Early pregnancy symptoms: What to expect and when

1. Missed or lighter period / implantation bleeding

For those with regular cycles, a missed period is often the earliest and most reliable indicator of pregnancy. Some may notice very light bleeding – implantation bleeding – around the time of the expected period, but lighter and shorter in duration.

When detectable: Usually from about 4 weeks pregnant – when a period is due, though implantation spotting occurs roughly 5–14 days after conception.

Advice: If spotting is light and brief, it’s often normal, but if bleeding is heavy or accompanied by pain, contact a GP or midwife.

 

2. Feeling sick (nausea / morning sickness)

Nausea – brain-foggy “morning sickness” – can strike at any time of day or night, and typically begins around weeks 4–6. It peaks between weeks 8 and 16, sometimes lasting beyond week 20 in 10% of women. A more severe form, hyperemesis gravidarum, leads to persistent vomiting and requires medical attention.

Management tips:

• Eat 6 small meals a day and keep snacks by your bed.
• Sip fluids throughout the day, avoid skipping meals, and rest often.
• Ginger (tea, ale, biscuits) may reduce nausea; some also find acupressure wristbands helpful.
• If you are unable to keep food or water down, see your GP or midwife; treatment options may include vitamin B6 (pyridoxine) and doxylamine.

 

3. Tiredness and fatigue

Extreme tiredness is common in early pregnancy – driven by hormonal shifts – and may begin very early, even when your baby is tiny.

When detectable: Often felt within the first few weeks and may last through the first trimester.

Management advice:

• Prioritise rest and sleep.
• Light exercise, such as walking, can boost energy.
• Accept help with chores where possible.

 

4. Sore or tender breasts

Early hormonal changes may cause breasts to become larger, tingling, tender or sore, with more visible veins, darkened nipples or areolas.

When detectable: Very early – often around week 4 onward.

Management:

• Wear a well-fitting, supportive bra.
• Avoid tight or underwiring that causes discomfort.

 

5. Increased urination

You may notice the need to pee more often, including through the night, as early as the first few weeks.

Management tips:

• Reduce fluid intake in the evenings to ease nighttime trips.
• Stay hydrated – especially during the day.

 

6. Strange tastes, smells, food aversions or cravings

Many experience a strange (often “metallic”) taste in the mouth, heightened smell sensitivity, aversions to previously enjoyed foods, or new, strong cravings.

Onset: Typically starts around 4 weeks and through early weeks.

Management:

• Eat what feels tolerable.
• Avoid triggers, such as strong smells.
• Keep bland, easily tolerated foods on hand (e.g., toast, plain rice).

 

7. Bloating, cramping and digestive discomfort

Changes in hormone levels can cause bloating, cramping (like period pains), heartburn and indigestion.

Management:

• Eat small, frequent meals and avoid late-night eating.
• Walk gently after meals.
• Avoid spicy, fatty, or caffeine-rich foods.
• For heartburn, try antacids or alginates if dietary changes aren’t enough.

 

8. Mood swings and emotional changes

Hormonal surges may lead to emotional ups and downs – one moment happy, the next tearful or anxious.

Management:

• Rest and practice self-care.
• Mindfulness and talking through feelings with someone trusted can help.
• If low mood persists, seek support – 1 in 5 pregnant women experience mental health challenges.

 

9. Skin, hair and pigmentation changes

You may notice darkening of certain areas – “mask of pregnancy” (chloasma) on the face, skin darkening around nipples, or thicker, shinier hair.

Management:

• Use gentle, hydrating skincare and sunscreen if pigmentation occurs.

 

10. Other possible signs (less common or later)

The NHS also notes a range of additional signs, though they often appear slightly later:

• Constipation, back or pelvic pain, bleeding gums, swollen ankles, leakage, pelvic girdle pain – but more typical in later weeks.

Management:

• For constipation: high-fibre diet, hydration.
• For pelvic/back pain: posture, rest; consult your midwife or online NHS guides for exercises and support.
• Any new or persistent symptoms, discuss with your midwife or GP.

 

What to do if you suspect you might be pregnant

1. Take a home pregnancy test

Home tests are very reliable if used correctly and taken from the first day of a missed period.
If the result is negative but your symptoms persist, wait a week and test again.

2. Contact the NHS for pregnancy care

You don’t usually need to see a GP first; you can refer yourself for NHS pregnancy care directly. For example, if you live in Liverpool, you can register directly with Liverpool Women’s Hospital via their website.

3. If symptoms are severe or worrisome

• If experiencing uncontrollable vomiting → potential hyperemesis gravidarum → seek urgent help.
• If you experience any bleeding, no matter how light, contact your GP or midwife promptly.

4. Ongoing support

• Sign up for Start4Life pregnancy emails for trusted weekly guidance from NHS.
• Reach out early: support from midwives, mental health support, dietary advice – all easily accessible through NHS services.

 

Common pregnancy symptoms and management

Symptom	Timing (approx.)	Management tips
Missed period / implantation	≈4 weeks / 5–14 days post-conception	Track cycles; test and consult GP if needed
Nausea / morning sickness	4–6 weeks onward	Small meals, ginger, rest, medical help if severe
Fatigue	Early first trimester	Rest, light activity, reduce stress
Breast tenderness	Weeks 4 onward	Supportive bra, gentle care
Frequent urination	Early weeks	Hydrate during day, reduce fluids at night
Taste/smell changes	Weeks 4+	Avoid triggers, comfort foods
Bloating / cramping / heartburn	Weeks 4–10+	Eat small meals, avoid late meals, antacids if needed
Mood swings	Throughout early weeks	Rest, talk, seek mental health support if needed
Skin, hair changes	First trimester	Gentle skincare, sunscreen where needed
Other symptoms (constipation, etc.)	Often later or variable	Diet, hydration, posture, consult your midwife/GP

 

Symptoms may vary

Early pregnancy symptoms vary widely, from classic signs such as a missed period and nausea, to subtler or rare symptoms such as pigmentation changes or bloating. It’s important to remember:

• Every pregnancy is unique. You may experience many, few, or different symptoms.
• Management often starts with simple self-care, but don’t hesitate to seek medical guidance when needed.
• NHS guidance and services are there to help – from pregnancy testing to emotional support and antenatal care.