In this article, we take a look at the different causes of PMS and pregnancy symptoms, provide tips for managing PMS, and suggest when the best time to take a pregnancy test is.
'Am I pregnant?'
This is the question many women ask themselves when they feel the first signs of a possible pregnancy. However, the signs of pregnancy can resemble the symptoms of premenstrual syndrome (PMS) and are often not easy to distinguish.
In this article, we will take a closer look at the possible signs, their similarities and how to determine whether you are pregnant through a home pregnancy test.
What are the signs of pregnancy?
Probable signs of pregnancy can include a variety of symptoms. In most cases, when a woman is pregnant, she feels physical symptoms. The majority of pregnant women report more than one symptom as early as the first trimester. In a study in which 1,455 women were interviewed, nausea, vomiting, abdominal pain and back pain were the most common symptoms reported. Of the respondents, 88% reported having two or more symptoms at the same time.
The signs of pregnancy can vary from woman to woman and can occur with varying degrees of intensity. Often, they also change throughout the stages of pregnancy. Though the signs may seem very clear, the most reliable way to diagnose pregnancy is with a positive pregnancy test. A urine test can be carried out independently at home, while pregnancy can also be verified by the gynecologist with a blood test or an ultrasound scan.
What is PMS?
Premenstrual syndrome, commonly abbreviated as PMS, is a term used to describe a range of physical and emotional symptoms that many women experience before their menstrual period begins. It usually occurs one to two weeks before your period and often subsides when menstrual bleeding begins.
There are diverse numbers reported with regards to how common PMS is. This is partially because the syndrome is not always recognised or evaluated in the same way across different cultural contexts. According to a 2014 systemic review, PMS is common in almost half of all menstruating women. About 20% of these women experienced severe symptoms, while the remaining women reported having mild to moderate symptoms.
The exact cause of PMS is not fully understood, but it is believed that hormonal changes during the menstrual cycle (especially the fluctuating levels of the hormones progesterone and estrogen) play a role. In particular, the drop in the hormone progesterone, which occurs during the late luteal phase of the female cycle, is associated with PMS symptoms. Other factors such as stress, genetics and certain lifestyle habits can also play a role.
Symptoms of PMS can vary from woman to woman and range from physical discomfort such as abdominal pain, breast tenderness, headache, fatigue and fluid retention to emotional changes. A particularly severe form of PMS is premenstrual dysphoric disorder (PMDD). Women with PMDD experience at least one strong mood symptom such as depressed mood, irritability, or anxiety. The symptoms of PMDD can severely interfere with everyday life and often require targeted medical treatment.
The diagnosis of PMS or PMDD is based on an accurate assessment of the symptoms over several menstrual cycles. It can be helpful for women with symptoms to consult a doctor to find appropriate treatment, as there are ways to treat and relieve PMS symptoms.
For mild symptoms, lifestyle changes such as regular exercise, a balanced diet, and stress management techniques can help. In some cases, pain relievers or anti-inflammatory drugs can be used to reduce physical discomfort. Women with more severe symptoms may also consider hormonal treatment.
PMS and early pregnancy symptoms
Because PMS and pregnancy can produce similar symptoms, it's often difficult to tell the difference. However, there is one clear sign that distinguishes PMS from pregnancy: missed periods.
If a woman has a regular menstrual cycle and suddenly misses her period, it is advisable to take a pregnancy test. An elevated basal body temperature can also indicate pregnancy. After ovulation, body temperature increases by around 0.2–0.6 °C (body temperature should be measured in the morning after waking up). Measuring the basal body temperature is one of the methods of so-called natural family planning (NFP).
Below we will look in detail at the symptoms that can occur with PMS as well as symptoms of early pregnancy and the causes of each.
Breast tenderness and swelling
PMS: With PMS, women may notice changes in their breasts a few days to two weeks before their menstrual period. Breast tenderness and swelling are typical symptoms and are caused by hormonal changes in the menstrual cycle. In the second half of the cycle, the hormone levels of progesterone and estrogen increase, which can lead to increased blood flow and fluid retention in the breasts. This breast tenderness can be perceived as painful or uncomfortable. Estrogen and progesterone levels drop again shortly before the period and reach their lowest point with the onset of menstruation. During this time, any breast pain should subside.
Pregnancy: Tenderness in the breasts is one of the most common signs of pregnancy. The female body goes through hormonal changes and prepares for the production of breast milk. In particular, the pregnancy hormone hCG (human chorionic gonadotropin) increases significantly. These hormone changes lead to increased blood flow and changes in breast tissue. The breasts can become larger and more sensitive, and the areolas can darken. With increasing size, there can be a slightly uncomfortable feeling of tension in the breasts. While breast tenderness associated with PMS subsides with the onset of menstruation, it can last for a longer period of time during pregnancy.
Fatigue and exhaustion
PMS: Women often report increasing tiredness and exhaustion in the days or weeks before their period starts. The drop in estrogen levels just before menstruation can affect energy balance.
Pregnancy: Tiredness and exhaustion are also common symptoms of pregnancy. Hormone levels increase during pregnancy, especially the hormone progesterone. Progesterone has a calming effect and helps maintain pregnancy. It also acts as a sedative to prepare the body for the needs of the growing embryo. This hormonal change can lead to severe tiredness and exhaustion. Fatigue can last throughout the day and continue even after adequate sleep.
Mood swings
PMS: The hormonal changes can affect the balance of neurotransmitters in the brain. These chemical messengers, such as serotonin, dopamine, and norepinephrine, are instrumental in regulating mood. Fluctuations in hormone levels can lead to changes in their availability and function. In particular, the drop in progesterone levels is often associated with negative mood changes.
Pregnancy: Likewise, during pregnancy, the hormonal changes can lead to heightened sensitivity and emotional swings. Pregnant women can feel happy and euphoric, but they can also be easily irritable, anxious, or sad.
Abdominal and back pain
PMS: During PMS, many women may experience lower back and abdominal pain before their menstrual period begins. After ovulation, the hormone prostaglandin (a tissue hormone that can increase the perception of pain) increases in the female body. This increase can cause the muscles of the uterus to contract. These contractions can cause pain and cramps in the lower abdomen. Digestive disorders such as constipation and bloating can occur in both PMS and pregnancy. These can also lead to pressure and pain in the lower abdomen.
Pregnancy: Abdominal cramps or back pain are also often described as perceived symptoms of pregnancy. During pregnancy, the uterus expands to accommodate the growing child. This stretching of the uterus can cause pain and cramping. Another aspect is the so-called implantation pain. Some women report a slight pain or cramp in the lower abdomen, which is said to indicate implantation of the fertilised egg in the uterus.
Water retention and weight gain
PMS: A common symptom of PMS is fluid retention in the tissues, known as edema. This water retention can cause the body to look "bloated" and feel more full than when the cycle started. In addition, cravings are often reported, which can contribute to unwanted weight gain. In particular, the increase in the hormone progesterone in the second half of the cycle can result in increased sodium and water retention in the body. This can cause a temporary accumulation of fluid in the tissues.
Pregnancy: Weight gain during pregnancy can vary greatly from woman to woman. In the early stages of pregnancy, i.e. during the first few weeks, body weight may not change. However, weight gain can also seem noticeable at the beginning of pregnancy. During the first few weeks, this weight gain is not due to the weight of the developing embryo, but rather due to bloating.
Nausea and vomiting
PMS: The hormonal fluctuations during the menstrual cycle can not only cause cramps and headaches, but also discomfort, dizziness and nausea. It is believed that the release of prostaglandins is also responsible for the nausea that occurs.
Pregnancy: During the first trimester, many women experience nausea, which is often referred to as 'morning sickness,' although it can occur at other times of the day. According to one study, 50 to 80% of pregnant women experience nausea and 50% experience vomiting. Low blood sugar levels in the morning can also contribute to morning sickness. Pregnant women also commonly report heartburn, a metallic taste in the mouth, increased sensitivity to smells, and cravings as early signs of pregnancy, which may be associated with nausea. In most cases, nausea goes away after the first trimester, but in rare cases, it can last throughout the pregnancy.
Headaches and Migraines
PMS: Menstrual headaches are influenced by several factors, most notably fluctuations in estrogen and serotonin levels. Towards the end of the menstrual cycle, when estrogen levels are low, serotonin production falls and substances associated with migraines are released.
Pregnancy: Headaches can also occur during pregnancy, and hormonal changes are likely to blame. In addition, tension or dehydration (which can occur due to vomiting and nausea) can be triggers. However, there may also be an improvement in women who already have migraines before pregnancy. About half to three-quarters of migraine sufferers experience a significant improvement in migraine headaches during pregnancy, with a significant reduction in the frequency and intensity of their attacks, if not a complete disappearance.
When can pregnancy be verified?
After the fertilisation of the egg cell, the so-called conception, by the sperm cell, it takes around 6 to 10 days for the fertilised egg cell to implant itself in the uterine lining. It is only at this point that the body begins to produce the pregnancy hormone hCG. The concentration of this hormone in the blood increases continuously during the first weeks of pregnancy (as does the hCG level every 2–3 days), but only when the level is high enough does the pregnancy test work.
In the case of fertility treatment, it is possible to have a pregnancy blood test carried out in a fertility clinic or by a gynecologist two weeks after insemination or embryo transfer. This is considered to be the fourth week of pregnancy, as pregnancy is calculated from the start of the previous period. Before these two weeks, hCG may not be detected, although pregnancy could be present. Some women report light bleeding, known as implantation bleeding, along with spotting and increased discharge during this time.
How can I reduce the effects of PMS?
Lifestyle adjustments
There are many ways to lessen the effects of PMS, such as diet and exercise. If you suffer from headaches and fatigue, you can try yoga, breathing exercises, or massage, for example. If flatulence is one of your main symptoms, a brief change in diet can help. For example, try to avoid dairy products during this time. Reducing your intake of salty foods can help to avoid water retention.
Medications and dietary supplements
If you experience depressive states before your period, it is best to discuss this with a healthcare professional. Depending on the severity of your pre-period mood and personal preferences, your doctor may suggest medications such as antidepressants.
The effect of dietary supplements is controversial. Calcium was found in a clinical trial to help alleviate PMS symptoms. While there is some evidence that magnesium and vitamin E also have symptom-relieving effects, more research is needed to confirm these findings.
Several studies have also indicated that selective serotonin uptake inhibitors (SSRIs) can be an appropriate treatment for the emotional aspects of PMS or PMDD. A class of medication commonly prescribed for depression, SSRIs can increase the amount of serotonin that is available by blocking the nearby nerve cells from absorbing it (also known as reuptake). Having more available serotonin is thought to positively impact emotions, mood and sleep.
No matter what tools you choose, just knowing you have PMS will make your life easier. Consider keeping a diary so that you can learn over time which days you feel particularly energetic and which days you don't. In the future, for example, you can postpone important appointments to days where you will feel the most emotionally and physically well.
Conclusion
When women who want to have children try to become pregnant, they often pay close attention to every small physical change. Sometimes they report possible signs of pregnancy even before the menstrual period has stopped. These signs can be very similar to premenstrual syndrome (PMS) and are sometimes difficult to tell apart.
Both PMS and pregnancy can have symptoms such as nausea, fatigue, mood swings, and tender breasts. In both cases, the symptoms are often due to hormonal fluctuations, but can also have other causes. The most obvious sign of pregnancy that isn't seen with PMS is a missed period. In order to be sure of pregnancy, it is still advisable to carry out a pregnancy test.
Would you like to learn more about possible signs of pregnancy? Then feel free to contact our Cada team for a free consultation.
