Pregnancy is a period of great physical, mental and emotional changes for a lady. Hormones (chemicals which act as messengers) are responsible for many of these changes. They begin to happen soon after you conceive and continue throughout pregnancy and childbirth. After delivery, they revert back over a period of few weeks. This article aims to highlight some of the important hormonal changes in pregnancy. Having an understanding of these changes (from the patient’s viewpoint) would prepare you on what to expect during pregnancy.

Physical Changes (due to the hormonal effects): One hormone that plays a predominant role in pregnancy is ‘Progesterone’. This hormone causes the body temperature to rise slightly and can make a pregnant lady feel hotter than usual. It can also lead to breast discomfort that is mostly felt in early pregnancy. Progesterone causes slowing of the movement of the digestive tract. This leads to a feeling of fullness after meals and increased acidity. Therefore it’s very important to eat “small and frequent meals”. Progesterone causes water retention in the body. Also as the size of the womb increases with the growing baby, it puts pressure on the blood vessel and less blood is able to go back from the legs to the heart. This can lead to the swelling commonly seen around ankles and feet in pregnancy. So don’t stand for long and always sit with legs slightly elevated. Also always lie on your side and never straight on your back during the second half of pregnancy. Another hormone that increases during pregnancy is the ‘Melanocyte Stimulating Hormone’. It is responsible for the increased skin pigmentation often seen during this time. The dark line travelling from the navel to the pelvic bone(linea nigra) or the butterfly-shaped dark pigmentation on the face (chloasma), seen in some women, is because of this hormone. They are like autographs that your babies give you …a gift of motherhood! As the hormones, Progesterone and Relaxin prepare to culminate the pregnancy with childbirth; they cause increased relaxation of ligaments and muscles. This can lead to increasing discomfort and backache as pregnancy advances. Doing pregnancy-specific exercises can help strengthen muscles and reduce aches. 

Metabolic changes (due to the hormonal effect): The thyroid gland becomes more active during pregnancy. The gland needs iodine to manufacture the thyroid hormone. So iodine requirement goes up to around 250 mcg/day during pregnancy. Salt fortified with iodine is a good way to take that. It’s important that adequate thyroid hormone is being produced by the mother’s gland, especially in the first three months, for baby’s brain development. In case you are hypo (low) or hyper (high)thyroid, your doctor will treat you appropriately.  There is an increased requirement of Calcium in pregnancy and lactation.It is around 1000mg/ day. Calcium-rich foods like cheese, milk, broccoli etc are a good source. Vitamin D (25(OH)D) levels should be adequate in a pregnant woman as it helps to absorb the dietary calcium. It’s good to expose your body to the sun for 15-20 min every day. This helps to synthesize Vitamin D in the skin.  Water metabolism also undergoes changes due to hormonal effects such that pregnant woman can develop transient polyuria (increased frequency of passing urine).  Always consult your Gynecologist if you feel pain or burning during the passage of urine, as it can be a sign of urinary infection. Food metabolism changes to accommodate the increased nutritional requirement of the growing baby. The mother takes a switch from carbohydrate to fat utilization. This diverts the glucose (carbohydrate) to the baby. Also, pregnancy is a state of ‘Insulin Resistance’ which means that the body is not able to utilize the glucose as well for a given amount of Insulin.In case the pregnant lady’s pancreatic function is not sufficient to overcome Insulin Resistance, she can develop Diabetes Mellitus. Your doctor will test you at the appropriate stage of gestational diabetes.  It is also very important to increase the protein intake (60 g/day) for baby’s growth. Taking pregnancy specific milk supplements along with diet can help to meet the increased requirement.

Emotional changes (due to the hormonal effect): At the emotional level, progesterone can be responsible for the mood swings and irritability. So all husbands, if you see your pregnant wife getting mad at you for no reason(as all husbands think!), please bear with the progesterone effect, it’s not deliberate!!! 

The whole process of pregnancy, labour and delivery are controlled by the delicate balance of various hormones. Hormones are like messengers giving signals to the body to act. Keep the mind healthy to release hormones that give happy signals to your body during your precious journey from pregnancy to birth.