When does pregnancy exhaustion start

Fatigue is one of the most common symptoms of early pregnancy. In fact, it’s one of the very few early symptoms you may experience before the pregnancy test even turns positive. Early pregnancy fatigue can make it hard to get through the day without a nap, but rest assured, it’s a normal symptom for most pregnant people.

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Why does pregnancy make you so tired?
When is pregnancy exhaustion not normal?
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In this article, we’ll explain why you’re feeling so tired, and what you can do to help alleviate pregnancy fatigue.

Fatigue is more than just being tired—it’s a constant feeling of lacking the energy it takes to get through the day. When you’re exhausted day after day, like many women experience in those early weeks of pregnancy, it can take a toll on your physical and mental well-being, says Staci Biegner, M.D., an OB-GYN with Clinic Sofia, based in Minnesota.

According to a small study in the American Journal of Perinatology, out of a random sample of 20 pregnant people and 15 non-pregnant people, those in the first trimester of pregnancy were found to experience significantly greater fatigue compared to a similar group of nonpregnant women.

“For most women, fatigue occurs as early as week five of pregnancy, and it often lasts through the first trimester of pregnancy (13 weeks) and improves in the second trimester,” says Dr. Biegner. “It can show up again toward the end of the third trimester,” she says.

It’s persistent low energy that causes many women to take a pregnancy test in the first place, notes Dr. Biegner. Along with breast tenderness, it’s one of the earliest symptoms of pregnancy. That’s because the hormones that cause a pregnancy test to be positive are already surging as early as week five of pregnancy, and these can cause women to feel sluggish and tired all day, whether they’re sleeping well or not, she explains.

When you first become pregnant, your body immediately begins to undergo major changes. These physiologic changes in the body are what contribute to early pregnancy fatigue, says Dr. Biegner. Some of the changes during early pregnancy that may lead to an increase in fatigue include:

Increase in hormones like progesterone
Increase in blood volume to help support a developing baby and placenta
Low blood sugar
Low blood pressure
Sleep disturbances
Nausea

The fatigue you experience in those early weeks of pregnancy may disappear as you enter your second trimester, but Dr. Biegner says to expect it to return as you enter the final weeks before delivery. “Some women will experience fatigue in the third trimester as well,” she explains. This can be caused by the following:

Carrying a growing baby is more work for the body and may cause fatigue
Multiple bathroom trips that disrupt a good night’s sleep
Difficulty sleeping due to inability to find a comfortable position

Since pregnancy fatigue, especially the drowsiness that hits in the early weeks, is mostly hormonal in nature, there isn’t much you can do to make it better. The constant feeling of needing a solid nap is normal, and will be your companion until you inch closer to the second trimester. However, Dr. Biegner suggests the following habits that can help ease early pregnancy fatigue:

Practice good sleep hygiene. Take naps during the day, even if it’s brief. Closing your eyes for just 10 minutes is preferable to powering through and becoming overtired.
Drink plenty of water. Staying hydrated is crucial to maintaining a healthy pregnancy, and can help with early pregnancy fatigue.
Get some exercise. Though it may seem counterintuitive, exercise can actually increase energy levels, says Dr. Biegner. Try going for a brisk walk in the middle of the day if you are prone to increased fatigue in the early afternoon.
Eat small, regular meals. Try to avoid foods that cause large spikes in blood sugar, as this can make you feel even more tired.

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Rest assured that the majority of the time, fatigue related to normal changes of pregnancy is not harmful to the pregnancy or pregnancy development, says Dr. Biegner. “However, it’s important to note that pregnancy fatigue can be a symptom of a more serious medical condition (such as thyroid issues or anemia),” she notes. “Severe or persistent fatigue that is not relieved with the above remedies may warrant additional evaluation.”

Call your doctor if you’re experiencing severe or unrelenting fatigue that isn’t made even slightly better by resting or a nap, as according to Dr. Biegner, common causes of pregnancy fatigue that might warrant evaluation by your doctor include the following:

Anemia (low hemoglobin). Low iron in the blood can also cause weakness and dizziness.
Thyroid abnormalities. Signs of hypothyroidism in pregnancy can also include feeling cold, muscle cramps and issues with memory and concentration, says Dr. Biegner.
Depression or anxiety. Always mention any symptoms of depression or anxiety to your doctor, especially if you’ve suffered from either before you were pregnant.
Underlying sleep disorders. Talk with your doctor about any changes in your sleeping pattern, especially those that seem concerning to you.

Often your health care provider will get more information about your symptoms, do a physical exam and potentially order blood tests to rule out any issues, says Dr. Biegner. “Any time you are concerned about a symptom you are experiencing during pregnancy, you should talk to your physician about it.”

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Are you dragging these days? Does a nap sound fantastic right now?

Life can be exhausting at times, but especially when you’re pregnant. It’s totally normal to have some degree of fatigue right now—you are growing a human inside of you!

“Fatigue may be one of the most common first symptoms of pregnancy a woman experiences,” said Kelley Saunders, MD, an OBGYN at Banner – University Medicine Women’s Institute in Phoenix, AZ. “It is very common and quite significant in the first trimester. For many women, this improves in the second trimester and returns in the late third trimester.”

Although it’s common among pregnant women, you may still wonder why.

Why does pregnancy make you so tired?

The biggest reason: It’s hard work making a baby and it can be taxing to your body. “Your body has to adjust to maintain your health and the health of the baby inside of you,” Dr. Saunders said. “The physiologic changes and increased metabolic demand start in early pregnancy and can continue even after childbirth while breastfeeding.”

Beginning somewhere between conception and implantation, pregnancy hormones kick in – affecting your body, mood and sleep. During the first trimester, you may also experience morning sickness, frequent nighttime bathroom breaks and leg cramps, which can leave you feeling pretty tired.

Then starting around your second trimester, you may start to get a little pep in your step. You may start to feel more like yourself again. But don’t be alarmed if you are still pretty exhausted—especially if you have other children to care for. Fatigue is still possible during the second trimester.

In late pregnancy, you’ll most likely begin to feel tired again. At this point, your baby has grown quite a bit and is putting more physical demands on your body. You’re carrying around extra weight and it’s more difficult to get comfortable when you sleep. Add in leg cramps and heartburn, and sleep becomes even more elusive.

When is pregnancy exhaustion not normal?

While exhaustion is a common symptom of pregnancy, extreme fatigue is not normal and may be a sign of an underlying health condition. Dr. Saunders said you should see your health care provider if your fatigue is severe and persistent.

“A sudden onset of exhaustion and continual symptoms may be a sign of abnormal fatigue,” she said. “When fatigue is associated with fever, chest pain, difficulty breathing or an inability to perform routine daily activities, you should see your OBGYN for evaluation.”

Some of the potential underlying causes for your fatigue both during and outside of pregnancy may be due to the following:

Gestational diabetes: Your body may become resistant to insulin during pregnancy, which can cause you to feel very tired. Other symptoms include extreme thirst and frequent urination.
Anemia: A lack of iron can cause you to have an insufficient number of red blood cells to transport oxygen to your tissues and can cause you to feel tired, lightheaded and weak.
Infections (viral, bacterial or fungal): Being pregnant can make you more vulnerable to infections, such as urinary tract infections, which can make you fatigued.
Thyroid problems: Having too much or too little thyroid hormones can cause you fatigue, along with fluctuations in your weight, irritability and depression.
Prenatal depression: Feeling tired all the time can also be a side effect of depression. Other symptoms may include sadness, feelings of hopelessness and an inability to complete daily tasks or activities.

If you’re in need of a health care provider or have questions or concerns, you can find a Banner Health specialist at bannerhealth.com who can help.