Cramps, a rise in body temperature, irrational food cravings, and mood swings. No, we are not talking about pregnancy.
Premenstrual syndrome or PMS is as troublesome as early pregnancy and may lead to symptoms that are similar to that of pregnancy. The only good thing is that they are gone once your period starts. MomJunction will help you understand PMS in detail and the differences between PMS and pregnancy symptoms.
What Is PMS?
Premenstrual syndrome is a combination of physical, emotional, psychological, and mood disturbances that some women experience after ovulation until their next period. Symptoms last for five to eleven days before the menstrual flow and disappear at the onset of your period.
There is a severe form of PMS called premenstrual dysphoric disorder (PMDD), also known as late luteal phase dysphoric disorder. While only a few women experience this condition, it does disrupt daily activities owing to unusually severe symptoms.
The American Psychiatric Association (APA) categorizes PMDD as a severe form of PMS where anger, anxiety, irritability, and tension are more prominent (1).
PMDD is rare, but PMS is very common.
How Common Is PMS?
According to the American College of Obstetricians and Gynecologists (AACOG), about 85% of women experience at least one PMS symptom in their menstrual cycle (2).
Most of them only experience mild symptoms that do not require any treatment. About 3% to 8% are known to have PMDD.
PMS is more common in women who:
- Are in their late 20s to early 40s
- Have a history of depression
- Have at least one child
- Have a medical history of any mood disorder or postpartum depression (1)
Let’s see why so many women suffer from PMS.
What Causes PMS?
There is no concrete evidence pinpointing the exact cause of PMS. However, it is assumed that regular changes in the endocrine system, which makes hormones that control the menstrual cycle, bring about PMS (3).
Certain conditions may affect PMS, without directly causing it. Those factors include:
- Stress (4)
- Lack of sleep
- Lack of exercise
- Low levels of vitamins and minerals
- Over intake of salt, sugar and red meat
- Excessive consumption of alcohol and caffeine
Some health conditions, such as asthma, allergies, and migraine headaches, could turn worse before periods (1).
Let us now move to an important question.
What Are PMS Symptoms?
PMS shows up in varied ways – it is different from one woman to another. Here are some of the signs and symptoms of PMS (5).
Physical signs may include:
- Sore breasts
- Bloated tummy
- Hunger pangs
- Muscle aches
- Swollen hands and feet
- Joint pain
- Weight gain
- Diarrhea or constipation
Emotional signs may include:
- Anxious or tensed behavior
- Mood swings
- Crying bouts or episodes
- Urge to be alone
- Anger outbursts
- Overwhelmed feelings
Behavioral signs of PMS may include:
- Loss of mental focus
- Forgetting things
[Read: Body Changes During Pregnancy]
Most PMS symptoms tend to be similar to the early symptoms of pregnancy. This makes it natural to be confused between the two, especially if your periods do not come on time. Our next section helps you to understand the difference.
PMS Symptoms Vs. Pregnancy Symptoms:
Before understanding the differences between PMS and pregnancy, let’s see the symptoms that are common between them.
Similarities Between PMS And Pregnancy
- Back pain: You may experience back pain when your period is nearing, and also when you are pregnant.
- Headaches: Headaches and migraines are common both during pregnancy and before periods.
- Constipation: The progesterone hormone leads to digestive issues such as constipation. As these levels rise during the second half of the menstrual cycle, it affects women experiencing PMS too. Also, hormonal changes early in pregnancy could cause constipation (8).
- Tender and swollen breasts: You will experience breast soreness, pain, swelling, and enlargement before period and in early pregnancy (9).
- Increased urination: You are likely to experience frequent urination when you are about to have your period and in your early pregnancy (10).
- Mood changes: Irritability, depression, anxiety, crying spells, and mood swings are all normal before your periods and in pregnancy (11).
These symptoms might make you anxious when you are hoping to have a baby or missed to take a contraceptive during intercourse. Knowing the differences would help.
[Read: Moods Swings During Pregnancy]
Differences Between PMS And Pregnancy
Read on to get more clarity on the oncoming pregnancy or periods.
PMS: You may not have any bleeding or spotting until your period starts.
Pregnancy: You might see light spotting (pink or dark brown) at the time of implantation (happens 10 to 14 days after conception) when the embryo attaches itself to the uterus. It can last for a couple of days.
PMS: You feel exhausted even if you have not done anything strenuous, and it goes away when your periods are round the corner (12). You feel better with a little bit of rest.
Pregnancy: If your periods are delayed, and you are experiencing extreme fatigue, it can be a symptom of pregnancy. It may last throughout the pregnancy due to the surge in progesterone levels that causes a drop in blood pressure and sugar levels.
3. Food cravings/aversions
PMS: Your eating habits are likely to change when you have PMS. You may crave sweets, chocolates, carbohydrates, or salty foods, and you will develop a ravenous appetite. Although you crave for some food, you can easily resist the cravings and temptations.
Pregnancy: You will have extreme cravings for some foods and have aversions to some others. Some women also suffer from a food eating condition – pica – where they feel like eating non-food items such as dried paint flakes, metal pieces, and ice. In this case, you should consult your doctor immediately (13). These signs do not show in a PMS.
4. Nausea and vomiting:
PMS: Women do not nauseate or vomit when their periods are late, so you can rule out nausea as a premenstrual syndrome symptom.
Pregnancy: Most women feel nauseous during early pregnancy. If your periods are delayed, and you are extremely nauseous, you may be pregnant. Nausea begins any time after two to eight weeks post conception and continues throughout pregnancy (14).
5. Abdominal or pelvic cramping:
PMS: Cramps or dysmenorrhea during PMS is common, and the severity varies according to genetic disposition and body system. However, as bleeding starts, the pain decreases and slowly goes away as the flow ends (15).
Pregnancy: When the fertilized egg embeds into the uterine wall, it may cause mild abdominal cramping along with spotting during early pregnancy. You may experience cramps in the lower back or lower stomach, which continues for weeks or even months, lasting much longer than PMS cramps.
Unique Pregnancy Symptoms Less Likely To Occur During PMS
Some symptoms are specific to pregnancy and will not show in case of a nearing period or PMS.
- Darkening of the nipple: Estrogen levels in the body increase, leading to the expansion of the areola size or nipple. As the pregnancy progresses, this development leads to the darkening of the areola, which remains dark, even after delivery (16).
- Changes in cervical mucus: One of the common indications of ovulation is changes in the cervical mucus (17). If a woman has conceived, then the mucus becomes white, milky, and is thin. It could be sticky as well. Before periods, the vaginal discharge is transparent, almost like an egg white.
- Shortness of breath: You would have a shortness of breath as the embryo developing in the sac requires extra oxygen (18).
- Increase in basal body temperature: If you are pregnant, the basal body temperature (BBT) increases slightly between 0.5 and 1.5 for at least 18 days or more during ovulation and continues to be high during pregnancy. Women may also experience an increase in the BBT as a PMS symptom, but the temperature decreases once the period begins (19).
It is essential to know the right reason behind your symptoms, as that would help determine whether or not you are pregnant. The best way to find the difference between PMS and pregnancy symptoms is to take a home pregnancy test in case your period is delayed.
In the next section, we answer a few common questions related to PMS and pregnancy symptoms that you may have at the top of your mind. Read on!
Frequently Asked Questions
1. What is the menstrual cycle?
It is a monthly series of bodily changes a woman experiences to prepare for pregnancy. One of the ovaries releases an egg every month (a process called ovulation), and the hormones keep your body healthy to prepare the uterus for pregnancy. If ovulation occurs and the egg is not fertilized, the uterine lining sheds away in the form of the menstrual period. A menstrual cycle is counted from day one of the period to the first day of the successive period. An average cycle lasts 28 days, and cycles range from 21 to 35 days in adults to even 21 to 45 days in teenagers (20).
2. When does PMS start?
PMS symptoms start around day 14 of the menstrual cycle and last until a week after your periods commence (21).
3. Is premenstrual syndrome normal?
Premenstrual syndrome is normal. Only a few symptoms disrupt daily routine by bringing in a wide range of physical, emotional, and behavioral changes. Making a few simple changes and adjustments in routine can help you get through PMS. However, in the case of PMDD, you must see a doctor.
4. Do women with PMS see hormonal changes?
Yes, from PMS to menopause, the changing hormones affect weight and mood. They also affect the brain’s serotonin, showing considerable changes in mood, often resulting in mood swings. In some women, PMS may be smooth without any adverse changes or effects, while in others, it may be a shipwreck at every hormonal fluctuation (22).
5. Can you have PMS while on birth control pills?
Some women say that birth control pills reduce PMS symptoms, while others experience severe PMS symptoms. The hormonal changes and drop in hormonal levels during PMS will not occur if you are on birth control pills. This means there would either be less or no PMS in some women. In some instances, however, the hormones will fluctuate while on birth control pills and manifest into PMS (23).
6. Can I have PMS but no period?
Yes, you can have PMS but no periods, due to several reasons. They include polycystic ovary syndrome (PCOS), anemia, psychological stress, nutritional imbalance, contraception, weight loss, strenuous exercise, and more.
7. Should I get treatment for PMS?
Yes, treatment can help you manage PMS so that it does not affect your daily activities. Diet and lifestyle changes can help in the case of mild to moderate PMS. But if it is severe, your doctor will prescribe medication or suggest treatment methods. The success of medical treatment, however, varies from woman to woman.
8. What dietary and lifestyle changes can I try for relief from PMS?
Take nutritional food, including vitamins, exercise, de-stress, and consider herbal remedies for relief from PMS.
9. What about herbal remedies for PMS?
Evening primrose oil, chaste tree extracts, saffron, Ginkgo Biloba, and St. John’s wort are the most effective herbal remedies that relieve PMS symptoms. However, you should check with your doctor before including them as they can cause side effects and drug interactions (23).
10. Can you still get PMS symptoms if you are pregnant?
You cannot have PMS symptoms when you are pregnant, as you are not premenstrual. Pregnancy has its own set of hormonal changes and symptoms.
[Read: Pregnancy Hormones]
For a woman without any prior pregnancy experience, the differentiation can be very difficult. So, if you are in doubt, always use a home pregnancy kit.
If you have any more queries, feel free to write to us. You can also share your experiences.
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12. Shazia Jehan, et al.; Sleep and Premenstrual Syndrome
13. Natalia C. Orloff and Julia M. Hormes; Pickles and ice cream! Food cravings in pregnancy: hypotheses, preliminary evidence, and directions for future research
14. What are some common signs of pregnancy?; US Department of Health and Human Services
15. Robert L Reid; Premenstrual Dysphoric Disorder (Formerly Premenstrual Syndrome)
16. Sumit Kar, et al.; Pregnancy and Skin
17. A. Krisman; The Fern Reaction of Cervical Mucus; Part I. The Effect of the Normal Ovarian Cycle and of Pregnancy. Part II. A Guide to the Early Diagnosis of Pregnancy
18. Shortness of Breath In Pregnancy; Harvard Health Publishing; Harvard Medical School
19. Diana P. Selvey; Changes in basal body temperature and the onset of labor; The University of Utah
20. Menstrual Cycle; US Department of Health and Human Services
21. Premenstrual syndrome; The United States National Library of Medicine
22. Reproductive health and mental health; US Department of Health and Human Services
23. Premenstrual syndrome: Treatment for PMS; Institute for Quality and Efficiency in Health Care (IQWiG); Cologne, Germany
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