Symptom Check: Is It PMS or Early Pregnancy?

The "two-week wait" between ovulation and your expected period can be stressful when you think you might be pregnant. Learn about the difference between PMS and pregnancy symptoms to make the wait more bearable.

Anyone trying to conceive knows about the nerve-wracking "two-week wait"—the time between ovulation and finding out if you're pregnant. Can't stop wondering whether you'll get your period or a positive pregnancy test? Read on to understand the difference between PMS symptoms and pregnancy symptoms.

Getty Images. Art: Jillian Sellers.

Tracking Your Symptoms After Ovulation

It might be tempting to analyze your symptoms after ovulation to determine if you're not pregnant or pregnant, but in this case, patience is truly key because the symptoms of pregnancy will not become apparent until well after ovulation and implantation.

The truth is, depending on the timing of sperm entering the vagina and the egg being released, it can be difficult to know the exact day of fertilization. The egg only lives for 24 hours, but sperm can live for up to 5 days in the female reproductive tract, so unless you know exactly when you ovulate, there's a 6-day fertile window.

Then, once the egg is fertilized, it has to travel to the uterus and actually implant, another several-day process. At the very, very earliest, if everything is perfectly timed and goes swimmingly (no pun intended!), some people get a pregnancy test as early as 6 days post-ovulation, but that is pretty uncommon. Instead, it's best to wait as long as possible until your expected period to look for signs of pregnancy.

PMS Symptoms vs. Pregnancy Symptoms

It can feel like a cruel reality that PMS and the early signs of pregnancy are nearly identical. The reason? You produce more progesterone the week after ovulation, whether you're pregnant or not. Progesterone is the hormone responsible for many PMS symptoms, like bloating, breast tenderness, and mood swings.

Your body will stop releasing progesterone if you're not pregnant about 10 days after ovulation. Then, as the hormone levels wear off, your symptoms subside, the uterine lining sloughs off, and you get your period.

If you are pregnant, you'll continue producing progesterone (and experiencing PMS-like symptoms). "The difference between PMS and early pregnancy is very subtle," says Helen Kim, M.D., associate professor of Obstetrics/Gynecology and Director of the In Vitro Fertilization Program at the University of Chicago.

Period vs. Pregnancy Bleeding and Cramping

According to the American Academy of Obstetrics and Gynecology (ACOG), bleeding in the first trimester occurs in 15-25% of pregnancies. Sometimes bleeding is caused by implantation, which happens when the fertilized egg attaches to the lining of your uterus. It usually starts when you expect your period or a few days sooner and can easily be mistaken for the start of menstruation. It might also be accompanied by mild cramping that feels like pulling or tingling.

There are a few distinctions between implantation bleeding and menstruation though: "Implantation bleeding tends to be lighter and shorter in duration than a period," says Dr. Kim. Unlike with menses, spotting associated with implantation will stay light and won't develop into to a full flow. It's also likely to be brown or pink instead of red. But if you don't experience implantation bleeding, don't fret: You can still be pregnant and have a healthy pregnancy without it.

What to Do During the 'Two-Week Wait'

The two-week wait can feel excruciatingly long when you're desperate to know if you're pregnant. Instead of fretting and wondering, use this time to prepare your body for a possible pregnancy. Whether or not you're pregnant, the habits you establish will help prepare your body for if and when you are.

Treat your body like it's pregnant

According to the American Society for Reproductive Medicine (ASRM), a healthy 30-year-old has about a 20% chance of becoming pregnant each month. Among other factors, your odds of pregnancy depend on your age: Your odds are greater when you are younger and decrease with age.

Even so, it's still important to act like you're pregnant until you know for sure. You don't have to go overboard with restrictions, but you should treat yourself as if you're pregnant because you could be, Dr. Kim says. Avoid alcohol, limit yourself to one to two cups of coffee per day, skip fish high in mercury, and avoid raw or undercooked seafood, meat, poultry, and eggs.

Take a prenatal vitamin

Once you start trying to conceive, ACOG recommends you start taking a prenatal vitamin that contains 400 micrograms of folic acid. If you have risk factors, like a previous baby with a neural tube defect (NTD), you may need to take more folic acid.

Folic acid helps prevent NTDs, and your baby's neural tube—which becomes your baby's brain and spinal cord—develops during the first four weeks of pregnancy. Don't worry if you haven't taken them yet; it's never too late to start.

Stay active

Finally, you should also be mindful of your physical fitness, no matter your two-week wait symptoms. "If you normally engage in moderate-intensity physical activity, keep it up," says Dr. Kim. That's because exercise is a great way to relieve stress, and stress affects your overall health and your fertility.

Still, Dr. Kim warns that this isn't the best time to adopt a new or intense training program, which can stress your nervous system. In addition, activities that significantly raise your core body temperature, such as hot yoga or heated spinning, could negatively affect implantation.

So, choose moderate-intensity exercises. For example, walking is a generally safe and accessible activity for all fitness levels. But, to be sure, talk to a health care provider to discuss options that are safest for you.

When to See a Health Care Provider

If you get your period less than 14 days after you ovulate, it could be a red flag that something is affecting your ability to become pregnant. It could be as minor as miscalculating ovulation, or it could be a condition like polycystic ovarian syndrome (PCOS).

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