman does not have regular menstrual cycles, she may notice some of the other symptoms of early pregnancy before it is apparent that the menstrual period has been missed. A missed menstrual period also does not confirm that a woman is pregnant even if she has regular cycles, since both emotional and physical conditions may cause absent or delayed periods.
The experience of pregnancy symptoms is highly individualized and differs among women. In fact, a woman may experience different symptoms in a second or subsequent pregnancy than she did in her first pregnancy.
How to Tell the Difference Between Pregnancy Symptoms vs. PMS Symptoms
Sometimes, a woman may have symptoms and not be sure whether she is pregnant or not. Many symptoms of early pregnancy, including breast tenderness, fatigue, bloating and mild cramping, can also signal an approaching menstrual period or may be related to premenstrual syndrome (PMS).
If you have not had a menstrual period and these symptoms are present, the only way to determine if you are pregnant is to take a pregnancy test.
What Are Common Early Signs and Symptoms of Pregnancy?
Other than missed periods, there are many other symptoms of pregnancy.
Many women have questions regarding the early symptoms of pregnancy and may wonder if their symptoms are suggestive of pregnancy. This article focuses on the most common symptoms a woman might experience in the first trimester of pregnancy. In addition to a missed period, these include:
- Breast tenderness
- Nausea and vomiting (morning sickness)
- Food cravings
- Abdominal cramping and bloating
- Frequent urination
- Elevated basal body temperature
- Changes in nipple color
- Darkening of the skin
- Mood swings
How Much Weight Gain Is Safe During Pregnancy?
Women can expect to gain about a pound per month during early pregnancy.
There is usually only a small amount of weight gain in the first trimester of pregnancy. In this early stage of pregnancy, a weight gain of about one pound per month is typical. Many women report cravings for certain foods during the early stages of pregnancy.
Morning Sickness (Nausea and Vomiting)
Nausea and vomiting (morning sickness) also are common in early pregnancy. Traditionally referred to as "morning sickness," nausea and vomiting associated with early pregnancy can occur at any time of the day or night. Its typical onset is anywhere between weeks 2-8 of pregnancy. Most women who have morning sickness develop nausea and vomiting about one month after conception, but it may develop sooner in some women. Sometimes women report an increased sensitivity to certain odors that can sometimes cause nausea and/or vomiting.
Elevations in progesterone that occur early in pregnancy are thought to slow the emptying of the stomach and may be related to the development of nausea. Accompanying the characteristic "morning sickness" may be cravings for, or aversions to, specific foods or even smells. It is not unusual for a pregnant woman to change her dietary preferences, often having no desire to eat previous "favorite" foods, and desiring to eat foods that were previously not preferred. In most women, nausea and vomiting begin to subside by the second trimester of pregnancy.
Breast Swelling, Tenderness, and Pain
Feelings of breast swelling, tenderness, or pain are also commonly associated with early pregnancy. These symptoms are sometimes similar to the sensations in the breasts in the days before an expected menstrual period. Women may also describe a feeling of heaviness or fullness in the breasts. These symptoms can begin in some women as early as 1-2 weeks after conception.
Some women may experience feelings of abdominal enlargement or bloating, but there is usually only a small amount of weight gain in the first trimester of pregnancy. In this early stage of pregnancy, weight gain of about 1 lb per month is typical. Sometimes women also experience mild abdominal cramps during the early weeks of pregnancy, which may be similar to the cramps that occur prior to or during the menstrual period.
Mood Swings and Stress
Mood swings and stress are common symptoms reported by many women in the early stages of pregnancy. Many women in the early stages of pregnancy describe feelings of heightened emotions or even crying spells. The rapid changes in hormone levels are believed to cause these changes in mood. Pregnant women may also notice more rapid and drastic changes in their moods. As with other nonspecific symptoms, mood swings can be caused by a number of conditions other than pregnancy.
Some women report suffering from headaches early on in their pregnancy, which may be related to corresponding changes in hormone levels. These headaches are nonspecific, usually not involving just one side of the head, and are not accompanied by changes in vision.
Fatigue and Tiredness
Fatigue and tiredness are symptoms experienced by many women in the early stages of pregnancy, and some women report feeling fatigued even in the weeks immediately prior to conception. The cause of this fatigue has not been fully determined, but it is believed to be related to rising levels of the hormone progesterone. Of course, fatigue is a very nonspecific symptom that can be related to many causes other than pregnancy.
Changes in Nipple Color
Women may notice a deepening of the color of the area surrounding the nipple, called the areola and/or a dark line going down from the middle of the central abdomen area to the pubic area (known as the linea nigra). Some degree of darkening of the areola persists after pregnancy in many women, but the linea nigra typically disappears in the months following delivery of the baby.
Related to morning sickness, a pregnant woman may find that her dietary preferences have changed. It may be that certain foods or smells aggravate nausea and vomiting of early pregnancy, or she may experience true food cravings. Food cravings can begin in the first trimester and last throughout the pregnancy.
A woman in the early stages of pregnancy may feel she has to urinate frequently, especially at nighttime, and she may leak urine with a cough, sneeze, or laugh. The increased desire to urinate may have both physical and hormonal causes.
Once the embryo has implanted in the uterus, it begins to produce the hormone known as human chorionic gonadotrophin (hCG), which is believed to stimulate frequent urination. Another cause of frequent urination that develops later is the pressure exerted by the growing uterus on the bladder, but this does not cause frequent urination until the second and third trimesters when the fetus is substantially larger.
Elevated Basal Body Temperature
A persistently elevated basal body temperature (the oral temperature measured first thing in the morning, upon arising from sleep) is another characteristic sign of early pregnancy. An elevation in the basal body temperature occurs shortly after ovulation and persists until the next menstrual period occurs. Persistence of the elevated basal body temperature beyond the time of the expected menstrual period is another sign of early pregnancy.
Melasma (Darkening of the Skin)
Some women may develop a so-called "mask of pregnancy" in the first trimester, referring to a darkening of the skin on the forehead, bridge of the nose, upper lip, or cheeks. The darkened skin is typically present on both sides of the face. Doctors refer to this condition as melasma or chloasma, and it is more common in darker-skinned women than in those with lighter skin. Melasma can also occur in some conditions other than pregnancy. Women who have a family history of melasma are at greater risk of developing this sign of pregnancy.
What Are the Signs and Symptoms of an Ectopic or Tubal Pregnancy?
An ectopic pregnancy is a condition in which the fertilized egg attaches to an abnormal location outside the uterus. In this situation, the fetus cannot survive, and treatment is necessary to prevent complications such as rupture and bleeding. Often, the site of implantation of an ectopic pregnancy is the fallopian tube which is thus termed a tubal pregnancy.
In the early weeks of pregnancy, the symptoms of an ectopic or tubal pregnancy are similar to those in a normal pregnancy. However, by weeks 6-8 after the missed menstrual period, unusual and uncommon symptoms develop, including:
It is important to seek medical care any time you develop these or other unusual symptoms during pregnancy.
Reviewed on 10/28/2022
Pregnancy Diagnosis. Medscape. Updated: Mar 28, 2017.