Many early pregnancy symptoms mimic those of PMS, making it difficult to determine whether you might be pregnant before you get a positive test. Still, there are a few specific symptoms that tend to indicate pregnancy you can look out for.
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When you’re trying to get pregnant, that two-week window between ovulation and a potential positive pregnancy test — or your period — can be nerve-wracking. Every month, you may wonder if this month is going to be the month — or just your time of the month again.
Unfortunately, the early signs of pregnancy and PMS are very similar, which can make it hard to tell what’s causing those sore boobs and strange food cravings.
Can you tell the difference between PMS and pregnancy?
Unfortunately, no. The only way to know for sure that you’re pregnant is to take a pregnancy test.
The good news is you don’t have to wait too long to find out: Home pregnancy tests are accurate enough now to pick up 90 percent of pregnancies the day of your expected period. (While some test manufacturers claim they can give you results as early as four or five days before your expected period, they’re only accurate about 60 percent of the time, which means if your result is negative, you should wait and retest to see if it’s the real deal.)
These home pregnancy tests all work by measuring levels of human chorionic gonadotropin (hCG) — a pregnancy-specific hormone — in your pee. Although some hCG is found in your urine as early as a week after conception, it’s usually not enough to register on a home pregnancy test. (If your period is irregular, wait the number of days equal to the longest cycle you’ve had in the last six months — and then test.)
Any positive test should be followed up by a call to your doctor, who can advise on next steps.
Symptoms of PMS vs. symptoms of pregnancy
The second half of your menstrual cycle is known as the luteal phase, when your body produces more progesterone, a hormone key sustaining an early pregnancy. These levels peak about a week after ovulation, even if you don’t become pregnant.
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High levels of this hormone can cause both physical and emotional changes, producing similar symptoms whether you’re in early pregnancy or right about to have a period. These include:[1]
- Breast tenderness
- Bloating
- Food cravings
- Fatigue
- Moodiness
- Constipation
- Increased nipple sensitivity
- Headaches and muscle aches
But there are also specific symptoms that tend to indicate pregnancy, rather than PMS. Look for:[2]
- Changes in your areolas. Breast changes caused by pregnancy hormones such as tenderness or sensitivity tend to stick around rather than disappear shortly before the arrival of your period. Another tell-tale sign: Your areolas — the circles around your nipples — darken in color and increase in diameter. You may also see an enlargement in the tiny bumps normally on your areola so that they resemble goosebumps. These bumps (called Montgomery glands) produce oils to lubricate your nipples and areolas in prep for eventual nursing.
- Implantation bleeding. Another sign that you might be pregnant is spotting that shows up anywhere from a few days to a week before the day you normally get your period. This is known as implantation bleeding, and around 20 to 30 percent of newly expectant moms experience it when the embryo burrows into the uterine wall. Implantation bleeding is usually much lighter than a period, and can last anywhere from a few hours to a few days. Unlike your period, implantation bleeding isn’t red: It’s usually pale to medium pink or light brown in color — sometimes even resembling pink-tinged mucus.
- Smell sensitivity. Some newly pregnant women report that their sniffer’s suddenly more sensitive, which is due to the increasing amount of estrogen coursing through your body during early pregnancy. A heightened sense of smell can appear in the first trimester.
When to see a doctor
Even if you don’t have a positive pregnancy test and your period runs more than a week or two late, you should check in with your doctor, who may want you to come in for an appointment. Your OB/GYN can run a blood test to check for pregnancy, as well as other blood tests to look for hormone abnormalities such as a thyroid disorder that could mess up your menstrual cycle.
And remember, you can have every single pregnancy symptom on the book and not be pregnant, or virtually no symptoms and have successfully conceived. That’s why it's so important to wait to test until the day of your expected period — and follow up with your doctor if youre uncertain about results.
From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You're Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.
Sources
References
- UpToDate, Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Disorder (PMDD) (Beyond the Basics), February 2021. | Show in the article
- Mayo Clinic, Symptoms of Pregnancy: What Happens First, December 2021. | Show in the article
- What to Expect Before You’re Expecting, 2nd edition, Heidi Murkoff.
- WhatToExpect.com, 14 Early Pregnancy Signs and Symptoms, July 2021.
- WhatToExpect.com, 11 Reasons for a Missed or Late Period, October 2020.
- WhatToExpect.com, HCG Levels During Pregnancy: What Is Normal?, May 2021.
- WhatToExpect.com, Irregular Periods and Getting Pregnant, September 2020.
- WhatToExpect.com, Pregnancy Tests, September 2020.
- WhatToExpect.com, Is It Implantation Bleeding or Just My Period?, June 2021.
- WhatToExpect.com, Has Your Sense of Smell Gotten Stronger During Pregnancy?, February 2021.
- WhatToExpect.com, Frequent Urination During Pregnancy, October 2020.
- UpToDate, Clinical Manifestations and Diagnosis of Premenstrual Syndrome and Premature Dysphoric Disorder, March 2022.
- Andrei Rebarber, M.D., Co-Director of the Division of Maternal Fetal Medicine at Englewood Hospital Medical Center, New York, NY, and member of the What to Expect Medical Review Board.
- Sarah Obican, M.D., Assistant Professor in the Department of Obstetrics and Gynecology at the Morsani College of Medicine at the University of South Florida, Tampa, FL, and member of the What to Expect Medical Review Board.
Updates history
September 21, 2022
Editor: Caroline Picard
- Minor copy and formatting changes.
- Medically reviewed to ensure accuracy.
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