When do you start feeling tired during pregnancy

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.

In this article, we’ll explain why you’re feeling so tired, and what you can do to help alleviate pregnancy fatigue.

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When do you start feeling tired during pregnancy

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What Is 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[1]Behrenz K, Monga M. Fatigue in Pregnancy: A Comparative Study. Am J Perinatol 1999;16(4):185-188. .

When Does Pregnancy Fatigue Start?

“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

Ways to Combat Pregnancy Fatigue

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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Can Pregnancy Fatigue Hurt My Baby?

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.”

When to Call a Doctor

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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Take Assessment

How early can pregnancy tiredness start?

Pregnancy fatigue can start as soon as one week after conception, which means it may be an early sign of pregnancy before a test can tell you for sure. It's also common to start feeling tired any time during the first 12 weeks.

What does early pregnancy tiredness feel like?

Fatigue is officially considered a constant lack of energy. During pregnancy, you might feel like you can't get up in the morning or can't wait to hit the sack as soon as you get home in the evening. Or you may feel like you're just dragging and sluggish from the moment you get up to the time you go to sleep.

Do you get tired fast in early pregnancy?

Hormone changes play a big role in making you feel tired, especially the hormone progesterone. This hormone rises sharply in the first trimester. In addition, as blood volume increases to supply the developing placenta and fetal circulation, your heart pumps faster and stronger.

What week pregnancy most tired?

In the second trimester, which begins at week 13, many women get a fresh surge of energy. This is a great time to tackle those important before-baby-arrives chores, because as you enter the third trimester, which begins at week 28, that extreme exhaustion returns.