What Early Pregnancy Symptoms Really Feel Like

Whether a pregnancy is planned or comes as a surprise, recognizing early pregnancy symptoms can bring up a wide range of emotions.

Dr. Angie Chisholm, DNP, CNM, a full-scope midwife, explains: “Even when a pregnancy is highly desired, people can be surprised to feel doubts and anxiety surface. Just knowing there’s a chance you might be pregnant can make things feel very real—you start thinking about changes to your body, the financial impact, and so much more.”

Not knowing if you’re pregnant can also be stressful, especially since many early pregnancy symptoms are similar to those of premenstrual syndrome (PMS). “Both involve hormonal changes—especially fluctuations in pregnancy hormones—which can cause fatigue, bloating, mood swings, acne, and more," Chisholm says.

To help you tell the difference, we asked experts to share everything you need to know about early pregnancy symptoms, such as how soon they can start, whether diarrhea is a symptom of pregnancy, and when it’s time to take a pregnancy test.

When do pregnancy symptoms typically start?

If you’re wondering when pregnancy symptoms start, Rachell Dumas, MSN, RN, a registered nurse and maternal health advocate, says that most people begin to notice pregnancy symptoms about four to six weeks after their last menstrual period (LMP).

However, everyone’s experience is different. “Some people may feel symptoms like breast tenderness, fatigue, or nausea quite early, while others notice very few or no symptoms at all in the beginning,” Dumas explains.

It’s also possible to spot early signs of pregnancy as soon as one to two weeks after conception, even before missing a period. “Implantation symptoms—such as light bleeding or spotting, mild cramping, or subtle mood swings—can start just a few days after conception,” says Dumas. “But these early signs are often mistaken for PMS or the start of a period, so they can be easy to miss.”

Common symptoms of early pregnancy before a missed period

Shalini Shah, CBD, CPpD, IBCLC, a reproductive wellness practitioner and perinatal educator, explains that you might notice early pregnancy symptoms even before missing your period.

“Some people start to feel subtle changes, like light spotting, breast tenderness, nausea, fatigue, or needing to pee more often,” Shah says. “While these symptoms can feel a lot like premenstrual ones, they often last a bit longer or just feel a little different than usual.”

Breast changes

In early pregnancy, your breasts may become more sensitive or sore, sometimes even before a positive test.

"You might notice a feeling of fullness, mild swelling, or tingling," Shah says. "The areolas can darken or look larger, and small bumps called Montgomery glands might become more noticeable."

Fatigue

"Fatigue in early pregnancy is real and often intense," Shah explains. "Progesterone has a calming, sedative effect that can make you feel much sleepier than usual. At the same time, your body is working hard to build the placenta and support a developing embryo, which takes a surprising amount of energy."

Implantation spotting and cramping

Implantation bleeding can be one of the earliest signs of pregnancy, though not everyone experiences it. "

If it happens, it’s usually light and short—much more like spotting than a period," Shah notes. "It might be pink, brown, or rusty-looking, and it often shows up about 10 to 14 days after ovulation."

Increased basal body temperature

If you're tracking your basal body temperature, you might notice it stays slightly higher after ovulation. "In a typical cycle, it drops again before your period. If you're pregnant, though, it usually stays elevated because of continued progesterone production," Shah says.

Heightened sense of smell

"A stronger or more sensitive sense of smell is very common in early pregnancy," Shah shares. "Hormonal changes, especially the rise in hCG and estrogen, can make certain smells feel extra strong or even unpleasant. While it can be intense, it usually eases up later in pregnancy."

Common pregnancy symptoms around or after a missed period

Dr. Alexandra Morell, MD, a board-certified obstetrician-gynecologist, explains that several common symptoms can signal pregnancy around or after a missed period, including nausea, bloating, and mood swings. Here’s what you can expect with each symptom.

Missed period

For women with regular cycles, a missed period is often the first sign of pregnancy. "Each month, the body prepares for a possible pregnancy by thickening the uterine lining," Morell explains. "If pregnancy doesn’t occur, hormone levels drop and menstruation begins. If conception happens, the lining stays thick, and you miss your period."

Nausea and vomiting (morning sickness)

Nausea and vomiting—commonly called morning sickness—are very common in early pregnancy.

“Despite the name, these symptoms can occur day or night,” says Morell. "Most women start to notice them between weeks 4 and 10, with symptoms usually improving by the end of the first trimester. By about 22 weeks, most women feel much better."

Frequent urination

“In early pregnancy, your body produces more blood and fluids to support the developing baby,” Morell notes. "This means your kidneys filter more fluid, resulting in more trips to the bathroom. The rate at which the kidneys filter blood can increase by up to 25% during pregnancy."

Bloating

Rising progesterone levels help relax muscles, including those in your digestive tract. “This slows down digestion, causing bloating and sometimes constipation,” Morell explains.

Mood swings

Major hormonal shifts, especially in estrogen and progesterone, can affect brain chemicals like serotonin and dopamine, which help regulate mood. “Mood swings are very common during pregnancy, but if you’re feeling persistently down or anxious, talk to your doctor,” advises Morell.

Less common signs of early pregnancy

Most people are familiar with early pregnancy signs like missed periods, nausea, and breast tenderness, but Dr. Manisha Purohit, MD, FACOG, a board-certified obstetrician and gynecologist, notes that there are several less common or easily overlooked symptoms to be aware of:

• Metallic taste (dysgeusia): “It’s common for some women to report a strange metallic taste in their mouth, often described as ‘chewing on coins,’” Purohit explains.

• Nasal congestion or nosebleeds: Purohit shares, “Hormonal changes and increased blood volume can cause mucous membranes in the nose to swell and bleed more easily.”

• Excessive saliva: This symptom often goes hand-in-hand with nausea. As Purohit explains, it “causes more saliva production than usual.”

• Mild cramping or pulling sensations: “Some women experience cramping which may be mistaken for an impending period,” suggests  Purohit.

• Food aversions: While cravings are common, Purohit also notes, “Early pregnancy can cause strong aversions to foods, especially those previously enjoyed.”

• Dizziness or lightheadedness: According to Purohit, this can be “caused by hormonal changes, lower blood pressure, or changes in blood sugar levels.”

Early pregnancy symptoms vs. PMS

Early pregnancy symptoms can closely resemble those of premenstrual syndrome (PMS), but there are some key differences, according to Dr. Arielle Bayer, MD, an OB-GYN and reproductive endocrinologist.

Last longer and are more intense

“Pregnancy symptoms tend to be more prolonged and intense than those associated with PMS,” she explains. “It can be difficult to tell the two apart without testing, especially in the earliest stages.” For instance, mood swings are common in both, but many women find them more intense during pregnancy.

Visual breast changes

Both PMS and early pregnancy can cause breast tenderness and swelling, but early pregnancy may also bring more prominent veins and darkening or enlargement of the areolas. Swollen breasts are often more pronounced in early pregnancy than during PMS and may persist longer.

Cramps are usually less severe

Cramping is another area where the experiences can differ. “Women often report that PMS cramps are more uncomfortable than those in early pregnancy,” Bayer notes.

PMS symptoms pass

"Additionally, a light period can sometimes be confused with early pregnancy spotting, making it even harder to tell the difference without a pregnancy test. The most significant difference, however, is that PMS symptoms usually resolve with the start of menstruation, while pregnancy symptoms persist and periods stop."

Because the symptoms overlap so much, Bayer recommends taking a pregnancy test or consulting your doctor for a clear answer. “Symptoms vary widely from person to person, so I never use them alone to diagnose a pregnancy,” she says.

How is implantation bleeding different from a normal menstrual period?

Implantation bleeding is a normal sign of early pregnancy, but it can be easy to mistake it for a period if you don’t know what to look for.

According to Bayer, implantation bleeding is usually more like light spotting, not the heavier flow you get with your period. "This spotting typically lasts a few hours to two days and often happens about six to 12 days after ovulation. In contrast, a menstrual period usually occurs around 14 days after ovulation and lasts three to seven days, with a moderate to heavy flow for part of that time."

The colour of the blood can also help you tell the difference. "Implantation bleeding is often light pink or brown, while period blood is usually bright or dark red," suggests Bayer.

However, not everyone experiences implantation bleeding, so if you don’t notice it, you could still be pregnant.

When to take a home pregnancy test

Dr. Jillian LoPiano, MD, a board-certified obstetrician-gynecologist, explains that the best time to take a home pregnancy test is after you’ve missed your period.

"Taking a pregnancy test after a missed period not only confirms pregnancy but also helps you start thinking about your pregnancy due date and prenatal care," LoPiano says. Although home pregnancy tests are quite sensitive, waiting until after your missed period helps ensure the pregnancy hormone is at a detectable level. Testing too early can lead to a false negative result.”

She also recommends using your first-morning urine for the test because it contains the highest concentration of hCG, making it easier to detect pregnancy accurately.

When to consult a healthcare professional

Dr. Katie Larson, PT, DPT, a licensed physical therapist specializing in pelvic floor health and perinatal care, emphasizes the importance of seeking medical advice when you suspect you might be pregnant.

“When you think you might be pregnant, it’s important to reach out to your doctor—or find one if you don’t have one yet—to confirm your positive pregnancy test,” Larson explains. “Typically, your first OB-GYN appointment will be scheduled between 8 and 12 weeks after a missed period. This timing allows the doctor to check for a heartbeat via ultrasound and ensure the pregnancy is progressing well.”

She adds that you should seek medical attention sooner if you experience any concerning symptoms such as heavy bleeding, severe abdominal pain, new or persistent headaches, sudden swelling, or a fever above 101°F. “Many healthcare providers now offer messaging through apps, making it easy to get timely advice on what steps to take next,” she notes.

Larson also stresses the value of confirming your pregnancy with a healthcare provider to accurately determine how far along you are and to start prenatal care.

“If you have questions about pregnancy, including how to recognize early symptoms or when to seek care, consult a healthcare professional for guidance,” she adds. “Getting professional advice early on helps you understand how to best support both yourself and your baby throughout every single week of pregnancy.”

Experts

• Dr. Angie Chisholm, DNP, CNM, is a full-scope midwife, and serves as the midwifery clinical faculty at Frontier Nursing University.
• Rachell Dumas, MSN, RN, is a registered nurse and maternal health advocate.
• Shalini Shah, CBD, CPpD, IBCLC, is a reproductive wellness practitioner and perinatal educator.
• Dr. Alexandra Morell, MD, is a board-certified obstetrician-gynecologist.
• Dr. Arielle Bayer, MD, is an OB-GYN and reproductive endocrinologist.
• Dr. Manisha Purohit, MD, FACOG, is a board-certified obstetrician and gynecologist.
• Dr. Jillian LoPiano, MD, is a board-certified obstetrician-gynecologist.
• Dr. Katie Larson, PT, DPT, is a licensed physical therapist specializing in pelvic floor health and perinatal care.