9 Signs You Need to Take a Pregnancy Test

You may be a few weeks along without even knowing it.

Medically reviewed in February 2022

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Most over-the-counter pregnancy tests are 99 percent effective when you take them after a missed period. But how do you know when it’s time to pee on a stick?

Pregnancy symptoms are different for everyone, and as the levels of the pregnancy hormone human chorionic gonadotropin (hCG) rise, your symptoms may increase, says OBGYN Jessica Brown, MD, of Grand Strand Medical Center in Myrtle Beach, South Carolina. “At four weeks, you may have a little bit of cramping, but classic symptoms like sore breasts, nausea and fatigue may not begin for six or seven weeks,” she says. 

So, how do you know if your symptoms point to pregnancy? Brown discusses some of the very first symptoms, along with how to ease the discomfort and the best time to take a pregnancy test.

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A missed period and light bleeding

A missed period is probably the most well-known pregnancy symptom, and the one that most often prompts women to take a pregnancy test. If your period is late or doesn’t come at all, you may be pregnant.

But newly pregnant women—one-third to be exact—may have what’s called implantation bleeding, or bleeding that is lighter, shorter and spottier than a regular period. When you become pregnant, the fertilized egg latches on to the uterus lining and embeds itself, which initiates the pregnancy. The movement may cause light bleeding a few days before your period is supposed to start. And while the amount differs from woman to woman, implantation bleeding is typically pinkish or dark brown (almost rust) in color. It will likely occur for a few days to a few weeks.  

Brown recommends that all women track their menstrual cycle, especially if they are trying to get pregnant. You can use a regular calendar, or one of many phone apps. These apps can help you see what a normal menstrual cycle looks like for you, including how long it is and how heavy your period is. They can also anticipate your period and ovulation days for the months to follow, says Brown. “I think this is really helpful for patients who are trying to get pregnant. It can help them track when they’re most fertile.” 

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Tender breasts

As early as one to two weeks after conception, pregnant women may notice changes in their breasts. Having tender, sore or enlarged breasts is a common body response to hormonal changes at the beginning of pregnancy. You may also see nipples begin to change in color, usually becoming slightly darker.

The sensitivity should subside after a few weeks, when your body gets used to the fluctuation of hormones. Your breasts may continue to grow and darken as your pregnancy progresses, however. This is completely normal—it’s your body’s way of preparing for breastfeeding after birth

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Abdominal cramping

Just as you have cramping during your period, light cramping is pretty common during the first trimester (12 to 13 weeks) of pregnancy. This tends to occur on one or both sides of your lower abdomen, as a result of an expanding uterus and stretching ligaments; it may even feel like something is pulling on that side.

Here are some ways to relieve these cramps:

  • Take a warm bath.
  • Put a hot water bottle wrapped in a towel on the painful area.
  • Stay hydrated.

If you have severe cramping that doesn’t go away, heavy bleeding, dizziness or lower abdominal pain, see your OBGYN. They will want to rule out other serious conditions like an ectopic pregnancy or miscarriage.

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Nausea and vomiting

Roughly half of all pregnant women will experience vomiting, and many more will have some kind of nausea—especially towards the beginning of pregnancy. These feelings usually start two weeks to two months after conception, and don’t necessarily strike exclusively in the morning. Some women will have just a few minutes of stomach trouble daily, while others may have severe symptoms that last for hours each day.

Nausea and vomiting should go away as you approach the second trimester, around 13 weeks, but they may continue throughout the pregnancy. These symptoms are not normally harmful to you or your baby. However, if you can’t keep any food down and you’re losing weight, see your OBGYN so they can access whether or not you’re malnourished or dehydrated, since this can affect your health and the baby’s development.  

Your OBGYN can also make sure you don’t have an ulcer, food-related infection, thyroid disease or gallbladder disease.

If you’re having trouble with nausea, here are some remedies that can help soothe your stomach:

  • Keep toast or crackers by your bed, so you can eat a snack before moving around on an empty stomach each morning.
  • Stay hydrated.
  • Try eating smaller, more frequent meals rather than three large meals.
  • When you’re feeling bad, stick to the BRATT diet: bananas, rice, applesauce, toast and tea.
  • Try food and drinks made with real ginger, like candies and soda. 
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Changes in bathroom and stomach habits

In addition to nausea and vomiting, you may experience other stomach problems when you first become pregnant—like constipation, frequent urination and bloating, to name a few.

  • Constipation is normally characterized by fewer than three bowel movements a week, hard stool, dry stool or stool that is difficult to pass. “The progesterone that starts to form from the placenta slows the bowels down,” says Brown. Constipation can occur early on in pregnancy, but can come back during the third trimester, too.
  • Frequent urination is common. Symptoms can start even earlier than your missed period, since the fertilized egg implants itself into the uterus and begins making the pregnancy hormone hCG, prompting you to run to the bathroom more often.
  • Bloating can happen early on in pregnancy, and may continue throughout your nine months. The progesterone hormone causes your muscle tissues to relax, slowing down digestion. That, in addition to an expanding uterus, can put pressure on your rectum and cause it to feel heavy.

Here’s how to keep your stomach happy during pregnancy:

  • Aim to get at least 25 grams of fiber a day from foods like leafy greens and whole grains.
  • Stay hydrated.
  • Exercise regularly.
  • Talk to your OBGYN about any iron supplements you’re taking.
  • Discuss with your OBGYN whether you need to try over-the-counter medications.
  • When you feel the urge, do not hold in bowel movements.
  • Eat slowly.
  • Take it easy on foods that may upset your stomach, like beans, cabbage and fried items.
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Does it feel like you just can’t hold your head up come 2 p.m.?

High levels of the hormone progesterone can cause fatigue, especially during the first trimester. In the first months of your pregnancy, your body is generating more blood to pass along nutrients to your baby and your blood sugar and blood pressure levels take a dip, bringing about exhaustion.

It’s important that you take time to rest during pregnancy; listen to your body and go to bed earlier than usual if you’re feeling pooped. Eat a well-balanced diet that includes iron, protein and calories so you’ll feel more energized during this exciting time. And unless your OBGYN advises against exercise, make sure you squeeze moderate activity into your weekly routine.

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Sinus issues

Sniffly? It may be because you’re pregnant! “Mucus membranes swell during pregnancy, so even if you don’t have a sinus infection or allergies, it may feel that way,” says Brown. The pressure on your sinuses may cause sneezing, a sore throat, congestion, drainage or headaches.  

Higher levels of the hormone estrogen trigger the swelling, which can lead you to produce more mucus. The increase in blood circulation also contributes to swollen blood vessels in your nose, causing congestion.

Here are some ways to minimize sinus issues during pregnancy:

  • Drink plenty of fluids.
  • Prop your head up when you sleep.
  • Take a warm, steamy shower or bath.
  • Add moisture to the air in your bedroom by using a humidifier or vaporizer.
  • Steer clear of things that may make symptoms worse, like smoke, alcohol, paint and chemical fumes.
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Food and odor aversions or cravings

Aversions to certain foods or odors are caused by your body’s hormonal changes during the first trimester of pregnancy. You may start to despise the way your favorite dinner smells or tastes, or, on the flip side, you may crave certain snacks, meals, beverages or food combinations.

When it comes to cravings or aversions, listen to your body. It’s okay to occasionally indulge in late-night ice cream runs—just don't overdo it. Talk to your OBGYN if you’re unable to stomach major food groups like vegetables or whole grains. The two of you can discuss foods that can easily be substituted in. 

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Mood swings

Are you happy as can be one minute, then sad and overwhelmed the next? These feelings are normal—moodiness is one of the most common early symptoms of pregnancy.

The same changes that cause you to become emotional—fluctuating levels of progesterone and estrogen—can make your neurotransmitters, or the chemicals in your brain that help control your mood, go haywire. You may start to feel anxious about raising a child, excited about being pregnant, worried about the health of the baby or overwhelmed with all you have to do before your little one comes. This normally occurs during the first and third trimesters.

When you’re feeling overwhelmed or moody, try going for a walk, taking a pregnancy yoga or meditation class, getting a massage or napping. Setting aside time for a date night or couples massage can also lower your stress and boost your mood. Remember that these changes are normal parts of pregnancy, and you shouldn’t be too hard on yourself.

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When to take a pregnancy test

Having symptoms? If you are, it’s best to take an at-home test 5 to 10 days after a missed period for an accurate reading. If it’s negative and you don’t get your period within the next week, Brown says to take another test. “You may have ovulated a little later in your menstrual cycle, and because of that, your pregnancy test results or your period may be delayed a bit.”

When taking an at-home pregnancy test, follow the directions carefully, since some tests require you to wait a bit longer to confirm results, while others have slightly different instructions for urinating. Remember that the levels of the hCG pregnancy hormone in your urine are easier to detect first thing in the morning. If you test yourself later in the day, make sure you haven’t peed for at least four hours.

Have you taken multiple negative tests but still haven’t had your period? See your OBGYN to talk through what may be causing the delay.

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