Trying to conceive and early pregnancy often involve a lot of waiting. Waiting to take a pregnancy test, waiting for your first ultrasound, and waiting to meet your baby face-to-face. During this time, it’s common to become more aware of every change in your body.

The period between possible conception and a confirmed pregnancy is often called the two-week wait. During this phase, many women begin “symptom-spotting,” wondering whether every twinge or sensation could be an early sign of pregnancy.¹

Below, we’ll explain the most common early signs of pregnancy, when they typically appear, and when you can expect reliable results from a pregnancy test.

What Causes Pregnancy Symptoms?

Most early pregnancy signs can be attributed to hormonal changes. At four weeks pregnant, your baby is not much bigger than a grain of sand. Still, their presence in your uterus is causing the pregnancy hormones like progesterone and human chorionic gonadotropin (hCG) to skyrocket.²

These hormones signal your body to ramp up for pregnancy. Your uterus will need to expand, your blood volume will increase, and your breasts will prepare for breastfeeding. Despite your tiny embryo existing only in a small area of your womb, you might experience different symptoms all over your body, all thanks to hormones.²

Related: Pregnancy Hormones: What’s Happening

When Do Pregnancy Symptoms Start?

When a fertilized egg implants into your uterine lining, it begins secreting hormones that can cause symptoms. Implantation happens six to eight days after ovulation or about a week before your missed period.³

Pregnancy signs can begin as soon as implantation occurs. These symptoms may intensify, and new symptoms may emerge over time. The pregnancy hormone responsible for many symptoms, hCG, rises quickly in early pregnancy and peaks around 10 weeks after conception.⁴

What Are the Early Signs of Pregnancy?

Early pregnancy symptoms can vary from person to person, but many women notice similar changes as pregnancy hormones begin to rise.

Breast tenderness

Changes to your breasts are often one of the first signs of pregnancy. Although breastfeeding is still far off, hormones are already at work, stimulating the production of milk in the glands. They may be swollen and feel heavier or fuller than they normally do. Your breasts may be extremely sensitive to the slightest touch, especially the nipple and areola. You may also notice that your areolas have become darker, larger, and bumpier.^5,6

Fatigue

The increased energy demands on your body, from enlarging breasts and uterus to increased blood supply for the heart to pump, can cause you to feel exhausted, even early in pregnancy.⁵

Related: Tips for Battling Pregnancy Fatigue

Frequent Urination

Increased blood volume and blood flow to your pelvic region can cause a frequent urge to pee long before the baby is big enough to put pressure on your bladder.^5,7

Dizziness and Headaches

Hormone changes, increased blood volume, and decreased blood pressure during early pregnancy can cause headaches and dizziness. If you experience these symptoms, sit down to prevent passing out.^7,8

Nausea

Despite the name “morning sickness,” nausea during pregnancy can occur at any time of day. Many women experience nausea without vomiting, but vomiting is possible, too. Although the cause of pregnancy nausea is unknown, it is thought to be related to hormones, so it often resolves in the second trimester, after hCG levels begin declining.

Nausea can become a problem if frequent vomiting causes dehydration and electrolyte imbalances. Otherwise, it is just an uncomfortable and annoying early symptom that can make it difficult to hide your pregnancy!⁹

Related: Ways To Relieve Morning Sickness and Feel Better Fast

Food Cravings or Aversions

Certain foods you have always loved may suddenly repulse you, which could be a sign that you may be pregnant. Anecdotally, many women report an aversion to meat, particularly in the first trimester.

You may also crave seemingly random or unusual foods compared to your usual preferences. It is OK to indulge in these cravings if you are adequately nourished and they are food items, not things like dirt or clay, which can signal a nutrient deficiency.^10,11

Related: Decoding Pregnancy Cravings and What They Mean

Metallic Taste

Along with cravings or aversions, some women report feeling like they have the taste of a coin in their mouth, even if they have not eaten anything. This is because pregnancy hormones can change your sense of taste very early in pregnancy. If it is bothersome, you can try neutralizing the metallic taste with oral hygiene, a saltwater and baking soda rinse, or acidic foods like citrus and vinegar.¹²

Congestion

Pregnancy congestion can begin early in the first trimester for some women, likely due to hormonal changes and increased blood flow and blood supply.⁷

Cramping and Spotting

When the fertilized egg implants in the uterus, this can cause uterine cramping and light vaginal bleeding. These symptoms can make it seem like your period is coming, which can be confusing. This usually happens around the time of implantation or a few days before your period is due.⁵

Related: Implantation Bleeding: What It Is and What It Means

Missed Period

All these symptoms can make you suspect you might be pregnant, but the telltale sign of pregnancy is a missed period. If your period is due to arrive and never comes, this is your best indication to take a pregnancy test.

When Can You Take a Pregnancy Test?

Once your period is late, it is an excellent time to take a pregnancy test and get reliable results. You may get a positive pregnancy test as early as nine days after ovulating, but you may not know exactly when you ovulate. Pregnancy tests are 98 percent accurate by the day of your missed period.³

Related: What to Do in Early Pregnancy

When To Call Your Doctor

As soon as you get a positive pregnancy test, you can call your doctor to book your first prenatal visit and maybe even your first ultrasound! Many obstetric practices book out weeks or months in advance, so it is a good idea to get on their schedule as soon as possible.

Depending on the practice and your medical history, your provider may want to confirm the pregnancy, draw blood, and run some labs early.

Always contact your doctor if you have any unusual or concerning symptoms. While light-headedness, vomiting, and vaginal bleeding can be normal early pregnancy signs, your doctor may want to rule out other concerns if these symptoms are severe. They may also be able to make recommendations for techniques or medications to help you manage these symptoms.

Speculating about early pregnancy signs can be exciting, but the most reliable indicator of pregnancy is a positive test. If you are experiencing early symptoms and suspect you may be pregnant, it may be time to take an at-home pregnancy test.

While many early pregnancy symptoms are uncomfortable, they often peak during the first trimester before easing as pregnancy progresses. These changes are a normal part of your body adjusting and supporting your growing baby.