Pregnancy is not always a time for glowing. Some women experience an increase in unusual symptoms during this time. Kirsten Braun
Leucorrhoea (vaginal discharge)
While all women experience some vaginal discharge, for many pregnant women this discharge increases, particularly in the second and third trimesters. This discharge is referred to as leucorrhoea, and it is caused by an increase in the production of oestrogen. It is thought that the increase in discharge is to protect the birth canal from infection. While the discharge can differ in colour and texture, generally it is thin, clear or milky, and mild-smelling. Women may find they need to wear panty liners or pads to cope with the extra discharge. Using tampons is not recommended as it can increase the risk of a vaginal infection. Vaginal discharge that is yellow or green in colour, thick and cheesy in consistency or accompanied by burning or itching could be a sign of an infection. Women with these symptoms should have the discharge checked by their doctor or midwife. Similarly, if a woman’s discharge is particularly heavy or increasing in volume and more watery in consistency it may be a sign that her waters have broken and the discharge is actually amniotic fluid. Women who are concerned that their waters have broken should also consult their doctor or midwife.
We have all heard of the myths about pregnant women craving pickles and ice-cream but for some women they crave much more unusual items such as plaster, chalk, ice, dirt, soap, hair, paper, paint chips and sand, to name a few. The term given to cravings for non-food substances is ‘pica’. It is estimated that as many as one in ten women experience pica. Many of the items that women crave are unsafe as they may contain toxins or bacteria that could be harmful to their health and/or the health of their unborn child (e.g., lead in lead-based paint, parasites in soil etc.). Additionally, the eating of such substances can also lead to intestinal or bowel problems such as cramping, pain and constipation. If women who experience pica feel they cannot control their urges, they can consult their doctor or midwife. It is thought that pica can sometimes be a sign of a nutritional deficiency, so women experiencing it might benefit from being tested for nutritional deficiencies.
This condition is characterised by parts of the tongue losing their papillae, the tiny pinkish white bumps that occur on the surface. This results in red, smooth, irregular patches on parts of the tongue. The name is given because the patches give the tongue a map like (geographic) appearance. The patches often change in size and move to different areas of the tongue. Most women with geographic tongue do not experience any discomfort but some may find their tongue is more sensitive to hot, spicy or acidic foods and toothpaste. While geographic tongue may look insidious, it is no cause for concern. It is most likely caused by hormonal changes in pregnancy and for many women it resolves after the delivery of the baby.
Gingivitis (bleeding gums)
During pregnancy, an increase in the hormones oestrogen and progesterone results in an increase in blood flow to the gums. The gums become more sensitive and are susceptible to bleeding, particularly during teeth brushing. For women who have previously not had dental issues, this increase in bleeding can be alarming. Women can try changing their toothbrush to a softer variety but should still brush twice a day. The hormonal changes that occur with pregnancy can also result in more plaque building up on teeth, increasing the risk of periodontitis, a serious gum disease. It is a good idea for women to continue with their regular dental visits during their pregnancy so that their dentist can monitor any changes.
Women are often aware of swelling feet during pregnancy but they may not know that their feet are also likely to actually grow. During pregnancy, women experience an increase in the hormone relaxin, which softens the ligaments in the body in preparation for birth. In addition to the ligaments in the pelvis becoming more flexible, so do the ligaments in the feet. This causes the feet to become longer and wider. One study of pregnant women found that 60-70% of their feet became wider and longer, with their foot length growing between 2-10 mm. The arch in a woman’s foot also drops during pregnancy leading to a flatter foot. Unlike some changes that occur during pregnancy, these changes are permanent.
This is also sometimes referred to as ‘the mask of pregnancy’ and it refers to irregular patches of brown, blotchy skin. These patches commonly occur on the face, in particular the forehead, upper lip and cheeks. Chloasma is caused by an increase in the hormone oestrogen, which boosts melanin production, the hormone responsible for pigmentation. Sun exposure can exacerbate the skin colour changes, so staying out of the sun and/or using a sunscreen is recommended. Women who are concerned about the discolouration during their pregnancy should avoid using skin bleaches and/or peels as these can be unsafe to use during pregnancy and/or cause severe irritation to a pregnant woman’s skin. For most women, the discolouration will disappear after pregnancy or after the completion of breastfeeding.
During pregnancy, hormonal changes cause the blood vessels to expand, including those in the nose. In addition, an increased blood supply means there is more pressure in the veins in the nose, which are extremely delicate, making it easier for a nose bleed to occur. Approximately one in five pregnant women experience nose bleeds, particularly from the second trimester onwards.
Skin tags (acrochordon)
These are small skin-coloured growths of skin, often attached to the body by a thin stalk. They mostly appear in areas where the skin is hot, moist or rubs together or rubs on clothing, such as the armpits, neck, chest, underneath the breasts, groin and abdomen. It would appear that the hormonal changes that occur during pregnancy cause the hyperactive growth of the outer layer of the skin. Skin tags are harmless and generally painless but can become twisted or inflamed if rubbed constantly. In many cases the skin tags will disappear following pregnancy and breastfeeding. If they don’t disappear, women can have them easily removed by their doctor. Women should avoid using chemical-based wart or skin tag removers during pregnancy.
Hormonal changes and the weight of the baby can cause vulval varices, or varicose veins in the vulva. Symptoms include pain in the vulva or a dragging or heavy feeling. For many women, the symptoms do resolve following childbirth but if they persist women should consult their doctor. During pregnancy, women can relieve the symptoms by the use of ice packs on the area, wearing support garments or taking pressure off the area by lying down. Avoiding constipation is also important as this can worsen the symptoms.
Metallic taste (dysgeusia)
Pregnant women report a metallic taste similar to putting a coin in their mouth. Pregnant women most commonly experience this change in taste in the first trimester of pregnancy. The taste occurs even when women are not eating. Like many occurrences in pregnancy, it seems that the metallic taste is caused by hormonal changes. The metallic taste often lessens or disappears when women reach their second trimester. To alleviate the taste, women can try brushing their tongue with a soft tooth brush and rinsing their mouth with a mild salt solution. Eating sour foods seems to also help, as this increases the production of saliva, helping wash the taste away. Women can try drinking water with a squeeze of lemon juice and eating citrus fruits, green apples, pineapple, pickles, olives and foods with vinegar-based sauces and dressings.
Last updated: June 2016
© Women's Health Queensland Wide Inc. This article was written by Kirsten Braun and reviewed by the Women's Health Queensland Wide editorial committee. It was published in Health Journey 2016 Issue 2.