Pregnancy can do a real number on your body — and it goes beyond the obvious effects, like causing you to sport a baby bump or skip your periods. The truth is, there are certain pregnancy symptoms you may not recognize as part of the territory until you're in the thick of them...and by that time, you may be nervous that they signal something bad. But rest easy: Weird, wacky (and occasionally TMI) side effects are normal more often than not. Of course, you should always speak to your OB-GYN if you have any concerns or questions, but it's important to remember that sometimes you just have to expect the unexpected where pregnancy is concerned.

We spoke to OB-GYN Dr. Ellen Manos, who weighed in on why women may be experiencing specific pregnancy symptoms...and what you can do if you're dealing with them.

First trimester fatigue

No, it's not just in your imagination. Creating a human can be downright exhausting — particularly in those early days. The good news? It should pass. 'Welcome to pregnancy!' Dr. Manos said. ' It is a perfectly normal response to the changes in multiple hormones in the first trimester. After 14 weeks, fatigue often lifts and many patients experience a burst of energy.'

Second trimester fatigue

If you're still bone-tired during the middle of your pregnancy, you may want to check in with your provider. 'When fatigue occurs in the second trimester, it is often associated with low iron/anemia as the needs of the growing fetus become greater,' Dr. Manos explained.

Third trimester fatigue

Yup, welcome back to the land of 'it's totally normal to be this tired.' According to Dr. Manos, you can thank physical discomfort and your, um, overactive bladder for disrupting your sleep, which (understandably!) leads to fatigue in your third trimester. Nap when you can for relief.

Excess gas and bloating

Hate to break it to you, but that may not be a brand new baby bump you're seeing — it could have more to do with gas and bloating, both of which are common early on in pregnancy. Dr. Manos chalked this up to the increase in progesterone, which can slow down your digestive system. This might also explain why you're experiencing so much...


Not many people discuss it, but constipation can be a big part of pregnancy. 'The progesterone hormone increases a lot in pregnancy, causing all smooth muscles in the body to relax, so the entire GI tract slows down,' Dr. Manos said. 'When this happens in the large intestine, gas and constipation can occur.' Be sure to chat with your OB before taking anything (even an over-the-counter remedy) to relieve this issue.

A change in your usual allergies

'Interestingly enough, most people afflicted with severe allergies actually improve during pregnancy,' said Dr. Manos. ' nature's way of dulling the immune system slightly to accommodate the fetus (which, of course is half alien to Mom’s immune system).' Not everyone sees improvement here, though. 'Progesterone can cause mild nasal congestion and should be treated with simple, nonmedical treatments,' the doctor explained. 'If environmental allergies do worsen (as they can in one-third of pregnant patients), there are safe medicines that can be used, only after discussing them with your OB—never use over-the-counter medication without checking first.'

Crampy pelvic pain

Scary? Yup — but don't worry, those pelvic cramps are likely totally normal. 'Mild crampy pelvic pain is very common and normal in the early stages of pregnancy as the uterus slowly expands,' Dr. Manos shared. There's a caveat, though: 'If it is severe or accompanied by any vaginal bleeding, your OB should be consulted,' Dr. Manos warned. 'Pelvic pain later in the pregnancy can often be related to a bladder infection and refer pain over the lower part of the uterus, even increasing the risk of preterm labor. Of course, this is totally treatable and another good reason to have good communication with your OB.'


They may catch you off guard, but pregnancy nosebleeds are a thing, and likely associated with dry mucus membranes. Talk to your doctor if yours become persistent.

Bleeding gums

Dr. Manos explained that this is common due to increased blood flow to the gums during pregnancy — however, she also urged patients to be on guard about this symptom. 'Every pregnant patient should go to the dentist for routine care/cleaning since teeth/gum disease can be associated with an increased risk of preterm labor and delivery,' she said.

Itchy skin

Consider this one a 'probably-normal-but-you-may-want-to-chat-with-your-doctor' symptom. Itchy skin can be a symptom of one of the many pregnancy-related skin conditions, the great majority of which are harmless, but annoying,' Dr. Manos told us. 'Hydrating orally and hydrating your skin with a hyaluronic acid containing lotion regularly usually does the trick. Nonetheless, your OB should be consulted since there are a few rare conditions where itchiness in the second and third trimesters are associated with .'


You thought pregnancy would usher in a vacation from any and all bleeding down there, so you may be bummed (or terrified) to see some blood. 'Since blood flow increases intensely to the pelvis in early pregnancy, a simple thing like intercourse can sometimes break a small blood vessel on the cervix and cause spotting,' Dr. Manos shared. But again, this is something you'll want to bring up with your doctor. As always, no question or concern is too small!

Dealing with these or any other surprising or alarming symptoms? Be sure to have a chat with your doctor. Dr. Manos shared her overarching piece of advice for pregnant women who are dealing with unexpected symptoms. 'I’m a great believer in communication and urge my patients to call my staff or me if they are unsure, especially with their first pregnancy,' she shared. 'Caution without paranoia!'

About the expert: Ellen Manos M.D. has been practicing obstetrics and gynecology on the Upper East Side of Manhattan for over three decades. She is a senior attending physician at Lenox Hill Hospital, where her interests include laparoscopic surgery, adolescent medicine, bio-identical hormone replacement therapy and, of course, the everlasting joys of obstetrics, both low and high risk, in a concierge setting. Dr. Manos graduated from the High School of Performing Arts in 1974 and received her bachelor's of science in biochemistry and musicology from New York University in 1978. She attended medical school at SUNY Upstate Medical Center in Syracuse and graduated in 1982. After returning to New York City, Dr. Manos completed her residency in obstetrics and gynecology at St. Luke's-Roosevelt Hospital Center in 1986 and immediately entered private practice. Dr. Manos's practice is distinguished by the personal, one-on-one care that she provides to all of her patients.