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PMS vs. Pregnancy: How To Tell the Difference

Most women have all had that pregnancy scare moment when you’re not sure if you missed a pill, missed your period, or somehow got pregnant without even realizing it. Pregnancy can be a huge responsibility, and it’s natural to be a little worried about getting pregnant before you’re ready. 

That’s why it’s helpful to recognize the differences between symptoms of pregnancy and PMS, so you can put your mind at ease and focus on managing the symptoms you’re experiencing and getting the relief you deserve.

One of the reasons it’s so challenging to determine if you’re experiencing early pregnancy symptoms or PMS is that many of the symptoms overlap. After all, you experience significant hormonal changes for both, which means it’s not uncommon to mistake one for the other. 

That’s why 10PM Curfew, your go-to for female lifestyle content, is sharing a closer look at the symptoms to watch for so you know what steps to take next. 

What Are Shared Symptoms of PMS and Pregnancy?

PMS stands for premenstrual syndrome and is the collection of symptoms that women typically experience in the days or weeks leading up to their periods, some of which can be quite uncomfortable. Some of these symptoms are quite similar to the ones you will be experiencing during early signs of pregnancy, including the following. 

Mood Swings

Mood swings and mood changes are incredibly common with hormonal changes and fluctuations, like the kind you’ll be experiencing during PMS and early pregnancy. Most often, these mood swings tend toward depression and irritation, feelings of irritability, crying spells, and anger. You may notice significant changes in short periods of time. 

If your moodiness is particularly severe before your period starts, consider talking to your OB/GYN to see if premenstrual dysphoric disorder (PMDD) may be to blame. 

Body Aches and Pain

Later in your pregnancy journey, you’ll be able to pinpoint and identify points of pain and their causes — like a whole person growing inside you! That said, early pregnancy pain is very similar to the pain you’ll experience from PMS, including lower back pain, leg pain, and cramping around the abdomen

If the pain is unusually severe for your experience, this may be an indication that something is different, like pregnancy, but you should contact your healthcare provider as needed. 

Nipple Tenderness and Changes

Of course, the breasts serve an important purpose during the pregnancy and early motherhood journey. Still, these symptoms of early pregnancy may be very similar symptoms to PMS breast sensitivity and pain. 

During both, you’ll likely experience breast tenderness or tender breasts and nipples, breast pain, and swelling. If you notice protrusion or darkening of the nipples, it may indicate that you should take a pregnancy test. 

Cravings and Appetite Changes

The only person who can keep up with a pregnant woman when it comes to strange food cravings is a person experiencing PMS. 

Both pregnancy and PMS are associated with cravings and appetite changes, though if you find yourself completely uninterested in food or experiencing food aversions, that’s often an early sign of pregnancy. 

Patients experiencing PMS will often reach for sweet and salty foods and may consume much more than they do during the rest of the month. 

Bloating and Weight Change

Bloating is one of the most common symptoms of PMS, though it’s often an early sign of pregnancy. The changes in levels of progesterone and estrogen in your body mean that you’re retaining more salt and water, which can contribute to feelings of bloating. This can be managed by avoiding saltier foods. 

It’s not uncommon to experience bloating early in pregnancy but watch for signs of sudden weight loss. Weight gain is typically much more associated with PMS, and weight loss may be a symptom of pregnancy early on. 

What Are Distinct Symptoms of PMS and Pregnancy?

While there are a few differences in the shared symptoms, it can be difficult to know what is an early pregnancy symptom and what’s simply the result of your menstrual cycle. 

While it can be useful to have at-home pregnancy tests on hand, just for your peace of mind, you can also keep an eye out for more distinct symptoms to know if it’s time to schedule an appointment with your gynecologist. 

Gastrointestinal Changes

One of the common and uncomfortable symptoms we often experience during our period is diarrhea. This is because your uterine lining is shedding, and your body essentially wants to help make the process a little easier. It does this through the use of prostaglandins, which are fatty acids designed to relax the muscles of your uterus. 

They also tend to relax the muscles of your bowels, which can increase bowel movements. You may also have an increase in electrolyte secretion during your menstrual cycle, which contributes to looser movements.

By comparison, individuals experiencing constipation are more likely to be in the early stages of pregnancy. In fact, constipation, in concordance with other symptoms, is often considered one of the early signs of the first stages of pregnancy and can start as early as the first trimester. This is also due to changing hormone levels, specifically progesterone. 


Fatigue and tiredness is not an uncommon side effect of PMS since women’s bodies go through so many changes and fluctuations, many of which can be very emotional. 

But while it’s common to sleep a little later on your period than the rest of the month, it’s not likely that you’re going to confuse PMS fatigue with the kind your body experiences during pregnancy.

Early pregnancy fatigue tends to be quite extreme, and you may find yourself exhausted or overwhelmed by tasks that have normally never tired you out before. It’s quite common to nearly double the amount of sleep you normally get during your first weeks of pregnancy, especially if you’re accustomed to just six or seven hours a night.

Since this is a big change, it’s something to watch for if you think you might be pregnant.

Another common symptom tied in with that fatigue is difficulty sleeping at night, either getting deep sleep or staying asleep for more than a few hours at a time. 


It’s normal for people experiencing their menstrual cycle to have some accompanying nausea for several reasons. Nausea may be related to changing hormones, along with diets and cravings. It can be due to the pain experienced during cramping, which often results in nausea. 

Typically, however, PMS nausea doesn’t get extreme enough to cause vomiting, as nausea that accompanies a positive pregnancy test often will. Early-stage pregnancy may or may not cause vomiting with morning sickness, but PMS most likely will not, which means it’s a symptom that you definitely want to watch out for. 

Missed Period

Of course, the most obvious symptom of them all is a missed period. It’s important to consider your typical cycle when accounting for the missed period. If you don’t have a cycle every month due to lifestyle, medical conditions, or contraceptives, this may not provide an accurate indication as to whether or not you are pregnant. 

However, if your period comes like clockwork every month and it doesn’t show — good chance.

One thing to consider is that early pregnancy may include light bleeding or spotting, which is caused by implantation bleeding. The spotting may be pink, red, or brown in color and may even resemble your typical early period spotting, though it will be much lighter. Take care to check your symptoms and watch carefully if this occurs so as not to mistake it for the arrival of your menstrual cycle. 


When it comes to pregnancy, the more you know, the better off you’ll be. This is true for every stage of life, whether you’re excited to have a child, you’re waiting for the perfect time, or you know it’s not for you. 

It’s especially important to know how to recognize the differences between pregnancy and PMS since they share many of the same symptoms, especially in the early stages of pregnancy.

There are a few important ones you’ll want to keep a very close eye out for, including changes in your gastrointestinal behaviors, nausea accompanied by vomiting, and extreme levels of fatigue, which are associated with pregnancy, but not with PMS. 

Of course, you also want to watch out for your missed period since that’s the most common indication that it’s time for a pregnancy test.

No matter your journey, we’re sharing tips to keep in mind so you feel confident, capable, and ready to take the next step. We know what it’s like to be a little unsure, and we’re here for menstruators along the way. Learn more about women’s health and lifestyle with the 10PM Curfew team


Premenstrual syndrome (PMS) - Symptoms and causes | Mayo Clinic

Premenstrual Syndrome (PMS): Causes, Symptoms & Treatment | Cleveland Clinic

Vomiting and morning sickness | NHS

What Is Implantation Bleeding? | American Pregnancy Association