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How do I Tell the Difference Between PMS and Pregnancy?

By Bethany Keene
Updated: May 17, 2024
Views: 197,846
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In many cases, it can be difficult to tell the difference between PMS and pregnancy because the symptoms are so similar. Symptoms of pregnancy are often noticeably worse than symptoms of PMS, but not always. The only true way you can tell the difference between PMS and pregnancy is to wait for a missed period, after which time you may take a pregnancy test to be sure.

Some of the symptoms that are common between both PMS and pregnancy include breast tenderness, irritability and mood changes, fatigue, headaches, and cramps. Because each woman experiences PMS differently, and some do not experience it at all, it should be most noticeable to you if something seems different one month. Usually, the symptoms associated with pregnancy are much more pronounced; for instance, rather than being just slightly tired, you might feel absolutely exhausted and need to take a nap in the afternoon.

In addition, breasts may appear to be very swollen and much more painful than usual. You might start getting severe headaches, or notice that certain foods or smells become very unappealing. In general, nausea and vomiting is not associated with PMS; if you are experiencing these symptoms, this is a fairly good indication of pregnancy rather than PMS. Conversely, though you may experience some mild stomach cramps, you should not experience severe stomach cramps during early pregnancy.

Otherwise, the best way to tell the difference between PMS and pregnancy is to listen to your body. The symptoms of PMS and pregnancy are very similar, but if you know how your body usually responds every month, you will often be able to tell if something is different. Fortunately, the symptoms will generally only last about one week before you know if you are pregnant, or just have PMS. If it was just PMS, the symptoms will disappear; if you are pregnant, however, the symptoms will continue, and will likely become more pronounced.

It can be difficult to wait to find out if it is just PMS or pregnancy, but most pregnancy tests cannot be taken until you actually skip a period because they are simply not sensitive enough to work any earlier. Once you have taken a pregnancy test and it comes back positive, you should visit a doctor for a blood test to be sure. Some women experience spotting that can be mistaken for a period in early pregnancy, so it is important to continue to monitor the progression of your symptoms if there is a possibility you could be pregnant, and to adjust your diet and other habits accordingly until you are sure.

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Discussion Comments
By anon974309 — On Oct 16, 2014

I have been having some symptoms as well. I had sexual intercourse the last day of my cycle on September 30 (unprotected) and a week and a half later I started to feel a little different then I started to get more nauseated and bloated for a whole week at a time and sense of smell was heightened a smidgen and started peeing a lot more. I'm having light cramps that shoot up through my lower abdomen and I've become way, way more fatigue. My breasts have become heavier and harder to deal with. My cycle is due next week but I'm really hoping that I am pregnant. Could I be and when should I test?

By anon937365 — On Mar 05, 2014

I am horribly moody, like, I feel great one minute, have racing thoughts the next, then am momentarily short-tempered, and then feel like I'm going to cry for no reason the next. This has never happened before. I also had a very bad headache/ears ringing last night, so maybe this is just stress?

I've had mild nausea/heartburn on and off for the past five days too, and everything tastes weird. Dark chocolate is really bitter, bananas are too sweet, water tastes metallic, and peanut butter is just gross all of a sudden. I can't seem to get enough dairy, and I normally hate milk! I'm also about a week late, but I've taken five home pregnancy tests (the expensive First Response ones), and all are negative.

I had laparoscopic surgery to remove endometriosis about six weeks ago, and my doctor said it could throw my cycles off a bit. Had the teeniest tiniest bit of pinkish/red speckled spotting yesterday, and woke up with mild cramps today, so I'm pretty sure my symptoms are just severe PMS, not pregnancy (unfortunately), and that Aunt Flo is on her way. But, everything I've been through lately just seems so weird. I don't think I've ever had PMS this bad before. I usually get very tired and a little grouchy during my period (but never before), but I've always attributed that to the fact that my periods tend to cause me a lot of pain. I can't believe this has all just been in my head this past week.

By anon347133 — On Sep 04, 2013

I've had headaches, can't sleep on my stomach and I was bloated a little bit, and my weight increased. Could I be pregnant?

By anon341156 — On Jul 09, 2013

I got my periods the other month, but have had unprotected sex now for a couple months and when I got my last period it was very long and there wasn't as much bleeding as normal. I have been getting headaches, feeling sick and tired. I did take a pregnancy test last month and it came back negative. Can I take another one or should I go to the doctor?

By amypollick — On Jun 20, 2013

@anon339081: If you weren't using any kind of protection and if you don't have your period in a couple of weeks, get a home pregnancy test. You were probably right in the middle of your ovulation window.

By anon339081 — On Jun 20, 2013

I had sexual intercourse with my boyfriend in early June. I should be getting my period in a few days, but I have had no symptoms of it. I usually get really sore breasts a week before, but this time the feeling was different. They were sore but very little not like usual. Can anybody help? Is something wrong?

By anon335855 — On May 24, 2013

To anyone who might find this helpful, my early pregnancy cramps were distinctly different from PMS cramps. My PMS cramps have a burning sensation; they feel like an inflammation in the uterus: a dull, hot, annoying pain. These pregnancy cramps were like twitches, short pulls, light muscle cramps, coming and going several times during the day. They were not as bothersome as PMS cramps. Because of this difference, I was sure the period wasn't on its way. The "special" cramps started on seven days past ovulation; I tested positive at 11 day past ovulation. Additionally, my breasts were sore on the sides, and much more painful than they are before my period.

By lluviaporos — On Mar 07, 2013

@anon306172 - Have you gone to a doctor about this? More than one doctor perhaps, or a doctor who specializes in hormonal or fertility problems? Because it sounds like you've probably got some kind of underlying condition, which might not be serious, but you definitely deserve to have someone look at it more closely than to just give you nausea medication.

Even if a little bit of sickness can be expected when you've got your period, feeling really sick shouldn't be tolerated.

By croydon — On Mar 06, 2013

Even a missed period isn't a good enough sign, especially if you often have trouble with your periods.

I know that I'll often have stronger PMS signals when my periods are going to be particularly out of whack. So, there's no point worrying about it until you've had a pregnancy test (and had it at least twice, because those things often get it wrong). Basically I wouldn't believe it until I had the doctor tell me when it was due.

By anon306172 — On Nov 28, 2012

I don't have any medical problems or take any medications and I have extreme nausea and occasional vomiting every month for several days before my cycle starts. It's bad enough I often take anti-emetics those days. I have girlfriends who have nausea with PMS as well, so I don't think it's super rare.

By anon299774 — On Oct 26, 2012

Women who have endometriosis do get nauseated.

By cupcake15 — On Dec 29, 2010

SauteePan-Perimenopause and pregnancy may seem similar and have similar symptoms. In perimenopause a women is experiencing an introductory period that will result in menopause years later.

Here like in a pregnancy a women ceases to have a menstrual cycle and begins to also experience weight gain due to an increasingly slower metabolism and the loss of lean muscle mass.

In addition, because of the hormonal changes, both women experiencing perimenopause and pregnancy might increase their level of irritability.

The women having perimenopause will become irritable because her hormone levels are too low, while a pregnant woman will also experience irritability but in her case her hormonal levels may be too high.

A balance of hormonal levels leads to balanced emotions and quality of life. This is why some women seek hormone replacement therapy when they reach menopause because they want to restore a level of happiness and a sense of well being with the added hormone therapy.

By SauteePan — On Dec 27, 2010

Subway11- This is usually a tell tale sign of pregnancy as well as the beginning aversion to certain foods while beginning to feel nauseous.

PMS does not cause nausea so this is another difference between PMS and pregnancy. A woman will also begin to feel tired when pregnant but if a women experiencing PMS will not.

Often she will have cramps which may be a major source of discomfort but most women do maintain a normal energy level.

On the rare occasions in which the women feels tired during this time period is it usually due to higher than average blood flows during her cycle which can cause anemia. In that case an iron supplement might be necessary.

By subway11 — On Dec 26, 2010

Suntan12-The difference between PMS and early pregnancy may seem hard to distinguish. In both cases you do feel a bit of depression and weepiness and that is a result of the changes in the hormonal level of the women.

Also, there is breast tenderness with slight pain and some women may experience enlarged breast during this time.

The enlargement of the breast is due to the preparation of the mammary glands for milk production in order to properly breast feed the child at birth.

By suntan12 — On Nov 03, 2010

The difference between PMS and early pregnancy symptoms involves feelings of tiredness. When a woman is pregnant she often feels tired and many times may feel nauseous.

Nausea often known as morning sickness usually offers another tell tale sign that a women may be pregnant.

Many of the other symptoms are similar such as PMS headaches, bloating, and breast tenderness. Perimenopause and weight gain also has many of the same symptoms. A small weight gain is typical during perimenopause as well as menopause and bloating as well.

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