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"With all the momentous changes to your body during pregnancy, it&amp;#039;s no surprise that many women sometimes feel under the weather.  The moment of conception triggers an amazing chain reaction of hormonal and physiological changes. These can affect your physical, emotional and overall sense of well being in many ways.  Some, very lucky, women seem to breeze through the whole nine months feeling great. Their skin is radiant, their hair shiny and lustrous . . . and they&amp;#039;re probably extremely unpopular with other pregnant friends!  Others may suffer a string of less welcome side effects - from constipation and cystitis to fainting and flatulence. Most mums-to-be experience one or two &amp;#039;niggles&amp;#039; at certain stages of their pregnancy. Thankfully, most of the complaints are irritating rather than dangerous. But don&amp;#039;t be afraid to raise any concerns with your midwife or doctor.  Here are the most common niggles in the first three months of pregnancy.  Backache What are the symptoms? This is most commonly experienced as a dull ache across the lower back that sometimes extends to the top of the buttocks. Women with a pre-existing back condition may find it is exacerbated by pregnancy.  What causes it? During pregnancy, the release of the hormone progesterone enables ligaments around the pelvic joints to soften and stretch in readiness for birth. The progesterone also relaxes other ligaments in the body, including those in your back. This puts extra strain on the muscles and joints of the lower back area, causing backache.  Good advice  A few minutes stretching each day can work wonders. Try doing the following, as recommended by our personal fitness instructor, Anne Marie Millard, (alternatively you could ask your midwife or doctor for some simple exercises).  Cat curls: get on all fours, with your hands directly underneath your shoulders, knees directly underneath hips. Then, try to curl up (just like a cat does) by rounding your back, using the abdominal muscles to do so. Make sure that you tuck your stomach in and towards you, and that you are breathing out as you lift up. Pelvic tilts: stand with your feet hip&amp;#039;s width apart, knees soft, ribcage lifted and shoulders back and down. Next, tilt your pelvis up and towards you, tucking the bottom in as you go. Return to the starting position and repeat.  Improve your posture. Slouching for long periods at a desk, for example, won&amp;#039;t help matters.  A beginner&amp;#039;s guide to the Alexander Technique (there are a number of books available on the subject from around \u00A35) will teach you the basics on good posture.  Avoid carrying heavy loads and wear low heels rather than stilettos and high heels. Try to avoid taking analgesics.  Consult your GP if the pain is prolonged or severe. You might also want to consider seeing an osteopath or chiropractor.  Bleeding gums and gingivitis (gum infection)  What are the symptoms?  Bleeding gums may occur after brushing your teeth or eating hard, crisp foods like toast. Excessive bleeding may indicate a gum infection, known as gingivitis.  What causes it?  Hormones in pregnancy boost the body&amp;#039;s blood supply to cater for the growing foetus. This extra blood causes gums to swell, creating more of a gap where they join the teeth. Food can accumulate there, causing bacteria to multiply, which can lead to tooth decay and gum infection. Good advice  Consult your dentist if you suspect a gum infection but warn him/her you are pregnant as X-rays should be avoided.  Brushing your teeth after every meal or snack will help tackle bleeding gums. Go for a check up if you haven&amp;#039;t seen your dentist in the last year.  Constipation  What are the symptoms?  Constipation during pregnancy causes discomfort in the lower abdomen and prevents you from passing stools frequently and easily.  What causes it?  Progesterone released during pregnancy relaxes the intestinal muscles, which slows down your bowel movements. As a result, stools stay in the bowel longer, become harder, and therefore difficult to pass. Iron supplements given to protect against anaemia in pregnancy can cause constipation or diarrhoea. If they are needed, then your GP can usually prescribe one which doesn&amp;#039;t give you problems.  Good advice Avoid strong laxatives. Instead drink lots of water, eat plenty of fruit and vegetables and don&amp;#039;t put off going to the loo when you feel the need.  If this doesn&amp;#039;t work, ask your midwife or GP for advice.  Fainting What are the symptoms?  You may pass out completely or experience giddiness and dizzy spells - usually when standing up.  What causes it?  Fainting happens when the brain is deprived of an adequate blood supply.  In pregnancy, it may occur due to a combination of the demands of your uterus for extra blood, and standing for a period of time causing blood to accumulate in the legs and feet.  Good advice  Don&amp;#039;t stand still for too long and avoid getting up suddenly. In hot weather, keep cool by wearing loose clothes and using a pocket fan.  Avoid too hot baths and always get out slowly. If you feel faint, lie down with your head flat on the floor and prop your legs up slightly. Don&amp;#039;t get up too soon.  Flatulence What are the symptoms? These include frequent passing of gas, a bloated, tender tummy and chronic stomach rumbling.  What causes it?  The intestine slows down in pregnancy allowing wind to build up inside. Certain foods like fibrous cereals and pulses, onions and spices increase flatulence. Swallowing air is another cause.  Good advice  Avoid the food types mentioned above and eat slowly to prevent you gulping air. You may find regularly sipping warm water eases the problem.  Cystitis  What are the symptoms? If you need to spend a penny more often and feel a sharp bladder pain while urinating, you probably have cystitis. Spots of blood may also be present in your urine.  What causes it?  Cystitis is caused by germs entering the bladder, leading to infection. In pregnancy, the bladder muscles slacken - increasing the risk of infection.  Good advice  Drinking lots of water helps to flush out the infection and makes urinating less painful. Cranberry juice is also known to be beneficial.  Your doctor can prescribe anti-infectives.  Varicose veins  What are the symptoms?  In early pregnancy, varicose veins may develop on the legs (nearer term they can appear in the vulva). Early signs are a dull aching pain or irritated skin. Gradually the veins start to appear as dark, pronounced lines.  What causes it?  Varicose veins often run in families. Prolonged periods of standing, sitting with your legs crossed tightly and excess weight gain are other causes.  Good advice  Although hardly fashionable, support tights will reduce the risk of varicose veins.  Don&amp;#039;t stand around for long periods or cross your legs tightly.  Elevate your feet whenever possible, sleeping with your feet propped on a pillow.  When sitting down, do gentle exercises (like rotating your feet) to improve circulation. Your midwife can advise you.  Fatigue  What are the symptoms?  You may find that you suddenly need more than your usual hours of sleep or that you feel the need for extra rest during the day. What causes it?  A variety of factors can cause tiredness during early pregnancy, including insomnia, anxiety and poor diet. Anaemia may develop in pregnancy if there is insufficient intake of iron in particular.  Good advice  The only real answer is to sleep more and do less! Also ensure you are eating a well-balanced diet. If in doubt, ask your midwife or GP for advice. Iron or vitamin supplements, if necessary, are best used on your doctor&amp;#039;s advice.  Frequent urination  What are the symptoms?  The urgency and frequency of urination increases throughout the day and night.  What causes it?  In the first few months of pregnancy, the expanding uterus presses onto the bladder causing it to empty itself more often.  Another reason is the impact of hormones on the muscles surrounding the bladder. Urine infection (cystitis) can also cause frequency without pain on passing urine, so it is a good idea to ask your doctor or midwife to check that your urine is clear.  Good advice  Cutting down on drinks in the hours before going to bed may help.  Morning sickness  What are the symptoms?  Morning sickness is usually experienced as a general feeling of nausea, sometimes with vomiting.  Strong food smells or the sight of certain foods may bring it on. The nausea may also occur throughout the day. Fortunately, in nearly all cases it subsides after the first three months. But a few unfortunate women suffer from it throughout their pregnancy.  What causes it?  Morning sickness is caused by the dramatic increase in hormone levels in early pregnancy combined with low blood sugar and tiredness.  Good advice  A little dry toast or dry crackers first thing in the morning may ease your queasiness. Avoid large, rich meals and any foods that make you nauseated. Drink lots of fluids, eat little and often.  Dried ginger or peppermints may help settle your stomach. Travel sickness bands could also provide relief and some women find homoeopathic medicines helpful.  Sleepless nights (insomnia)  What are the symptoms?  If you have insomnia, you will either take hours to fall asleep, and/or will have great difficulty getting back to sleep after waking in the night.  What causes it?  Sleeplessness is often a side effect of frequent urination, but is also caused by the overall increase in the body&amp;#039;s metabolism in pregnancy. Good advice  Try the usual insomnia remedies, but avoid sleeping tablets. Try to wind down before going to bed. A hot milky drink or a warm bath might help. A gentle massage or head stroke from your partner may also relax you.  Thrush What are the symptoms?  Extreme vaginal itchiness accompanied by a thick, white and curdy discharge, a bit like cottage cheese, usually indicates thrush. Some women also experience pain when urinating.  What causes it?  Thrush is caused by a yeast infection called Candida albicans in the vagina.  What treatment is available?  Your GP can prescribe cream and pessaries, which should clear up the infection in a few days. These are also available without prescription from pharmacies, but tell the pharmacist you are pregnant as oral treatments aren&amp;#039;t safe to use during pregnancy.  Last updated 08.11.2005 "^^<http://www.w3.org/2001/XMLSchema#string>
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