Pregnancy: Recognizing the First 12 Signs

Nausea, missed periods, fatigue: the early signs of pregnancy are numerous. While some of them need no introduction, others such as cramps or acne are often less well known. So how can you recognize them? Can you really rely on them? What impact does the pill have on these early symptoms?

Let’s break it down!

When do the first signs of pregnancy appear?

When it comes to early signs of pregnancy, not all women are in the same boat. It all comes down to genetic lottery: the intensity of symptoms, their type, and… when they appear!

First signs of pregnancy: how long after intercourse?

In most cases, the first signs of pregnancy usually appear around the end of the first month of pregnancy, that is, about two weeks after the fertilizing intercourse. Depending on the woman, these first signs may appear much earlier… or much later.
For others, these symptoms may be so mild that they don’t even realize they’re pregnant. Generally, it’s the absence of menstruation that tends to raise suspicions.

What does this period correspond to?

Like the vast majority of early pregnancy symptoms, nausea and other joys are caused… by your hormones. At the start of pregnancy, your body — more specifically your placenta — begins to secrete the ultimate pregnancy hormone: beta-hCG. This hormone acts on the corpus luteum (what’s left of the follicle that contained the egg), and from 8 weeks onwards, on the placenta to produce two very important hormones: progesterone and estradiol (estrogens).
The level of progesterone will gradually increase throughout the nine months, and estrogen levels will skyrocket from the start of pregnancy, quickly reaching very high levels — the cause of the first pregnancy symptoms! The time between fertilizing intercourse and noticeable symptoms corresponds to the rise in hormone levels and how your body reacts to these changes. That’s why there’s no specific date: every body reacts differently to these changes.

What are the first symptoms when you’re pregnant?

Let’s get to the heart of the matter: recognizing the early signs of pregnancy. Of course, this list is far from exhaustive, especially knowing how much symptoms can vary from one woman to another. Still, it provides a good overview of early signs to watch for if you’re hoping to be pregnant.

Missed period

This one’s well-known: the absence or delay of menstruation is one of the first indicators of pregnancy.
However, it’s not a sufficient sign. Some women have irregular cycles, and for others, missed periods can be due to stress or periods of so-called amenorrhea (spontaneous cessation of menstruation).

Breast swelling

Breast swelling is explained by the release of the sex hormones mentioned earlier (estrogen and progesterone), produced in large amounts early in pregnancy. Nipples become more prominent and darker. Breast swelling is sometimes accompanied by breast pain.

Increased urination

During pregnancy, your growing uterus increases pressure in the abdomen. This pressure directly affects the bladder, reducing its expansion and increasing its internal pressure: so you feel the need to urinate more often.
By the end of pregnancy, you may also experience urinary leakage when sneezing (or during laughter, coughing, etc.). What’s happening: the urethral sphincter (the little “gate” between the bladder and urethra) depends on the pressure we mentioned earlier. It can’t stay closed when the pressure gets too high. It’s like “pushing in” that gate.

That’s exactly what happens when we add “natural hyperpressure” (related to pregnancy) to “thoraco-abdominal pressure on exertion” (those “hits” to the pelvic organs caused by coughing, sneezing, laughing, singing, jumping, etc.): the pressure becomes so strong that the sphincter gives way.

Fatigue

Many pregnant women experience intense fatigue during the day, and feel exhausted. And for good reason: your entire body is adjusting to allow the embryo to develop. Progesterone, which you actively secrete and which is essential to these physical changes, doesn’t help: this hormone is well known for its sedative effects.

Pains and twinges

You may feel light cramps in the lower abdomen, similar to menstrual cramps at the beginning of pregnancy. These can be due to the implantation of the embryo (when it settles into the uterine lining).
Implantation may also cause some bleeding. The future placenta attaches to the endometrial vessels, like Velcro, thanks to small extensions that dig into the endometrium.

Also note that cramps (usually in the calves) are very common during pregnancy. They are one manifestation of venous insufficiency but can also be worsened by deficiencies in magnesium, calcium and/or potassium.

Vaginal bleeding and discharge

Sometimes, slight bleeding (which can be mistaken for a period!) occurs early in pregnancy, and vaginal discharge becomes more abundant. The reason? Physiological changes taking place in your body (implantation but also hormonal changes).
As for vaginal discharge, also known as leucorrhea, it is — as we’ve seen — more abundant than usual. This is nothing to worry about unless its appearance seems unusual and/or there is a noticeable odor, in which case, consult a professional.

Digestive issues

Nausea, vomiting, and heartburn can be signs of early pregnancy and usually last through the first trimester before easing up as your body adapts to hormonal changes. Many women also experience bloating (feeling puffy or swollen in the abdomen) or constipation early in pregnancy.
Indeed, hormones — especially progesterone, whose levels rise during pregnancy — have a relaxing effect to prevent uterine contractions. But they also affect the intestines, sending them a signal to slow down, which can lead to constipation.

➡️A word on hyperemesis gravidarum: while nausea affects around 80% of pregnant women, only 1–2% experience hyperemesis — thankfully. This is a highly disabling condition involving extreme nausea and persistent vomiting, similar to having a stomach flu for weeks or even months. If you suspect you have this condition, don’t hesitate to seek help from your healthcare provider.

Weight gain or loss

Some women gain or lose weight in the first months of pregnancy. Nausea and other digestive troubles, which affect appetite, may lead to weight loss, while cravings and/or fetal development may lead to weight gain. In any case, if you notice concerning or abnormal weight changes, don’t hesitate to consult a healthcare provider.
❗Losing more than 5% of your pre-pregnancy weight requires a prompt consultation.

Acne

Due to the high levels of estrogen and progesterone during pregnancy, an acne flare-up can occur, even if you don’t usually have acne. This is because sebum production becomes unbalanced during this period.

Mood swings

Mood swings, changes in libido, altered work perception, growing impatience, forgetfulness, difficulty concentrating, fatigue, energy bursts, nightmares, all sorts of discomfort, tearfulness, uncontrollable laughter, sadness… no doubt, your hormones are having a field day. Few women go through pregnancy without some emotional swings — and that’s perfectly normal.

Shortness of breath

As we’ve seen, pregnancy may bring a number of symptoms. Here’s one you may not know: shortness of breath. While pregnant, your oxygen needs increase by 20 to 30% (since your body also supplies oxygen to the fetus and placenta). Your breathing rate increases. You feel more out of breath than usual!

Changes in taste and sensitivity to odors

All these bodily changes come with a superpower: your sense of smell becomes much more developed than usual (thanks again, hormones). But as with everything, there’s a downside: you may not be able to tolerate certain smells at all. You may have to delegate trash duty for a while!
Want to learn more? Feel free to download the May app, where you’ll find plenty of resources to support and guide you throughout your pregnancy.

Recognizing the early signs of pregnancy while on the pill

Since 1967, the pill has been legal in France and, without a doubt, hormonal contraception has played a major role in women’s empowerment… So it’s only been half a century that women have had this precious tool to avoid pregnancy.

Hormonal contraceptives all have a very high efficacy. Theoretically, they all offer at least 99.7% protection and over 90% in practice. This gap is due to the fact that contraceptive effectiveness is tested under ideal conditions. In real life, people may forget a pill, their body may react differently, or certain conditions may interfere with effectiveness.

➡️The crown for efficacy goes to IUDs and implants, with 99.8% and 99.9% effectiveness both theoretically and practically!

Still, there’s a small chance that some women, even when taking their pill regularly or using an effective contraceptive, may become pregnant.

The early signs of pregnancy may be a bit harder to notice, even though they are theoretically the same. This is because being on the pill often leads a woman to dismiss the possibility outright when symptoms appear. Plus, missed periods (the clearest sign of pregnancy) won’t show up since menstruation is already halted by the pill (even if the pill is associated with withdrawal bleeding, which should not be confused with true periods).

In case of doubt, it’s always best to consult your healthcare provider and/or take a pregnancy test.

How can you be sure you’re pregnant? Different pregnancy tests

First of all, a pregnancy test is a good way to determine if you’re pregnant. If you notice a missed period, you can take an at-home urine test. These are available in many outlets: pharmacies, grocery stores, supermarkets, etc.
Be sure to use the test with your first morning urine and do so one to two weeks after the expected date of your period. This test detects beta-hCG in your urine, and this hormone appears about 10 days after the sperm fertilizes the egg. If the test is taken too early, the result may be inaccurate and give you a false negative even if you’re actually pregnant. Be sure to read the instructions to find the best time to take your specific test.

If the test is positive, you should consult your doctor. They can order a blood test to confirm the result of the urine test.

It’s important to note that pregnancy symptoms alone are not reliable. They may suggest a possible pregnancy, but only a test or bloodwork followed by a consultation can confirm or rule out the hypothesis.

This text was translated from French by an artificial intelligence. The information, advice, and sources it contains comply with French standards and may therefore not apply to your situation. Make sure to complement this reading by visiting the May ES/UK app and consulting the healthcare professionals who are supporting you.

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Photo: Envato