Chicken Soup for the Pregnancy Symptom Freakout's Soul

This article is not the way to tell if you're pregnant.

In fact, I strongly suspect that more people who read this article will NOT be pregnant than those who will be. You can certainly use this article to review some common symptoms of early pregnancy, but what it's really here for is to talk you off the ledge if you're driving yourself crazy with lists of pregnancy symptoms or the feeling that every teeny different thing about your body today is a clear sign that you're pregnant.

The internet is a fantastic place of infinite wonder, but when you're freaking out thinking you might be pregnant, sometimes a lot of information is too much information, and the Internet is not our friend. People worried they're pregnant can wind up freaked out by the 'net the way people have freaked out over the Merck Manual in days of yore. We have one or two symptoms or changes in our bodies, and we flip through a bunch of medical pages only to feel we've discovered that the upset stomach we have today clearly is not nerves or a common flu bug, but some terrible, fatal disease and we're in our final hours of life. Not likely, but it can be easy to feel that way, especially if you're feeling terrified to begin with.

As well, online we can sometimes find anecdotal stories of every reliable birth control method under the sun failing, even in perfect use, even with more than one method used, even though we know, from long-term, reliable study, that while that does indeed happen to people every year, it is not as common as those stories would lead us to believe.

The vast, vast majority of the time, when people become pregnant, it is via vaginal intercourse and either because a reliable method of birth control was not used at all or was used inconsistently or improperly. Some of the people posting those stories may well be those who did have failures with perfect use, but most will be people who really didn't, and are either not being truthful because they feel guilty, upset or ashamed about misuing a method (or not using any at all), or because they just didn't understand what perfect use was for their method.

For more information on methods of birth control and how to use them, click here. For more information on what activities, and what goes on during them, may pose risks of pregnancy, click here. For advice on what to do if you're having a pregnancy scare, click here. For more on how conception happens in the first place, check this out.

Some people also don't realize that pregnancy can happen through more than just whatever they consider "full" vaginal intercourse, even though vaginal intercourse is, by far, the way most pregnancies occur. For example, a couple who uses condoms perfectly for vaginal intercourse may have gone without them for anal sex, and had a pregnancy occur due to semen running down to the vulva, or maybe did a lot of unprotected, direct genital-to-genital rubbing they didn't "count" as intercourse which resulted in a pregnancy.

In other words: if you have been using one, or more than one, reliable method of birth control properly all of the times you needed one, pregnancy is unlikely. Even if you threw up this morning, or suddenly felt like a gumdrop and peanut butter sandwich sounded totally delicious.

So, what are the symptoms of early pregnancy?

Our Bodies, Ourselves shares this concise list of some common changes in the body pregnant people may experience:

  • A missed, lighter, or shorter menstrual period than usual
  • Breast tenderness or enlargement
  • Nipple sensitivity
  • Frequent urination
  • Feeling unusually tired
  • Nausea and/or vomiting
  • Feeling bloated
  • Cramps
  • Increased or decreased appetite
  • Feeling more emotional than usual

When we say "early symptoms," we're usually talking about symptoms in the first couple months of pregnancy, not in the first few days or even the first few weeks. For most, the first symptom of pregnancy they experience is a missed period. For some, that's the ONLY noticeable sign of early pregnancy, even a month or two into a pregnancy.

Pregnancy is not instantaneous, but a lot of people don't know that. In other words, we don't have sex, then minutes, hours, or even a couple days later -- KAPOW! -- wind up totally pregnant and start experiencing all of these symptoms. It takes around a week or so to get from sex to fertilization to implantation (to conception: when a fertilized egg implants itself in the uterine wall, and we then have an actual pregnancy), and most symptoms don't tend to occur until at least then, and often later than that for many people. You can rest assured that even if you are having all of these symptoms the day after you have had sex, they are not because of pregnancy from that sex.

Some people even experience symptoms of pregnancy which may be entirely psychosomatic, in other words, based on belief of pregnancy, not on an actual pregnancy at all. "Pseudocyesis, or false pregnancy, is rare, occurring at a rate of 1 to 6 for every 22,000 births... Those who suffer from the disorder present a constellation of symptoms that mystify even seasoned practitioners. Not only do they fervently believe they are pregnant, but they also have bonafide symptoms to back up their claims, like cessation of menstruation, abdominal enlargement, nausea and vomiting, breast enlargement and food cravings." Find out more at the New York Times here.

We've said it once, we've said it a thousand times, but let's make it 1,001: symptoms alone are not a good way to determine a pregnancy. Because so many of the common symptoms of early pregnancy could be due to many different things, and also because many people don't have early symptoms, symptoms all by themselves just aren't reliable.

A pregnancy test -- either a home test, or a test from your healthcare provider -- is the only truly reliable way to find out if you're pregnant or not. If you're concerned you may be pregnant, the best thing to do is to get that test when it's time for one -- you can do that as soon as around two weeks after any sex which may have put you at risk -- and not make yourself nuts scouring the web for symptoms and worrying that every little bit of nausea, every time you pee a little more than usual is all because you're pregnant.

So you can see what I'm talking about, let's go back to that list of symptoms. Besides pregnancy, here are some other reasons a person may be experiencing any of them.

  • A missed, lighter, or shorter menstrual period than usual
    Could also be from: stress, thyroid problems, eating disorders, certain medications (like hormonal birth control methods), drastic or quick weight loss, weight gain or being underweight, hormonal imbalances or shifts, overexercising, uterine scarring, lack of ovulation in a given cycle or premature ovarian failure
  • Breast tenderness or enlargement
    Could also be from: Pre-menstrual syndrome, starting your period, puberty (breast growth), breast injury, from drinking alcohol or caffeine, sexual arousal, breast infection, shingles, the side effects of certain medications
  • Nipple sensitivity
    Could also be from: Pre-menstrual syndrome, puberty, chafing, breast injury, being cold, breast infection, the side effects of certain medications, sexual arousal
  • Frequent urination
    Could also be from: Cystitis (bladder or urinary tract -- UTI -- infection), an overactive bladder, neurological illness, the side effects of certain medications, diabetes, drinking more fluids than usual
  • Feeling unusually tired
    Could also be from: Pre-menstrual syndrome, starting your period, puberty, the side effects of certain medications, allergies, depression, diabetes, thyroid problems, chronic pain, anemia, eating disorders, autoimmune disorders, sleep disorders or lack of adequate sleep and rest, stress, mononucleosis
  • Nausea and/or vomiting
    Could also be from: the side effects of certain medications, migraine headaches, food allergies or food poisoning, eating disorders, use of alcohol or other recreational drugs, stress or emotional upset, the flu or other viruses or infections, smoking, ulcers
  • Feeling bloated
    Could also be from: Pre-menstrual syndrome, puberty, the side effects of certain medications, gas, constipation, lactose intolerance or other food allergies, overeating, irritable bowel syndrome
  • Cramps
    Could also be from: Pre-menstrual syndrome, starting your period, constipation, food allergies or food poisoning, gastrointestinal inflammation (such as from gallbladder problems or inflammatory bowel disease), sexually transmitted infections, mononucleosis, vasocongestion, urinary tract infections, gas, ulcers
  • Increased or decreased appetite
    Could also be from: Pre-menstrual syndrome, puberty, the side effects of certain medications, stress, depression, exercising more than usual, thyroid problems, use of alcohol or other recreational drugs, mononucleosis
  • Feeling more emotional than usual
    Could also be from: Pre-menstrual syndrome, starting your period, puberty, the side effects of certain medications, use of alcohol or other recreational drugs, depression, eating disorders, stress

You'll notice that a person may have most of these symptoms and be just as likely to simply be in puberty as it's likely they are pregnant. A person may have a handful of early pregnancy symptoms and just be under stress, have a flu, not be eating right or be experiencing the symptoms many people get before their periods begin. Some of these symptoms can even be caused by the stress of a pregnancy scare itself: it's normal to feel emotional, nauseated, tired and to have eating habits change when you're freaked out about a possible pregnancy.

With all of these symptoms, there are so many other things that could be causing them that it just doesn't make sense to get fixated on any or even all of them being about pregnancy.

It's common enough to be especially worried about pregnancy when starting an "invisible" method of birth control, like birth control pills, where you can't really tell if it's working or not in any concrete way. Bear in mind that often, side effects of many hormonal methods are actually pretty similar to many early pregnancy symptoms, especially when you just start using a new hormonal method and your body is getting used to it. For instance, with the pill, bloating, weight changes, nausea, changes in periods, breast tenderness and mood changes are all very common side effects.

Some young people worry that they may be pregnant even when they have or seem to have normal periods. That's pretty unlikely. If it looks like a period, acts like a period, and comes when you expect your period, it probably is a period, and it is not likely you are pregnant. As well, many young people, especially those not trying to become pregnant, don't chart their periods to know when to expect them, and expect periods to show up around the same date every month, even though regular periods won't tend to do that. To find out about how to figure out if your period is really late, click here. Too, many young people have irregular periods to begin with, or use birth control methods like Depo-Provera which can suppress periods, so have no idea when a period should be coming.

We do know that around 25% of people do or have experienced some vaginal bleeding even when pregnant, which can confuse all of this a bit, and seems to result in panic for some. (Do recognize that around 75% of women do NOT have that bleeding, so getting your period really is a pretty reliable way to know you're not pregnant. Really.) That's not a period, but it can be some other things. Some folks, for instance, will have lighter spotting around the time they expect their periods which may be due to an egg implanting itself in the uterine wall: that implantation bleeding, however, is not particularly common, and often something some will still not notice who do have it. It also will not tend to be like your usual periods, even though if it happens, it can appear around the time you might expect a period. That kind of bleeding tends to only last a day or two and is very light, a lot like breakthrough bleeding while using hormonal contraceptives.

Some other people experience something called decidual (decidua is the term for the uterine lining during pregnancy) bleeding with or throughout pregnancy, which is thought to be caused by hormonal imbalances and changes. Some can confuse decidual bleeding with having periods during pregnancy.

Again, this leads us back to just getting and taking that pregnancy test when it's been around two weeks after you may have had a risk, and recognizing that until you can take a test, you're unlikely to have any symptoms, and freaking out over them isn't likely to help you out.

I understand that it's not always simple to just go and get a pregnancy test. Some young people are worried they will be discovered buying or using home pregnancy tests, or that if they see a healthcare provider for a test, their parents or neighbors will be told. Know that in most areas, when it comes to tests via your doctor or clinic, your privacy is protected when it comes to your sexual healthcare. While, if you're using family insurance in countries without national healthcare, your visit may show up on a bill, so that's an issue where your privacy may be breached, you can counter that by paying cash for your visit, or can use a clinic like Planned Parenthood separate from your regular healthcare.

If you'd prefer to take a home test but are worried about someone working or shopping at your pharmacy finding out, here are a few creative ways to avoid that:

  • Go in with a handful of friends and each buy a test as a bunch. If anyone at the counter gives you the hairy eyeball, you can giggle it off (they might just assume you're all being silly), or say they're for a science or art project.
  • Buy it with a card for a new baby, and pass it off like it's a gag gift for a relative who just gave birth.
  • Be as blithe about it as you would be if you were getting it for a friend. If you don't look panicked, it won't tend to be assumed that you are someone panicked about a possible pregnancy.
  • Order a box of tests from a site online, like a drugstore site, if you can do that.
  • If you're still with the partner who was part of your risk, let him take a turn buying the pregnancy test. After all, you didn't wind up in this spot all by yourself, so you shouldn't automatically have to go it alone.
  • If you are heterosexually active, and not having a scare right now, next time you're out somewhere away from home, go to a pharmacy there and just pick up a few in case you need them sometimes down the road. That way, you'll have them ahead of time if and when you need them and won't have to worry about any of this.

I also understand that sometimes, even when a person can get a test without any problems, you can feel like you don't want to take one because you just do not want to know the answer, especially if it's one you don't want. I once had a friend ask if I'd read her Tarot cards to find out if she was pregnant or not, and when I suggested that I thought a pregnancy test would be a better way to do that, she made clear she just wasn't ready for that concrete an answer yet. (For the record, the reading did not suggest she was pregnant, even though she was, so either that is as unreliable as I suspected, or I'm a crap Tarot reader. Probably both.)

You don't have to test for pregnancy on the first day you can probably get a reliable result if you don't feel ready for it. Just bear in mind that it is pretty important to find out as soon as you can if you're pregnant, for a few smart reasons. All three of the options available to you with a pregnancy -- abortion, adoption or parenting -- do have their own timetables. Abortion is not only not available through all of a pregnancy, it gets more expensive and tougher the further into a pregnancy a woman is. If you plan on remaining pregnant and giving birth, whether that's about adoption or parenting yourself, both your health and that of a fetus can be impacted if you don't get good pre-natal care, and don't start to adapt your life and your habits as you need to for a healthy pregnancy and delivery, and/or to become ready for parenting. And if you're not pregnant at all, extending that period of not knowing can seriously stress you out and keep you miserable when you just don't have to be. No matter what, a test also doesn't change reality: you are or are not pregnant, with or without the test to verify what the deal is. If you're pregnant, avoiding a test for a long time won't make you un-pregnant, it just will likely make dealing with your pregnancy tougher on you.

Scarleteen users who fear they may be pregnant often ask us, "Should I worry?" The answer to that one from us is always going to be no.

Worrying just doesn't do anything: we can't worry away a pregnancy, after all. What worrying does is amp up our levels of stress, make us feel physically and emotionally worse, and also tends to leave us less able to think clearly and manage a crisis if there is one to manage. Of course, "Just chill out," is hardly sage advice when you're concerned about something that is absolutely a huge deal, and mighty hard to be chill about, but whatever you can do to try and stay calm and relax at least a little bit is going to help you out whether you are pregnant or not. Young people tend to carry a lot of stress, and stress just isn't good for you, nor does it help us cope with the tough stuff: in fact, it makes coping a lot tougher.

So, if you are in the midst of a pregnancy scare, do be sure to take care of yourself as best you can. Get enough sleep, keep eating well, and do what you normally do to manage stress. That might be taking a long walk with the dog at night, having a bath, writing in your journal, hanging out with friends, deep breathing, talking to a counselor, painting your toenails, working out, whatever you know helps you recenter and calm yourself down.

Don't forget! If you know or think you DID have a recent risk of pregnancy within the last 120 hours, you can reduce your risk of becoming pregnant in a big way -- as much as 89% -- by using emergency contraception. For more on emergency contraception, click here.

If you do have a couple early pregnancy symptoms in the list, by all means, see your healthcare provider soon if they stick around, because you could be pregnant, but also because you could have another health issue that needs tending to.

If you find you're freaking out about pregnancy a lot, take a look at that to evaluate what's best for you. If that's because you're often having sex without birth control when you need it, you can change your habits so that you DO always use birth control when you need it, or only choose partners who cooperate when it comes to use of birth control and safer sex. If you are already using one reliable method of birth control with sex, but are still worried, you may want to back up your existing method with another sound method. And if you're doing all of that and still freaking out, then you might want to check in with yourself to see if right now being sexually active -- or active in the way you are, or with the particular partner you're with -- is really in your best interest. Any of us, at any age, may have times when sexual partnership just isn't right for us, or offers us more bummers than the good parts, and it's always okay to take a break from sex if we need one.

Lastly, for the love of Pete, do step away from the internet and it's dizzying array of symptoms and freakouts. Yep, even from this very site. We love you, but... go away. Seriously, get gone now. Go take a break, get a breather, test if you need to, and if it's too early or you can't get a test just yet, do something much better for you than swimming in your own panic and a bunch of medical terminology that'd make anyone feel like throwing up.

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