There are several ways a person can tell when a period is due. Many people experience a range of physical and emotional symptoms, known as premenstrual syndrome (PMS), as their hormone levels drop.

This article discusses how to tell when a period is coming and possible reasons for having period symptoms with no period. It also compares PMS to early pregnancy symptoms.

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Many people experience PMS before their period starts. This can act as a sign that a period is on the way. Some of the physical symptoms of PMS include:

  • abdominal bloating
  • abdominal cramping
  • tender or swollen breasts
  • back pain
  • changes in appetite
  • pimples or acne
  • sleeping more or less than usual
  • headaches
  • sensitivity to light or sound
  • vaginal discharge becoming dry, sticky, or absent

Emotional symptoms of PMS may include:

Learn more about symptoms of PMS here.

Does everyone get PMS?

PMS does not affect everyone in the same way. Some people have their period with no PMS or only a few mild symptoms, whereas other people experience severe symptoms that interfere with their daily activities. Severe PMS is known as premenstrual dysphoric disorder (PMDD).

PMS symptoms can also change throughout a person’s life. People may notice different PMS symptoms as they get older or after their first pregnancy.

Learn more about how many people get PMS here.

How long does PMS last?

According to the Office on Women’s Health, PMS symptoms often begin around 5 days before a period and usually resolve once the body’s estrogen and progesterone levels start rising. This typically occurs about 4 days after a person’s period begins.

PMS occurs after ovulation, which is when an ovary releases an egg into a fallopian tube. After this point in the menstrual cycle, estrogen and progesterone levels decrease significantly. Researchers believe this is what causes PMS symptoms.

If someone has PMS-like symptoms but their period does not arrive when they expect it to, there are several potential explanations, such as:

  • Irregular periods: It is common for periods not to begin at the same time in each cycle. If the length of someone’s cycle varies widely from month to month or they have a very long cycle, they may have irregular periods. Irregularity is typical for people going through puberty or perimenopause, but it can have other causes.
  • Stress: Psychological stress causes a range of physical and emotional symptoms. It may make someone feel anxious, overwhelmed, or more emotional than usual. It can also cause aches and pains, tiredness, changes to digestion, and a low sex drive.
  • Hormonal birth control: Contraceptive pills, patches, implants, and intrauterine devices can cause side effects that resemble PMS. However, some people stop having a monthly bleed while they use these forms of birth control.
  • Physical conditions: Some health conditions cause PMS-like symptoms. Some examples include polycystic ovary syndrome (PCOS), certain nutritional deficiencies, and thyroid disease.
  • Pregnancy: Early pregnancy has similar symptoms to PMS and results in periods stopping. If pregnancy is a possibility, seek testing.

PMS and early pregnancy can cause similar symptoms. Here is a comparison.

Bleeding or spotting

Although bleeding does not typically occur during PMS, some people experience light bleeding or spotting. This can also be a sign of early pregnancy.

Nearly 15–25% of pregnant people report spotting or light bleeding during the first trimester. When this occurs 1–2 weeks after a fertilized egg implants in the uterine lining, it is usually called implantation bleeding.

Implantation bleeding is much lighter than menstrual bleeding. It may look like a pale pink or brown discharge, whereas menstrual blood appears bright red.

Abdominal pain or cramping

Both PMS and pregnancy can cause abdominal pain. People may also notice mild-to-moderate cramping in the lower abdomen.

During pregnancy, these cramps feel similar to premenstrual cramps, and they occur as the embryo grows and stretches the uterus.

Breast changes

Both PMS and pregnancy affect hormone levels, which may result in breast changes, such as:

  • pain
  • tenderness or sensitivity
  • swelling
  • heaviness

PMS-related breast changes usually resolve at the beginning or end of a person’s period. However, breast changes that occur due to pregnancy can persist throughout the pregnancy.

Fatigue

Fatigue is a potential symptom of both PMS and early pregnancy. Fatigue during pregnancy might be due to elevated hormone levels. An imbalance of the neurotransmitter serotonin may contribute to feelings of fatigue during PMS.

Serotonin helps regulate mood and the body’s sleep cycle, and its levels change throughout a person’s menstrual cycle. These changes may affect some people more than others.

Learn more about fatigue and periods here.

Changes in mood

The hormonal changes that occur during menstruation and pregnancy can affect a person’s mood, leaving them feeling anxious, sad, or irritable. Persistent feelings of sadness, apathy, or irritability that last longer than 2 weeks may indicate depression or another mood disorder. Dramatic mood changes that only occur before a period may be a sign of PMDD.

The symptoms of PMDD are similar to PMS but much more intense. They include:

Learn more about the differences between PMS and PMDD here.

People may wish to see a healthcare professional if they have PMS symptoms that affect their daily life, if the symptoms occur outside of their period, or if they experience any sudden or dramatic changes to PMS or period symptoms.

If a person expects to have a period, but it does not arrive, it is best to speak with a healthcare professional about the potential causes. They may recommend a pregnancy test if someone could be pregnant or other tests if pregnancy is not the cause.

Heavy bleeding and severe abdominal cramping can indicate pregnancy complications, such as pregnancy loss or ectopic pregnancy. Contact a provider immediately if a pregnant person experiences any of the following symptoms:

  • heavy bleeding
  • intense lower back pain
  • painful abdominal cramps
  • a sudden, intense headache
  • severe, persistent fatigue
  • difficulty breathing
  • vomiting numerous times a day

Learn more about bleeding between periods here.

Several symptoms can inform someone if they are about to have a period and can include spotting, pain or cramping, bloating, swollen or tender breasts, acne, and mood changes.

PMS usually appears the week before and goes away a few days after a period begins. Although these symptoms can cause discomfort, they should not interfere with a person’s daily life.

If someone has severe PMS or symptoms that occur with no period, they should speak with a medical provider.