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PMS vs. pregnancy symptoms

A woman lying in bed with a hot water bottle on her belly

If you’re feeling a bit crampy and tired, and your period is almost due, you may wonder if the symptoms you’re feeling mean that your period is coming or you’re pregnant. 

The only way to know if it’s PMS is if your period arrives shortly after. And the only way to know if you’re pregnant is if you confirm your pregnancy with a positive pregnancy test. But there are some nuances to early pregnancy and PMS symptoms that can offer additional clues.

What is PMS?

According to The American College of Obstetricians and Gynecologists, the “PM,” or “premenstrual,” in “PMS” refers to the physical and/or mood changes women experience in the days before menstruation. The “S,” or “syndrome,” in “PMS” refers to instances in which these symptoms occur month after month, affecting a woman’s everyday life.1 Because these symptoms can be similar to early pregnancy symptoms, many women who experience PMS symptoms may wonder, am I about to get my period, or am I pregnant? Here we look at the subtle differences behind each. 

A Venn diagram showing the differences between PMS symptoms and early pregnancy symptoms

PMS vs. pregnancy symptoms

  • Headache: This is a common early pregnancy and PMS symptom.1-3
  • Fatigue/sleep problems: Whereas PMS sleep issues vary and can include feeling a bit more tired, sleeping too little or too much, taking more naps throughout the day and insomnia, early pregnancy fatigue is more commonly described as “extreme” or “feeling very tired.” 1-4
  • Mood changes: While general “mood swings” are often listed as an early pregnancy symptom, specific mood changes that can occur with PMS include feelings of sadness, depression, not wanting to be around other people, anxiety, irritability, angry outbursts, crying more than usual, feelings of confusion, poor concentration, issues with memory, clumsiness and changes in sexual desire. 1-4
  • Gastrointestinal issues: Constipation is a common early pregnancy and PMS symptom. Diarrhea is more frequently associated with PMS.2-4
  • Bloating/weight change: It’s possible to experience weight gain, bloating and a gassy feeling with both early pregnancy and PMS. Some women experience weight loss early in their pregnancy, especially those who have more severe nausea with vomiting.1-4
  • Breast/nipple changes: With both early pregnancy and PMS, your breasts may be swollen, more sensitive and more tender. When pregnant, you may see more nipple changes, including nipples that stick out more and darkened areolas.1-5
  • Pain (cramping, backache): General aches and pains are common in both early pregnancy and PMS. Abdominal cramping and backaches are common PMS complaints.1, 2 Many women wonder if their cramps are implantation cramps or period cramps. Some women report light bleeding, spotting and/or cramping during early pregnancy.6 While abdominal pain is common in early pregnancy, if, after a confirmed pregnancy test, your abdominal pain accompanies other symptoms (such as bleeding, low back pain, unusual vaginal discharge or severe pain), be sure to contact your healthcare provider.6
  • Nausea: While nausea is a common symptom with both early pregnancy and PMS, nausea with vomiting tends to be more common with early pregnancy.1-4
  • Appetite changes: When pregnant, you may find yourself craving certain foods while avoiding others, and you may even lose your appetite altogether during the early stages. PMS typically comes with a sudden increase in appetite and cravings for more sweet and salty foods.1-4
  • More frequent urination: Common with both pregnancy and PMS.3, 4, 7
  • Acne: Common with both pregnancy and PMS.1, 5, 7

Bottom line? If you’re experiencing PMS-like symptoms and you think you could be pregnant, consider taking an early detection pregnancy test. And if there is a chance you could be pregnant and your period is late, you should definitely take a pregnancy test or talk to your healthcare provider if any of these symptoms persist. 



  1. “Premenstrual Syndrome (PMS),” (2021, May), The American College of Obstetricians and Gynecologists, https://www.acog.org/womens-health/faqs/premenstrual-syndrome.
  2. “Premenstrual syndrome (PMS),” (updated March 16, 2018), Office on Women’s Health, U.S. Department of Health & Human Services, https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome.
  3. “Stages of pregnancy,” (updated April 18, 2019), Office on Women’s Health, U.S. Department of Health & Human Services, https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/stages-pregnancy.
  4. “Changes During Pregnancy,” (2020, October), The American College of Obstetricians and Gynecologists, https://www.acog.org/womens-health/infographics/changes-during-pregnancy.
  5. “Skin Conditions During Pregnancy,” (2020, June), The American College of Obstetricians and Gynecologists, https://www.acog.org/womens-health/faqs/skin-conditions-during-pregnancy.
  6. “Stomach pain in pregnancy,” (last reviewed June 20, 2021), NHS, https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/stomach-pain/.
  7. M.A. Moreno, A.L. Zuckerman, “Premenstrual Syndrome Clinical Presentation,” Medscape, (February 19, 2021), https://emedicine.medscape.com/article/953696-clinical.