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Pregnancy vs. PMS symptoms: how to tell the difference

PMS (premenstrual syndrome) causes several symptoms that mimic those of early pregnancy, which can make it difficult to determine whether you’re pregnant or just a few days away from your period. That said, there are some specific symptoms that are well-known to indicate pregnancy that you can look out for.

Is there a way to tell the difference between pregnancy and PMS?

The only definitive way to tell if you’re pregnant and not just experiencing PMS symptoms is by taking a pregnancy test. Fortunately, you don’t usually have to wait too long to find out - home pregnancy tests today are accurate enough to detect 90% of pregnancies the day of the expected period. While some pregnancy test manufacturers claim that their products can give you results as early as four or five days before your expected period, most of them are only accurate about 60% of the time, which means if your result turns out to be negative, you should wait and retest for confirmation).

Home pregnancy tests work by detecting levels of hCG (human chorionic gonadotropin) in your urine. Although there may be some hCG in urine as early as a week after you conceive, it’s usually not enough for a home pregnancy test to detect. Any positive pregnancy test should be followed up with a blood test by your health practitioner to confirm it.

What are similar symptoms of pregnancy and PMS?

Symptoms that occur both in pregnancy and PMS include:

1. Changes in mood

Feeling sad, anxious, or irritable, or having crying spells, are symptoms that are commonly associated with both the first trimester of pregnancy and the days leading up to a period. In the case of PMS, these symptoms typically disappear once your period begins. However, if mood swings persist and you miss your period, this may suggest pregnancy. Persistent feelings of irritability or sadness can also indicate depression, so make a point of seeing the doctor if this is the case.

2. Breast tenderness

It is common to notice some of the following changes in your breasts during both PMS and early pregnancy:

  • Tenderness
  • Heaviness
  • Pain
  • Bumpy breast tissue
  • Swelling 

The severity of these symptoms vary from one individual to another. However, breast-related symptoms in PMS are usually most apparent just before a menstrual period, and they improve as the period progresses or just after it ends. 

In early pregnancy, your breasts may feel tender to the touch, and they can also get heavier. Some women also report developing distinct blue veins on their breasts during early pregnancy.

3. Fatigue

Tiredness and fatigue in the days leading to a menstrual period is caused in part by the hormone progesterone. Once your period begins, the fatigue should go away on its own. However, if you experience heavy periods, the feeling of tiredness can last throughout the period.

Fatigue is also a symptom of pregnancy to watch out for in those early days. For many women, excessive tiredness persists throughout the first trimester, disappears in the second trimester, and then rears its ugly head once again in the third trimester.

4. Back pain and headaches

Fluctuation in hormone levels can result in both back pain and headaches in early pregnancy and before a menstrual period.

5. Bloating

Bloating is a symptom many women experience before a menstrual period as well as during the early days of pregnancy. It may result from changes in the levels of hormones such as estrogen and progesterone.

6. Constipation

In addition to bloating, the fluctuations in hormone levels during pregnancy and before a period can also slow down bowel movements, leading to constipation. Pregnant women are likely to deal with constipation in the first two trimesters, while women with PMS- related bowel issues typically experience relief when they get their periods.

7. Food cravings

Increased appetite and food cravings are symptoms that are commonly associated with pregnancy, but they can also occur in women with PMS. it’s not uncommon to crave fatty or sweet foods, or carb-loaded meals in the days leading up to your period. This is likely due to changes in the levels of the hormones progesterone and estrogen.

Many pregnant women have even more specific food cravings, as well as strong aversions to others.

Symptoms unique to pregnancy

Some specific symptoms indicate that you might need to shop for cute rompers or travel-ready strollers in future. Symptoms that are more likely to signal pregnancy include:

1. A missed period

A missed period is one of the first signs of pregnancy for women who have regular periods. That said, there can be many other reasons for a late or missed period, including polycystic ovary syndrome (POS), stress, menopause, low body weight, medical conditions such as diabetes or thyroid disease, and going off or on birth control.

2. Change in your nipples

Breast changes resulting from pregnancy hormones tend to stick around rather than disappear as with PMS. Furthermore, if you’re pregnant, you’ll notice changes in your areolas - they typically darken and increase in diameter. You may also notice an increase in the number of tiny bumps on your areola. These “bumps' ' are glands that secrete oils to lubricate your areolas and nipples in preparation for eventual breastfeeding.

3. Nausea

While some women report experiencing mild digestive discomfort just before a menstrual period, nausea and vomiting are rarely associated with PMS. On the other hand, nausea affects the majority of pregnant women, and the symptom typically shows up in the first trimester.

4. Implantation bleeding

Implantation bleeding is a small amount of bleeding or light spotting that occurs around 10 to 14 days after conception. Implantation bleeding, unlike menstrual bleeding, is usually a pink-brown color. It is often accompanied by light and short-lived cramping and can last anywhere from a few hours to a few days.

5. Peeing frequently 

The need to pee more often can begin as early as four weeks after conception. This symptom occurs because the kidneys are forced to work overtime to filter extra waste from the blood when you’re pregnant.

Final thoughts

If you suspect that you’re pregnant, consider taking a home pregnancy test. If the result turns out to be positive, your next step should be to make an appointment with your doctor to get confirmation of the pregnancy and subsequently plan the next steps. If the test is negative but you don’t get your period 1 or 2 weeks after it was due, you might also want to see a doctor.

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