• Lifestyle

PMS Symptoms vs. Early Pregnancy Signs: What’s the Difference?

Determining whether you’re experiencing early pregnancy symptoms or just the start of your regular period can be tricky. This is because the symptoms of early pregnancy and premenstrual syndrome (PMS) have some overlap. While a pregnancy test is the only way to confirm pregnancy, there are signs that may help you differentiate your PMS symptoms from pregnancy signs. 

Why is it Difficult to Tell the Difference?

It’s often challenging to distinguish between PMS and early pregnancy since the symptoms can appear around the same time you’d expect your period. PMS symptoms typically start a week or two before menstruation, which coincides with the time early pregnancy symptoms may also appear. This overlap can make it difficult to determine whether your symptoms are signaling an approaching period or that you may be pregnant. Adding to the confusion, the severity and duration of PMS can vary each month, making it harder to identify a clear pattern.

While the shared symptoms and timing can be confusing, there are differences that can help you differentiate pregnancy from your PMS symptoms. For instance, nausea and changes in smell or taste are the common signs of early pregnancy. However, they are less likely to occur during PMS.

Understanding PMS Symptoms

The menstrual cycle typically spans around 28 days. It includes four phases: the menstrual phase, the follicular phase, ovulation, and the luteal phase. Premenstrual syndrome (PMS) refers to a range of symptoms that occur after ovulation and in the days leading up to your period. 

Many women of reproductive age experience physical discomfort and changes in emotion  approximately two weeks before menstruation. PMS affects about 48% of women, while its most severe form, premenstrual dysphoric disorder (PMDD), impacts 3-8%. 

Physical symptoms of PMS typically are:

• Bloating

• Sore breasts

• Aches

• Food cravings

• Cramps

• Emotional symptoms of PMS may include:

• Mood swings

• Anxiety

The severity of symptoms may vary. Especially individuals with premenstrual dysphoric disorder may experience intense mood swings and severe physical discomfort. In contrast, regular PMS typically presents milder symptoms like mild mood changes and bloating. These do not usually disrupt daily life to an extent.

Understanding Early Pregnancy Signs

The most noticeable sign of early pregnancy is a missed period. However, a missed period does not always mean that you are pregnant. It’s common for women to experience menstrual irregularities. These irregularities can arise from various causes, including the use of birth control or certain medications, as well as conditions like polycystic ovary syndrome, diabetes, or eating disorders.

This is why, while looking for early signs of pregnancy, it’s important to watch for additional signs, such as:

• Nausea (with or without vomiting): Nausea is one of the first signs of pregnancy. It can occur at any time of the day and may or may not include vomiting. It’s related to the rapid increase in pregnancy hormones, particularly human chorionic gonadotropin (hCG).

• Frequent urination: The amount of blood in your body increases during pregnancy. This causes your kidneys to process extra fluid that ends up in your bladder.

• Changes in taste and smell: Early pregnancy can bring about unexpected changes in your senses, particularly in taste and smell. Research suggests that early pregnancy may lead to a decrease in taste acuity potentially influenced by hormonal and physiological changes beyond just fluctuations in progesterone and estrogen.

• Breast tenderness and swelling: As your body gets ready for breastfeeding, your breasts may feel more sensitive, fuller, and heavier. This is due to higher levels of hormones like estrogen and progesterone, which promote the growth of milk ducts.

• Fatigue: Feeling unusually tired is common in early pregnancy. The surge in progesterone levels combined with the physical and emotional demands of early pregnancy can lead to overwhelming fatigue. During early pregnancy, your body is working hard to support the developing embryo, which can leave you feeling exhausted, even after a full night's sleep.

• Light spotting: Spotting typically happens at the time of implantation of the fertilized egg (about six to 12 days after conception). It’s usually light pink and dark brown and is much lighter than a menstrual period. 

Overlapping Symptoms of Pregnancy and PMS

Breast tenderness

Both early pregnancy and PMS can cause breasts to feel sore, swollen, or sensitive. This tenderness results from hormonal changes that affect breast tissue.

In early pregnancy, breast tenderness is often one of the first symptoms due to increased estrogen and progesterone. These hormones cause the breasts to enlarge and the nipples and areolas (the area of dark-colored skin on the breast that surrounds the nipple) to become more prominent and darker. 

Breast tenderness due to PMS typically fluctuates and may feel more cyclic. It worsens in the days leading up to your period and eases once menstruation begins. It often feels more concentrated in specific areas rather than being widespread across the entire breast, and may not be as severe as in early pregnancy.

Fatigue

Whether you’re pregnant or experiencing PMS, you may find yourself needing extra rest.

In early pregnancy, fatigue is caused by hormonal changes, especially the rise in progesterone, increased blood volume, and your body's adjustment to carrying an embryo.

Fatigue associated with PMS is usually milder. It may feel more like a general low energy or sluggishness that tends to improve once menstruation starts.

Mood swings

Hormonal fluctuations can lead to emotional ups and downs, regardless of whether you’re pregnant or just dealing with PMS.

Mood swings in early pregnancy can be more pronounced and frequent. 

Mood swings with PMS are typically less intense but can include irritability, sadness, or anxiety.

Bloating

Many women experience bloating due to hormonal shifts. This can occur with either pregnancy or PMS.

Bloating in early pregnancy can feel persistent and may be accompanied by other symptoms such as frequent urination and abdominal cramping. This is typically due to increased progesterone levels and can persist throughout the first trimester.

Bloating with PMS is typically milder than it is in early pregnancy. It worsens in the days before your period starts and lessens after menstruation begins.

Food cravings

Changes in appetite — including cravings for certain foods and/or aversions to others — can happen in both early pregnancy and PMS.

Food cravings during early pregnancy are often more specific and intense, with sudden desires for particular foods or aversions to previously enjoyed foods. These cravings can be quite strong and persistent.

Food cravings related to PMS are generally more predictable and may be linked to a desire for comfort foods or increased appetite. These are typically short-lived. 

Back pain

While back pain can be a symptom in both early pregnancy and PMS, the causes and its intensity may vary.

This pain in early pregnancy is often related to the body's adjustments to support the growing uterus and hormonal changes that relax the ligaments. It may be a dull ache or a sharper pain in the lower back.

Back pain associated with PMS usually feels more like lower back discomfort or a dull ache, often linked to the hormonal changes that occur before menstruation. 

Headaches

Headaches are another symptom that can occur in both early pregnancy and PMS.

Headaches can be caused by increased blood volume and hormonal changes, including shifts in progesterone and estrogen levels. They may be more frequent or severe during the early weeks.

Headaches related to PMS are often due to the decline in estrogen levels. They may worsen in the days leading up to your period. They typically improve once menstruation starts.

When to Take a Pregnancy Test

While it’s important to pay attention to differing symptoms of PMS and pregnancy, remember that the only definitive way to determine if you’re pregnant is to take a pregnancy test.

Since pregnancy hormone levels (especially human chorionic gonadotropin) are usually detectable after a missed period, it's advisable to wait until then for the most accurate results. Testing too early might result in a false negative, as hCG levels may not be sufficient to detect before your period is due. 

For the best results, be sure to follow the test’s instructions carefully and consult a healthcare provider if you have any concerns or questions.

How LifeMD Can Help

Differentiating early pregnancy signs from PMS symptoms can be challenging, especially if you tend to experience irregular menstrual cycles. 

Whether you’re dealing with menstrual irregularities and want to understand their causes, or you're looking for ways to manage PMS symptoms, LifeMD is here to help. 

Make an appointment today to learn more about taking care of your menstrual health — all from the comfort of your home. 

LifeMD makes it easy to stay on top of your health because talking to a doctor, filling your prescriptions, getting your labs done—and more—are all easy and cost-effective. Come discover a healthcare solution built around you and your life.

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