What should you know about premenstrual syndrome and pregnancy?

PMS may bring breast tenderness, bloating, cramps, tiredness, appetite changes and mood changes before menstruation. Early pregnancy can also involve breast changes, fatigue, nausea, altered appetite and emotional changes. Symptoms alone cannot reliably distinguish the two. PMS generally follows a familiar pattern and eases when menstruation begins, while pregnancy may cause a missed or unusual period and symptoms that continue. A late period can have causes other than pregnancy, including stress, illness, weight change or cycle variation.

If you have had sex that could result in pregnancy and your period is late or unusual, use a home pregnancy test according to its instructions. If the result is negative but your period does not arrive, repeat the test as directed or speak with a clinician. Until you know the result, check medicines and supplements with a pharmacist or doctor, especially if you may be pregnant. Do not stop prescribed treatment without advice. Tracking cycle dates and symptoms can make the discussion clearer.

Seek urgent care for severe or one-sided lower abdominal pain, heavy bleeding, shoulder-tip pain, dizziness, fainting or feeling very unwell when pregnancy is possible. These symptoms need prompt assessment. Contact a clinician for a persistent missed period, repeated negative tests with ongoing uncertainty, or symptoms that are disrupting daily life. Breast pain is often related to hormonal changes, but a new lump, skin change, nipple discharge or a red, hot breast should be assessed.

When should I test? Should I repeat a negative test? Could my medicines affect pregnancy or PMS symptoms? What symptoms require urgent help? What contraception options are suitable for me?