Pregnancy vs. PMS: Vague Symptom Overlaps
Medically reviewed by Renita White, MD
Symptoms such as cramping, breast tenderness, and mood swings can occur with premenstrual syndrome (PMS) and early pregnancy. While these symptoms can overlap, there are some key differences to help you distinguish the two. In addition, some symptoms are unique to pregnancy.
This article reviews cramping intensity and duration with pregnancy vs. PMS, shared symptoms, differing symptoms, and how to rule out pregnancy or PMS.
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Pregnancy vs. PMS: Cramping Intensity and Duration
PMS involves a set of symptoms that can occur during the week or two leading up to your period. "Early pregnancy" refers to the first weeks after conception. Abdominal (belly) or pelvic (between the hips) cramping is a symptom that overlaps both conditions. However, the intensity and duration of cramping differ with each.
PMS cramps occur as the body prepares to shed the uterine lining that leaves the body as blood during your period. These achy cramps are stronger and more persistent than pregnancy cramps. Some people continue to experience them in the first days of their period, but they go away afterward.
Early pregnancy cramps occur as the uterine lining and ligaments begin to expand to accommodate a growing fetus. These cramps are typically milder than PMS and sporadic (come and go). Some people describe them as dull aches, spasms, or twinges. Pregnancy cramps may last throughout the first trimester (first 12 weeks of pregnancy).
Non-PMS/Non-pregnancy Abdominal Cramping
Abdominal cramping can also be a symptom of:
Gas
Constipation
Gastrointestinal (GI or digestive system) disorders
GI infections
Gynecological conditions (those affecting the female reproductive system) conditions.
Related: Week-to-Week Pregnancy Timeline
Shared Symptoms in Pregnancy vs. PMS
Due to fluctuating hormones with PMS and pregnancy, the following symptoms can occur in both conditions, with subtle differences between each.
Breast tenderness: The entire breast may feel heavy or sore with PMS. With pregnancy, breast tenderness is typically more intense, tends to be around the areola and nipple, and lasts longer.
Mood swings: PMS and pregnancy can make you feel grouchy or cause you to cry more easily. With PMS, this resolves within the first days of period bleeding. But, if mood swings continue and you miss your period, this could indicate pregnancy.
Fatigue: While over-tiredness can occur during PMS, pregnancy fatigue is typically more intense and usually lasts through the first trimester.
Bloating: Bloating (tightness in your belly) can occur due to gas or water retention. While you may notice mild bloating with PMS, significant bloating is more likely with pregnancy.
Food cravings or aversions (dislikes): Are you craving chocolate or salty chips but can’t stand eggs or meat? Food cravings and aversions often occur with hormone shifts due to PMS or pregnancy. These are short-lived with PMS but can occur throughout pregnancy.
Mild weight gain: Before your menstrual cycle, your body produces more hormones that can cause you to hold in water and salt. This can lead to gaining a few pounds of water weight. While you may gain a few pounds during the first trimester of pregnancy, it’s not usually evident in the first few weeks.
Bleeding or spotting: Menstrual bleeding occurs after PMS but is absent with pregnancy. However, with pregnancy, you may have light pink or brown spotting during implantation. Some people mistake it for a period because the timing is similar. However, implantation bleeding is lighter (doesn’t fill a tampon or pad) and lasts only one or two days, unlike a period’s heavier and longer-lasting flow.
Related: How to Tell the Difference Between Implantation Bleeding vs. Period Bleeding
Differing Symptoms in Pregnancy vs. PMS
In addition to the symptoms PMS and pregnancy share, the following are unique to pregnancy.
Missed periods: Missing a period is often the first pregnancy symptom people notice, especially those who typically have a regular cycle. However, this can occur for other reasons, such as extreme exercise, stress, hormonal birth control, or conditions like polycystic ovary syndrome (PCOS).
Morning sickness: Persistent nausea and vomiting are stronger indicators of pregnancy than PMS. The term "morning sickness" is misleading, as nausea and vomiting can occur at any time during the day with pregnancy.
Frequent urination (peeing): If you find yourself having to pee more frequently, especially in combination with a missed period and nausea, this can indicate pregnancy.
Related: 8 Morning Sickness Remedies for All-Day Relief
How to Rule Out Pregnancy or PMS
Here are a few ways to help you differentiate between PMS and pregnancy.
Timing: PMS symptoms usually start the week before your period and disappear once the period begins.
Bleeding or spotting: Menstruation (period) bleeding happens immediately after PMS. In contrast, you may have light implantation spotting, but you won’t have a period with pregnancy.
Nausea: Nausea or “morning sickness” is more commonly associated with pregnancy.
An at-home pregnancy test may also give you a quick answer. You can take an early detection test eight days after conception (when sperm fertilizes the egg). For the most accurate results, wait about 10-14 days after having unprotected sex. For most, this is when you would expect to start your period. Testing too early can lead to a false negative. If you think you are pregnant but test negative, consider retesting in a few days.
If home testing is inconclusive or if you continue to experience confusing symptoms, consult a healthcare provider. They may conduct a blood test or an ultrasound to confirm or rule out pregnancy.
How Do You Do a Finger Test for Early Pregnancy?
The cervix is the opening to the uterus that sits at the top of the vaginal canal. You can check it by gently inserting a clean finger into the vagina in an upward motion to the very end. Your cervix will feel like a round dimple or donut. During early pregnancy, it may rise higher and feel softer. However, the finger test is not a validated way to test for pregnancy. This method may lead to confusion, false reassurance, or a late pregnancy diagnosis.
Related: How Soon Can You Take a Pregnancy Test?
Summary
Premenstrual syndrome (PMS) and pregnancy can present similar symptoms due to hormonal changes that occur with each. This might include abdominal (belly) cramping, bloating, mood swings, fatigue, and breast tenderness. However, there are symptoms unique to pregnancy, including a missed period, nausea ("morning sickness"), and frequent urination. Consider a home pregnancy test or consultation with a healthcare provider, especially if you miss a menstrual period.
Read the original article on Verywell Health.
