PMS Cramping vs. Common Early Pregnancy Symptoms

PMS Cramping vs. Common Early Pregnancy Symptoms

1. Cramps Before Your Period (“Implantation Cramps”)

If you're having cramps a week before your period when you usually only start having cramps a few days before, then you may be experiencing implantation cramping. Implantation is when the fertilized egg (or blastocyst) implants itself into the lining of the uterus. After ovulation, it takes about a week (6-12 days) for the fertilized egg to enter the uterus and burrow its way into the thick, rich lining, which can cause mild pain. Typically this happens about a week before you’d expect your period (in a normal 28-30 day cycle), so it might seem odd. It can also happen close to the time you’d expect your period, so some women confuse it with their normal menstrual cramps. But, if you experience these cramps a week before your period is due, and that is abnormal for you, you may very well be expecting!

Menstrual Cramping or Implantation Cramping?

Dr. Linda Burke-Galloway, MD says, "The character and intensity of pain in "period cramps" and "pregnancy cramps" are very similar, but the timing of pain might provide clues." Period cramps, otherwise known as primary dysmenorrhea, occur 24-48 hours before your period and go away once menstruation starts. They can range from mild to severe, depending on the level of prostaglandins—a hormone-like substance that triggers uterine muscle contractions. In contrast, implantation cramping occurs 2-7 days before your period and starts off very mild. You will only feel it intermittently in your lower stomach or lower back.

What Do Early Pregnancy Cramps Feel Like?

Rebecca Lee, RN explains, "Pregnancy cramps are more mild and intermittent, occurring on and off for 1-3 days." If you feel dull pain and have no period, then you might be carrying a baby! However, if you feel sharp lower abdominal pain on one side that feels like a stitch, and the pain radiates to the rest of the abdomen along with bleeding, then you may have an ectopic pregnancy. This is when the embryo implants itself somewhere other than the uterus—usually in the fallopian tubes. Note that ectopic pregnancies only occur in 1-2% of pregnant women. Severe cramps may also be a sign of pelvic inflammatory disease. See your doctor right away if the cramps before your period are more intense than usual.

What Does It Mean If I Have Cramping 10 Days Before My Period?

It is most likely ovulation cramping, which occurs when the follicle—a sac in your ovary that contains eggs—ruptures and releases an egg. Ovulation, otherwise known as "mittelschmerz," a German word that means "middle" and "pain," happens every menstrual cycle, usually mid-cycle, but most women do not feel any pain. Note, however, that because implantation can occur anywhere from 1-2 weeks before your period, 10 days is right in the range for implantation to occur, so many women may confuse what is actually implantation for ovulation pain.

How to Tell the Difference Between Ovulation and Implantation Cramping

If you have mittleschmertz, otherwise known as ovulation cramping, you'll feel a pinch or twinge on one side of your lower abdomen that occurs two weeks prior to your period. The pain should only last a few minutes to a few hours, and it is a sharp pain. In contrast, implantation cramping is a dull pain that is felt around the general lower abdomen area and your lower back. Unlike ovulation cramps, implantation cramping lasts for 1-3 days. If cramping continues for several days, and you do not usually get cramps a week or two before your period, then you may be pregnant.

If I Have Cramps a Week Before My Period, Does That Mean I'm Pregnant?

Not necessarily. Although implantation does take place about a week before your period and can cause mild cramping, there may be other causes. You may be experiencing early pre-menstrual cramps or ovulation cramping.

2. Unusual Spotting Outside Your Period (Better Known as “Implantation Bleeding”)

Are you seeing light pink to brown spotting a week before your period? According to board-certified reproductive endocrinologist and infertility specialist Dr. Mark Trolice, "Vaginal spotting one week after ovulation could represent implantation." Implantation bleeding occurs when the fertilized egg attaches itself to the lining of your uterus. This can cause some light bleeding or spotting due to the massive burrowing the embryo has to do to completely implant itself. Some of the lining of the uterus (which is made of blood) is sloughed off and passes through your cervix.

Spotting between periods is definitely more common than cramps between periods, so this can be harder for women to distinguish. Some get the spotting so close to their periods they just assume it is the start of their normal period. Normally, implantation spotting should not be heavy and should not last for more than three days. There are also other crucial signs to tell the difference between a regular period versus implantation bleeding. But it's safe to say that if you aren’t used to spotting in between, and your period is not due for more than a few days, then it could be the result of conception and implantation!

3. Dark Areola or Nipples

A rise in estrogen and progesterone levels produces more pigmentation in your breast area. This is a very telling sign of pregnancy because not enough estrogen and progesterone is produced before your period to darken your areola.

If you have hormonal imbalance, you may see a fluctuation in the color of your areola, which is not a sign of pregnancy. But, if you are regular, and you are suddenly seeing darker nipples before your period when you wouldn't normally see it otherwise, you may be pregnant!

4. Tender or Sore Breasts

If you boobs are sensitive to even the softest touch, then you may have a bun in the oven. Sore breasts can appear as early as two weeks after conception. As soon as the egg is implanted, your body starts making HCG – the pregnancy hormone needed to support a pregnancy. The rapid increase of this hormone (typically your levels will double every 48 hours in early pregnancy) leads to breast tenderness or fullness.

Some women might mistake this for regular breast pain before a period, but in early pregnancy, your breasts will feel 100 times more sensitive.

5. Nausea (Morning Sickness)

The rapid increase in the HCG hormone and the rapidly rising levels of estrogen causes a woman's stomach to empty more slowly, which may contribute to feelings of queasiness. A woman's sense of smell is also heightened in early pregnancy, which leads to a sensitive—almost finicky—reaction to certain smells. For most women, these symptoms don’t usually arrive until after the missed period, but some experience them right off the bat. If you're feeling queasy and want to get rid of it, this mom offers tips on how she cured her morning sickness and instantly felt better.

7. Dysgeusia (Metallic Taste in Mouth)

Feeling like you have a mouthful of loose change? The rise in estrogen during early pregnancy changes a woman's perception of taste. Doctor's are still not quite sure what causes this bitter, metallic taste that many women experience in early pregnancy, but they believe it has to do with the role that pregnancy hormones have in skewing a woman's sense of smell and taste in the first trimester. "Metal mouth," as this phenomenon is called, is one of the weird symptoms of pregnancy that women experience very early on, even before a missed period.

6. Food Aversions or Cravings

Taste is one thing that can be altered pretty quickly in early pregnancy. Even before a missed period, some women experience a shift in their taste buds. Some of the foods and drinks that seem to have the most commonly altered tastes in early pregnancy tend to be alcohol and fruits. One’s interest in cigarettes can also change pretty quickly. This may be caused by a heightened sense of smell, which is brought about by a rise in estrogen. This can all happen pretty quickly after implantation and can be a sure sign you may be pregnant.

7. Fatigue

Dr. Jacqueline Darna, N.M.D explains that feeling tired during your period and feeling tired during early pregnancy are very different. She says, "Feeling tired is one thing, but women within their first trimester will feel complete exhaustion to where they just can't get up and function." During early pregnancy, an increase in progesterone levels can put you to sleep. This high levels of progesterone coupled with an increase in blood production and expenditure of calories will sap your energy, which explains why you might feel weak, sick, and tired. Feeling like you’re coming down with something can be a classic sign you are expecting. If you're too exhausted to function, there are ways to fight pregnancy fatigue so that you can feel spritely and get on with your day like normal.

8. Headaches

The sudden rise in hormones and the 50% increase in blood production could cause a rush of blood to your head and give you headaches. Because of the change in hormone levels, some women may also experience low blood pressure, which causes migraines. To feel better, drink ample amounts of water, get plenty of sleep, and try to decrease stress as much as possible. Contact your doctor before taking any medications for headaches because it may effect the baby.

9. Frequent Urination

Shortly after conception, your body produces more blood. The heightened rate of blood flow to your kidneys leads to extra fluid being processed and ending up in your bladder. So if you feel a need to keep peeing, you may be pregnant!

10. Implantation Dip

If your menstrual cycle is regular, and you chart your basal body temperature (BBT) every month, then you may notice an implantation dip (or a drop in temperature) during your luteal phase (about one week after ovulation). Usually, a drop in BBT is not a good indictor of pregnancy because you also experience a dip in temperature in the middle of your menstrual cycle before your period comes. However, if you are pregnant, the implantation dip will last just one day and then shoot back up again the next day. When you have your period, your temperature dips and stays low until your period is over.

Note that only 25% of pregnancy positive charts show an implantation dip, so 75% of pregnant women don't see a dip or feel any symptoms at all.

PMS Symptoms vs. Pregnancy Symptoms

Common PMS Symptoms

  • Bloating
  • Acne
  • Mood swings
  • Cramps (dysmenorrhea)

Symptoms Unique to Pregnancy

  • Nausea
  • Change in appetite (food aversions or unusual cravings)
  • Darkened areola or nipples
  • Spotting a week before period
  • Constipation
  • Metallic taste in mouth

Common to Both

  • Mood swings, depression, anxiety
  • Tender or sore breasts
  • Fatigue
  • Lower abdominal cramps
  • Back pain
  • Headaches
  • Constipation
  • Increased urination
  • Low sex drive

A Pregnancy Test Is the Only Way to Confirm a Pregnancy

While experiencing one or more of these signs may likely indicate a pregnancy, a lot of these signs are similar to pre-menstrual symptoms, so the only way to know for sure is to take a pregnancy test.


  1. "Signs and Symptoms of Pregnancy," University of California, Santa Barbara. Accessed February 17, 2018.
  2. "What Is Implantation Bleeding?" WebMD. Accessed February 17, 2018.
  3. Melissa Conrad Stöppler, MD, "PMS vs. Pregnancy: How to Tell the Difference," MedicineNet. Accessed February 17, 2018.
  4. Kimberly Williams, "Implantation Pain Vs Ovulation Pain – Know How They Are Different?" Pregnancy Week by Week. Accessed February 17, 2018.
  5. Elsa, "Implantation Dip: 10 Things You Should Know," CheckPregnancy. July 11, 2016. Accessed February 17, 2018.