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PMS or Pregnancy Symptoms?

by DP Nguyen

in PMS, Pregnancy

PMS vs Pregnancy

PMS or Pregnancy?

This is very commonly asked question, and unfortunately, there is no easy answer. PMS symptoms and early pregnancy symptoms can be eerily similar, and it can be hard for you to distinguish between the two. The easiest way to find out if you’re pregnant is to take a home pregnancy test. (Or better – make an appointment with your gynecologist or doctor and get a blood pregnancy test to see if you have any pregnant hormones in your blood stream.)

Women who have never been pregnant before may have a more difficult time distinguishing pregnancy from PMS. But women who have had children and have indeed been pregnant in the past will tell you that it can be hard to tell the two apart.

If you’ve been trying to conceive, or on the flip side, if you are worried about an unplanned or unexpected pregnancy, this article will help you understand the difference between PMS and early pregnancy symptoms.

Common PMS Symptoms

Premenstrual syndrome – or PMS for short – are symptoms that women can start to experience 1 to 2 weeks before your period. They typically strike after ovulation (day 14 of your menstrual cycle, if you have a regular 28-day cycle). PMS symptoms go away after you start your period. And of course, they come back again a few weeks later. That is the joy of being a woman!

Women experience PMS in different ways and in varying degree of severity. For some women, they have such severe PMS symptoms that it disrupts their daily lives. For others, their PMS is just annoying.

The most common PMS symptoms include swollen and tender breasts (which can be a common early pregnancy symptom); fatigue and tiredness (another possible sign you’re pregnant); bloating (yet another pregnancy symptom); headaches; anxiety and depression along with mood swings; food cravings (which also strike when you are pregnant); joint and muscle pain; harder time with concentration and your memory; and menstrual cramps.

As you can see, all of these premenstrual symptoms are identical to early pregnancy symptoms and signs of pregnancy. So it can be super easy to confuse the two of them apart, especially if your period is late.

Women who are trying to conceive, who chart their basal body temperature on a regular basis, may have an easier time answering the question, “Is it PMS or Pregnancy?” But most women who are sexually active with a late or delayed period will have a really hard time telling the two apart.


So how can you tell whether your symptoms are PMS or pregnancy symptoms? A home pregnancy test, or a blood pregnancy test taken at your doctor’s office, is the easiest way to find out.

Read my related post: How Accurate are Home Pregnancy Tests? You can also read my recommendations for the best, most accurate home pregnancy test at my Pregnancy and Baby Store.

Early Signs of Pregnancy

Natural Morning Sickness Relief Queasy PopsWhat makes PMS versus Pregnancy such a complicated issue is the fact that the earliest signs of pregnancy can appear in the first weeks after you conceive – even before you’ve missed a period.

  • Having tender, swollen breasts (just like with PMS) is a very common first sign of pregnancy. They may feel tingly, sensitive to touch and even full. It’s really uncomfortable but it may be a warning sign that you’ve conceived, and your breasts are getting revved up for breastfeeding in nine months.
  • Nausea is a classic pregnancy symptom; however, you should know that some women can also get nauseous when they PMS. It’s a less common PMS symptom, but it does happen.
  • Extreme exhaustion and fatigue (another PMS symptom) can also mean that you’ve conceived and are expecting a baby. This is actually one of the first signs that you’ll notice. It’s like an overwhelming tiredness, like you’ve been running a marathon and you just want to collapse and rest.
  • Food cravings (or aversions) can also signal that you’re pregnant. But again, some women who have PMS typically eat more and often crave certain foods, like chocolate.
  • Mood swings, crying spells and feeling weepy, is another early sign of pregnancy, but it is also very common when you have PMS.
  • Spotting and cramping may be a sign of implantation – the embryo (growing baby) has implanted itself into the wall of your uterus. Not all women experience implantation bleeding (which is very light in nature), but it is considered one of the very first signs of pregnancy. Along with spotting, some women feel abdominal cramping, similar to the menstrual cramping you experience during your period. You might just feel achy, and this might be a clue that your little one has successfully implanted itself.

Some women who get pregnant don’t experience any of these early signs and symptoms of pregnancy. But they are classic pregnancy symptoms that can be easily misinterpreted as just plain PMS.

If you think there is a chance that you could be expecting, you should make an appointment with your doctor or healthcare provider to take a home pregnancy test. Remember, if you are pregnant, the earlier you start getting prenatal care, the healthier your pregnancy and your baby will be!

Now, let’s discuss the common symptoms of PMS and Pregnancy.

Fatigue and Exhaustion – Both a PMS and Pregnancy Symptom

A vast majority of women experience fatigue and tiredness when they are PMSing. You might not experience fatigue every single month, but chances are you’ve experienced PMS fatigue before.

Fatigue is actually one of the first pregnancy symptoms to show up. It can strike about one week after conception – before you’ve even missed a period. This early pregnancy symptom is caused by increased levels of progesterone, a hormone that helps support the pregnancy and baby.

Some pregnant women describe pregnancy fatigue to be very similar to the very worst PMS fatigue. You are just so exhausted that all you want to do is take a nap. Fortunately, fatigue dissipates and goes away for a little while during the second trimester.

Fatigue is a common symptom to both PMS and Pregnancy.

Tender and Swollen Breasts – Symptoms of Both

Breast changes are common to both pregnancy and PMS.

After ovulation, some women with PMS may notice that your breasts become swollen, enlarged and are tender to touch. For smaller breasted women, this uncomfortable PMS symptoms causes your breasts to grow and they are bigger than normal. But it’s only temporary, because they will go back to their regular size after your period begins.

Tender and swollen breasts are also a very common pregnancy symptom, and one of the first signs of pregnancy. Your breasts can be tender, or they can feel sore and tingly. You might notice that they are fuller and heavier. Breast changes in pregnancy can occur as early as two weeks post-conception.

Mood Swings and Crying Spells – PMSing and Pregnant Women

PMS can come with crazy mood swings. You’re happy and laughing one minute, and the next, someone says something that you take completely the wrong way and it has you angry or in tears. You don’t know what’s wrong with you, or why your hormones are so out of whack and you are so emotional. Sound familiar?

Mood swings, crying spells, irritability, and emotional changes are also very common in early pregnancy. All those hormones in a pregnant woman’s body can make her very moody and emotional.

Because both PMS mood swings and Pregnancy emotional changes are nearly identical to each other, it can be hard to tell whether you’re just PMSing or if you’re pregnant based on this symptom alone.

Food Cravings – Premenstrual Symptom and Classic Pregnancy

This is yet another shared symptom of PMS and Pregnancy.

When you are experience premenstrual symptoms, you can definitely notice a change in your eating habits. Some premenstruating women may eat more, because all of a sudden their appetite just explodes. Others may start to crave chocolate and other sweets. And yet others have more of a hankering for salty foods. Food cravings are very common when you are PMSing.

Likewise, this is yet another common pregnancy symptom. Some pregnant women may have an increased appetite. However, in early pregnancy, food aversions are also common. Certain smells and tastes just are repulsive to you. Even a slight whiff of it may trigger your nausea and morning sickness to strike.

Food aversion is classic to early pregnancy, and it can be an indication that you’re going to have a baby.

Acne and Breakouts – Yet Another Shared Symptom

Belli Complexion Duo Gift SetHormones can wreck havoc on your skin, both when you are PMSing and when you’re pregnant.

When you’re expecting, you have higher levels of androgens (a hormone), which cause the sebaceous glands in your skin to get larger and these hormones also increase oil production and this can clog your pores and prompt you to have more breakouts and acne. In fact, it’s not uncommon for many moms-to-be to feel like their teenage years are back with their acne.

Similarly, premenstrual women also experience more breakouts and worst acne during PMS. Some studies estimate that as high as 78% of adult acne in women experience these unwanted pimples and zits during PMS. In fact, it’s called premenstrual acne, and it is a real phenomenon. It all has to do with the hormonal fluctuations that occur during a normal menstrual cycle. For this reason, hormonal contraceptives (birth control pills and shots) have long been used to help reduce premenstrual breakouts.

Darn those hormones causing this shared symptom of PMS and pregnancy!

Bloating and Weight Gain – PMS and Pregnancy

Who doesn’t dread the bloating you experience before your period arrives? Your bra starts to feel tight, as your breasts swell up; your stomach tends to stick out a little further, making your pants feel tighter than normal. Many women even can gain a few extra pounds. PMS bloating sucks (and luckily, it goes away when you start your period).

Out of all the annoying PMS symptoms, bloating (or water retention) and the extra weight gain it can bring are one of the most hated premenstrual symptoms.

In early pregnancy, bloating is one of the very first signs of pregnancy. And it can be incredibly difficult to distinguish pregnancy bloating from your PMS bloating, since they feel similar. Your pants might start to feel tight, and you might even notice a little pooch. The pregnancy hormone, progesterone, is to blame for your pregnancy bloating, and it definitely sucks.

Since it can be hard to determine what’s the cause of your bloating – normal premenstrual symptoms or you’re pregnant- you should take a home pregnancy test after you’ve missed your period.

Morning Sickness and Nausea – A Hallmark of Pregnancy

Even if you know nothing about pregnancy symptoms, you know that morning sickness is a classic and an infamous pregnancy symptom. According to researchers, up to 90 percent of all expectant mothers will experience morning sickness (nausea and/or vomiting) to some degree during their 40 weeks of pregnancy? The 10 percent of women who are incredibly lucky will never get nauseous or even feel an inkling of when pregnant.

Morning sickness can begin as early as two weeks after you conceive.

Nausea can be a PMS symptom, but it’s only a small percentage of women who actually experience nausea during their premenstrual weeks. So nausea can be common to both PMS and Pregnancy.

Missed Period – Only Pregnancy

PMS ends when you have your period, and an absence of a period means that you’re most likely period. However, a late or delayed period can make it tricky to figure out whether you’re going to be a mother or not.

If you’ve always had regular periods – a menstrual period every single month without fail – experiencing a missed period is definitely the first and unmistakable sign of pregnancy.

Some pregnant women may experience light bleeding or spotting, which can be mistaken for a regular period or a light period, especially if they’ve had irregular periods in the past. This spotting during pregnancy is a sign of implantation – the fertilized egg burrowing itself into the lining of your uterus, where it will make a nice and healthy home for itself of the next nine months.

For a small percentage of women, they may spot randomly on and off throughout their pregnancy. Occasional spotting can be considered normal, but it may also be a sign of a miscarriage.

In fact, because spotting is so confusing, if you’ve ever watched “I Didn’t Know I Was Pregnant” on Discovery Health, most of those women never realized they were pregnant because they experienced spotting during their pregnancy, which they mistakenly believed was a period.

Implantation spotting doesn’t look like your regular menstrual flow. It’s lighter in flow, and the color is usually a light pink or brownish coffee grounds kind of color.

PMS versus Pregnancy – A Breakdown of Symptoms

As you can see, there is a lot of overlap between PMS and Pregnancy. So I’ve broken it down for you to get a better understanding. This comparison chart compares each symptom side by side. Pay close attention and you can figure out which symptom is unique to pregnancy alone.

Symptoms of PMS Pregnancy Symptoms
   Not a PMS Symptom      Missed Period
   Bloating and Water Retention      Bloating and Water Retention (Edema)
   Breast Swelling and Tenderness      Breast Swelling and Tenderness
   Insomnia and Trouble Sleeping      Insomnia and Trouble Sleeping (2nd and 3rd Trimester)
   Acne and Breakouts      Acne, Breakouts and Skin Changes
   Fatigue      Fatigue (Worst in First and Third Trimester)
   Upset Stomach, Constipation      Upset Stomach, Constipation
   Headache      Headache (common in First Trimester)
   Backache      Backache and Back Discomfort (Second and Third Trimester)
   Appetite Changes and Food Cravings     Appetite Changes and Food Cravings (usually in Second Trimester, after Morning Sickness has passed.)
   Trouble Concentration      Trouble Concentration and Memory – called “Pregnancy Brain”
   Mood Swings and Crying Spells      Mood Swings, Emotional Rollercoaster
   Nipple discharge      Nipple discharge (Colostrum – Second and Third Trimester)
   Changes in Libido (Sex Drive)      Changes in Libido (Low Sex Drive in First Trimester, Increases in Second Trimester)
   Abdominal and Pelvic Cramps      Cramping (Second Trimester as Womb stretches for baby)
   Not a PMS Symptom      Increased Urination
   Not a PMS Symptom      Melasma (Darkening of Skin)
   Nausea      Nausea and Vomiting (Morning Sickness) – More Common in First Trimester but can last entire pregnancy
   Elevated Basal Body Temperature (until your period starts and it lowers)     Elevated Basal Body Temperature (If it remains high 2 weeks after you ovulate, you’re pregnant.)

Ovulation Symptoms

Because PMS symptoms occur in the days and weeks following ovulation, it’s important that you are aware of ovulation symptoms. Sometimes, PMS symptoms are actually ovulation symptoms. It’s important that you’re aware of these symptoms for many reasons – including the fact that it’s good to be aware of your body’s changes, especially if you’re wondering “Am I pregnant?” And if you are trying to conceive, knowing your ovulation symptoms may help improve your chances of getting pregnant.

Women with a regular 28-day cycle will ovulate around day 14 (the second week after their last period begins). Around this time, you might notice some of the following symptoms of ovulation

Cervical mucus changes – A common sign of ovulation is a difference in your cervical mucus. Around the time you ovulate, your vaginal discharge might be transparent, like the color of egg whites. You will have a lot more discharge than normal, and when you examine your mucus, you will notice that it’s sticky and stretchy. You can actually hold it between your thumb and index finger and stretch it for about an inch, and it will not break.

Basal Body Temperature Increase – As you may have noticed in the PMS vs. Pregnancy chart above, premenstrual women and expectant mothers will experience a rise in their basal body temperature. During ovulation, you can expect your BBT to rise between 0.5 to 1.5 degrees. Your BBT will remain higher until you have your period, when it will decrease. If you happen to be pregnant, your basal body temperature will remain high and not decrease.

Abdominal Cramping or Pain on One Side – Called Mittelschmerz (or “middle pain”), this is a common ovulation symptom that roughly 1 in 5 women will experience. The abdominal discomfort can be mild or severe excruciating pain. It doesn’t last too long, and it’s caused by the bursting of the egg from the follicle during ovulation.

Spotting – Light spotting is also a common ovulation symptom. Not all ovulating women experience spotting, but it can occur.

To learn more, read Ovulation Symptoms – Signs to Tell When You Ovulate

Are You Pregnant?

After reading the above PMS and early pregnancy symptoms, and you believe you might be pregnant, go take a home pregnancy test or schedule an appointment with your doctor or healthcare provider and get a blood pregnancy test.

The best time, and you will get the most accurate result, is if you take a home pregnancy test after you’ve missed your period. Different HPTs have varying degrees of sensitivity – some are more sensitive to the pregnancy hormone, hCG than others. Sometimes, if you test too early, you will get a negative result even if you are pregnant, because not enough of the hormone has built up in your bloodstream. In other cases, testing too early may give you a false positive result. In these situations, you get a positive result and then end up getting your period. What you experienced is a chemical pregnancy, or a very early miscarriage.

So if you are wondering if you are pregnant, or just experience PMS symptoms, test, test, and test for pregnancy, since it is really the only surefire way to figure out. And if you are ever worried about anything, contact your gynecologist or healthcare provider and make an appointment. Good luck!

Video – Early Signs of Pregnancy

I produced a video for a popular women’s health website on the early signs of pregnancy. Hope it will answer some of your questions about the first signs of pregnancy!

Have any other questions that this article didn’t cover? Leave me a comment below, and I will do my best to answer your questions as quickly as I can! Sometimes I get super busy and forget to answer your questions, but I am trying to be better at responding to my comments! Thanks for understanding!


DP Nguyen is founder and editor of Hip Chick's Guide to PMS, Pregnancy and Babies. She’s an expert pregnancy and women’s health blogger. She is NOT a medical doctor and does NOT offer medical advice. Connect with her on Google+, Twitter and Facebook.

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