Is it PMS or early pregnancy?

PMS and early pregnancy symptoms can often overlap, so it’s not surprising that many people mistake one condition for the other. It’s worth mentioning that if you are trying to conceive, you may start to feel more in tune with your body every month, which can cause you to notice PMS symptoms that you didn’t notice before. This can create some confusion and doubts as to whether you are pregnant or not.

Thankfully, there are some key differences between PMS and pregnancy symptoms. While early pregnancy often causes nausea and/or vomiting, this doesn’t usually occur with PMS. Similarly, spotting or bleeding doesn’t usually occur before a period, but it can be an early sign of pregnancy. Here’s what you need to know about PMS symptoms vs. pregnancy symptoms.

PMS vs. pregnancy symptoms

“Symptoms of PMS and early pregnancy often overlap,” says Shonda Corbett, MD, an OB-GYN with Holy Name Medical Center in Teaneck, NJ. “One of the most common symptoms that may occur just before menses and early pregnancy is breast tenderness or heaviness.” 

In addition to this, it’s common to experience mild abdominal discomfort, pelvic cramping, or back pain with PMS and early pregnancy. 

Sometimes, increased IBS symptoms such as gas and bloating can occur in the week leading up to a period, as well. Interestingly, research has shown that women with IBS experience an increase in symptoms during menstruation. This can occur in the days leading up to your period, during your period, and shortly after the end of menstruation. What’s the cause behind the increase in IBS symptoms? Hormones, of course. Fluctuations in hormones are also to blame for uncomfortable premenstrual symptoms such as acne, fatigue, and mood swings.

While some women may track their discharge for signs of pregnancy, this isn’t a reliable way to tell if you are pregnant. Monte Swarup, MD, an OB/GYN in Chandler, AZ, and founder of Vaginal Health Hub, explains how a change in vaginal discharge can be an early sign of pregnancy. You may notice a white discharge that appears “milky.” However, this isn’t necessarily associated with pregnancy and can occur in the week leading up to your period simply due to hormonal changes.

RELATED: What does discharge before your period look like?

Since many symptoms may occur with both PMS and early pregnancy, Dr. Corbett says that it’s often difficult to distinguish between the two. Instead, you should look out for clear signs of a pregnancy, such as a delayed period or unusual bleeding. Additionally, if you notice any symptoms that are out of the ordinary, it might be worth taking a pregnancy test to confirm whether pregnancy is the cause.

Some strong indications of PMS vs. early pregnancy symptoms are the presence of nausea and/or vomiting as well as light bleeding or spotting. However, it’s worth noting that nausea can still occur without a pregnancy due to hormonal or dietary changes. 

Spotting or bleeding in the days leading up to a period doesn’t always indicate pregnancy either. Dr. Swarup says there can be many causes for this, such as hormonal changes, hormonal contraception, or imbalances. If you have any concerns, you should contact your healthcare provider.

It’s important to get to know your cycle and your usual symptoms so you can easily track any changes. For instance, if you don’t usually get breast tenderness just before your period, then this could be an indication of pregnancy. Using a calendar or period tracker app to track your cycle can be really helpful.

Can I have my period and be pregnant?

“Pregnant women no longer get a period,” Dr. Swarup says. “They can still experience bleeding from egg implants in the uterus, which is implantation bleeding prior to a pregnancy test turning positive.”

Implantation bleeding is often quite distinguishable from menstrual bleeding because it will typically be brown or light pink rather than red. If it’s implantation bleeding, it won’t be enough to fill a menstrual pad, but you may still need to wear a panty liner. While implantation bleeding only affects around 25% of pregnant women, it’s considered to be a normal occurrence and not something to be concerned about. 

There are some circumstances when bleeding may be cause for concern, explains Dr. Corbett. Early bleeding (which is anything other than spotting), alongside a positive pregnancy test, should be evaluated as early bleeding could indicate an abnormal pregnancy, such as an ectopic pregnancy, a miscarriage, or bleeding around the developing pregnancy called a subchorionic hemorrhage. Abdominal or pelvic pain with bleeding or spotting during pregnancy is also a reason to see your healthcare provider.

In the absence of a positive pregnancy test, there are a few explanations for spotting and/or bleeding in the days leading up to a period. Hormonal imbalances, birth control, sexually transmitted infections, and cervical polyps are possible factors. Sometimes, bleeding before a period or during vaginal intercourse can be a sign of a reproductive issue such as polycystic ovary syndrome, endometriosis, or pelvic inflammatory disease. Therefore, if you have any unusual bleeding or you’re experiencing any other new and alarming symptoms, contact your healthcare provider immediately. 

RELATED: What does the color of your period mean?

How soon do pregnancy symptoms start?

Pregnancy symptoms vary from person to person, so there’s no clear timeframe for when you should expect to notice them. A study published in the Journal of Clinical Epidemiology found that nearly 90% of pregnant women with successful pregnancies experienced symptoms within eight weeks from the date of their last period, and many of them noticed symptoms by day 36 (or five weeks) from their last period. 

Every woman is different, so some may start to notice symptoms as early as two weeks after conception. These symptoms may include nausea, fatigue, appetite changes, and breast tenderness. 

It’s also worth noting that not every pregnant woman will experience early pregnancy symptoms. Some women may not have any signs of pregnancy other than a positive pregnancy test, and urine pregnancy tests are very likely to be positive at the time of a missed period. This is considered to be normal, but of course, you should speak to a healthcare professional if you have any concerns.

When do PMS symptoms start?

In comparison, PMS symptoms will often crop up a week before your expected period and worsen two days before it starts, according to research by Louisiana State University. 

Around 90% of menstruating women will experience symptoms such as bloating, headaches, breast tenderness, and cramping. While PMS symptoms can often be similar to early pregnancy symptoms, there are some ways to tell them apart. If you start to experience some of these symptoms a week before your expected period, it’s more likely to be PMS than pregnancy. 

Why is my period late?

If your period is late, you may start to wonder if you could be pregnant, but wait—there are many other causes for a delayed period. More specifically, if your period is only late by a day or two, there really is no cause for concern since menstrual cycles can vary in length. A typical menstrual cycle occurs between 21 and 35 days, not on the “same” day each month. If your period is more than a few days late, then there could be a few contributing factors. 

Hormonal contraception such as pills, the IUD, Implant, vaginal ring, or injection, excessive exercise, weight changes, stress, PCOS, thyroid dysfunction, and perimenopause are a few explanations as to why your period is late, Dr. Swarup says. If this is a one-off caused by a stressful event or a change in contraception, then there’s really no cause for concern. Your cycle will likely return to normal. If this is recurring or accompanied by new or unusual symptoms such as cramping or spotting, reach out to a healthcare professional so they can do a comprehensive physical exam and tests to find the cause. 

How early can I take a pregnancy test?

If you’re unsure if your symptoms are PMS or pregnancy-related, then it makes sense to take a pregnancy test for confirmation. After all, it’s better to test and not guess. But what is the ideal time to take a pregnancy test? 

Dr. Swarup says you could get an accurate result as early as 10 days after conception. In fact, there are many pregnancy tests on the market that have a high success rate of up to six days before a missed period. Therefore, if you are feeling impatient, then you could take an early pregnancy test and still get an accurate result. 

Taking a pregnancy test a few days before your expected period could lead to a false negative. For the most accurate results, it’s advised to wait at least until the day of your expected period. 

What to do if you’re unsure whether you’re pregnant

There are some circumstances where you may be unsure if you’re pregnant. For instance, if you take a pregnancy test and get a negative result but your period has still not shown up, this can cause some confusion and worry. Similarly, if you’re experiencing symptoms that are unusual for you, this could cause you to feel unsure if you are pregnant. 

In the event that you’re unsure whether you’re pregnant, you should speak to your healthcare provider, as they may be able to offer you a blood test. A blood test can pick up hCG sooner (as early as eight to 10 days after ovulation) than a urine test can; therefore, it may give you a more accurate result. Your healthcare provider may also ask about your symptoms and menstrual cycle to rule out other causes.