Fatigue, Nausea, and Swollen Breasts: First-Trimester Pregnancy Symptoms Explained

Updated on 3/20/2023 at 2:05 PM

Whether you are actively trying to conceive or suspect you might be pregnant, knowing what early pregnancy symptoms to look out for can be really helpful. During the first trimester, a lot of changes happen pretty quickly, which means early pregnancy symptoms can happen before a missed period.

In pregnancy, the first trimester represents the earliest weeks of pregnancy and lasts until the end of the 13th week, according to the American Pregnancy Association. But how early can you really start to feel pregnancy symptoms, and what might those look like? Here's everything you need to know about first-trimester pregnancy symptoms.

How Early Can You Feel Pregnancy Symptoms?

It depends on the person. Some people feel pregnancy symptoms "within a few days of conception, while other people don't feel pregnant for weeks after a positive pregnancy test," Cleveland Clinic reports.

Some people can feel pregnancy symptoms start as early as one week after a missed period, says Amy Wetter, MD, board-certified ob-gyn at Pediatrix Medical Group.

However, there are others who can feel early pregnancy symptoms even sooner than that. According to Planned Parenthood, "some early pregnancy symptoms can sometimes feel like other common conditions (like PMS)." So if you don't typically feel PMS-like symptoms before your period is due, and you think you could be pregnant, you might be right.

For those who typically feel symptoms of PMS each month, differentiating between a potential pregnancy or just your average cycle starting on time can be challenging.

On average, according to a 2018 study published in international reproductive health journal Contraception, the majority of people (72 percent in this case) detect their pregnancy when they're six weeks pregnant, which is approximately two weeks after a missed period.

Early Pregnancy Symptoms Before Your Missed Period

Missing your period when it's usually pretty consistent is often the first clue that you might be pregnant, but there are some other subtle signs you might experience before your period is due.

According to the American Pregnancy Association, early pregnancy symptoms you might feel before your period is even late include:

Fatigue or tiredness
Nausea, especially on an empty stomach
Increased urination
Tender or swollen breasts
Light bleeding or spotting

Early Pregnancy Symptoms Week by Week

Since most pregnancy symptoms don't start to happen until around the fourth or fifth week of pregnancy, it can be hard to tell the difference between early pregnancy symptoms and signs that your period is on the way. As the weeks go on, however, the symptoms become clearer. Here's a breakdown, according to our experts.

Week 1: At this stage, your period isn't late yet; in fact, your cycle would have just ended, and you're now waiting for ovulation.

Week 2: Ovulation occurs, and during this time, you might feel slight twinges on the left or right side of your pelvis. According to Cleveland Clinic, only around 40 percent of people who ovulate are able to feel those twinges.

Week 3: Your fertile window has passed, and if sperm has found an egg, the ovum will be traveling to the uterus. Some people can feel very early symptoms at this stage, including implantation bleeding, which happens when the fertilized egg attaches to the lining of the uterus, Mayo Clinic explains. You may also experience a heightened sense of smell, nausea or mild queasiness, and breast tenderness, according to NY Presbyterian.

Week 4: Your period is likely late, and you should be able to take a home pregnancy test. You might be feeling extra tired or have waves of nausea. Tender breasts and abdominal pressure are also common.

Weeks 5-6: Nausea or morning sickness might be more consistent, and feeling tired will likely continue.

Weeks 7-9: You might experience ongoing nausea and fatigue, plus bloating, constipation, sore breasts, and heartburn.

Weeks 10-12: Many of the symptoms from the weeks before will likely continue, though nausea and fatigue may start to ease up.

Understanding Bloating in the First Trimester

For many people, one of the first and most obvious symptoms of pregnancy in the first trimester is bloating. It's also another symptom that can show up even before missing a period.

"Bloating is a very common symptom of pregnancy," Dr. Wetter shares. "This is due to the hormone progesterone, which increases in early pregnancy in order to support the fetus as it grows. A side effect of the increased progesterone is it relaxes muscles, including the muscles in your GI tract. This can slow digestion, which can cause gas to be trapped and constipation."

Weird Pregnancy Symptoms You Might Not Expect

So many fast changes happen in the first trimester, and hormones largely drive those early changes, according to Johns Hopkins Medicine. These hormones, including human chorionic gonadotropin (hCG) and progesterone, spike during the first trimester and drive many necessary changes for the pregnancy to develop.

"HCG hormone levels found in the mother's blood and urine rise a lot during the first trimester," Johns Hopkins Medicine notes. "They may play a part in the nausea and vomiting often linked to pregnancy."

And the other main player, progesterone, rises very early in pregnancy, according to Johns Hopkins Medicine. "This hormone is made by the ovaries and by the placenta during pregnancy," the site explains. "It stimulates the thickening of the uterine lining for implantation of a fertilized egg."

Another early pregnancy hormone called human placental lactogen (HPL) "is a peptide hormone produced by the placenta. It is detectable as early as 6 weeks' gestation and increases across gestation, peaking at around 30 weeks," according to a 2022 study published in BMJ Open.

With all those hormones surging, experts believe they play a big part in the development of pregnancy symptoms, including some symptoms beyond nausea and fatigue. According to NHS, symptoms during the first trimester that you might not expect may include feeling dizzy, getting nosebleeds, experiencing blurry vision, having bleeding gums, and tasting metal.

Pregnancy can be confusing, especially during those early few weeks. It's always good practice to reach out to your care providers if you're concerned or worried about any of your pregnancy symptoms.