Irritations come with the territory when you are pregnant. Dr Howard Lee looks at some of the common complaints

Pregnancy causes physical and psychological changes that affect all aspects of a woman's life. Even if you're super-fit you'll encounter them - and they can be irritating or upsetting.

At its most fundamental biological level, pregnancy is a 'load' causing alterations not just in the mother's pelvic organs but all over the body. As it grows, your baby interacts with your systems, causing adaptation, and change of function in your body.

These adaptations generally minimise the stresses imposed and provide the best environment for your baby's development. They are usually interlinked smoothly so that the effects on your whole body are minimised.

Common problems

• Nausea (not always an 'early morning' problem, but sometimes appearing at any time) is extremely common. It's often accompanied by changes in taste sensations and general digestive upsets.
• Fatigue. Your body is already having to work harder to adapt to the demands of your pregnancy so everyday tasks will naturally seem more exhausting.
• Headaches are also quite normal, but you should consult your GP if they persist.
• Mood changes. The first few weeks are a time of immense hormonal and emotional changes. You may find that you get upset much more easily, even if you're usually a happy, placid person. You may get tearful, depressed or angry over even trivial situations. This is all quite normal, often centering on fears for your baby, or worries that you won't be able to cope, etc. If you are concerned in any way about your mood changes talk them over with your midwife or GP.

• Vaginal discharge. This usually increases, but tell your GP if you develop any irritation or soreness as this may be a sign of an infection such as Candida (thrush).
• Slight vaginal bleeding can sometimes occur in the very early weeks and will settle spontaneously and with no abnormal affects to your baby. Your GP should, of course, be notified if you have any bleeding at all.
• There is an increased load on your heart in pregnancy, because you need to supply extra oxygen to your baby's body and organs to help it grow. Your muscles also need to work harder because now they're moving you and your baby. Expect to get tired quickly and make allowances in your normal routine to accommodate this.
• You may notice that in the early part of your pregnancy you are breathing more deeply. This is a normal way of getting more oxygen. Later, of course, as your baby grows and takes up more space within your abdominal cavity, your diaphragm will not be able to move as freely and you will probably notice that you get short of breath.
• Fluid retention. With all of these changes in your heart, circulation and breathing it's not unusual to find that by the end of the day you'll have swelling in your ankles, and sometimes fingers, due to fluid retention. This should normally settle after a good rest.
• Frequent visits to the toilet are a common feature of early pregnancy. As your pregnancy continues your kidneys will, of course, take on more work as they clear the additional waste products from your baby's growth. There are also changes that occur within your bladder muscles because of your pregnancy, and urinary infections are more likely.
• Back and leg pains. You're carrying more weight than usual so there are bound to be extra stresses on your spine and leg joints. Back and leg pains are quite common. Your midwife will be able to advise on suitable rest positions together with specific exercises to relieve discomfort.
• Indigestion. As your womb grows and presses upwards on your stomach, indigestion and heartburn can occur. Talk to your doctor about the best antacid remedies to use.
• In the later stages of pregnancy you may find you suffer from skin irritation. This is caused by increasing workload for your circulation which can swell the size of the veins, especially in your legs. This in turn can lead to itchy skin etc. Rest with elevation usually solves the problems.
• Constipation. High levels of progesterone cause bowel movements to slow, while your growing womb can press against your large bowel to make voiding difficult. Straining to pass motions can also contribute to piles.

Not all of these conditions appear in every pregnancy. But they are all a consequence of a normal process and many pregnant women will experience one or more of them during their antenatal period.

With proper care and advice discomfort can be minimised, allowing you to enjoy your pregnancy to the full.