If someone has severe PMS or symptoms that occur with no period, they should speak with a medical provider.
How to tell that a period is coming
There are several ways to 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:
- irritability
- anxiety
- fatigue
- food cravings
- difficulty concentrating
- feelings of sadness or apathy
- crying spells or angry outbursts
- reduced sex drive
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.
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.
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:
- persistent irritability
- symptoms of depression and anxiety
- panic attacks
- mood swings
- difficulty falling asleep
- severe daytime fatigue
- food cravings
- binge eating
- headaches
- bloating
- cramps
- joint and muscle pain
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
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.
Last medically reviewed on November 10, 2021
- Pregnancy / Obstetrics
- Women’s Health / Gynecology
How we reviewed this article:
Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.
- Bai, G., et al. (2016). Associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy: The generation R study.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5096665/ - Bleeding during pregnancy. (2019).
https://www.acog.org/Patients/FAQs/Bleeding-During-Pregnancy - Body changes and discomforts. (2019).
https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/body-changes-and-discomforts - Depression. (2018).
https://www.nimh.nih.gov/health/topics/depression/index.shtml - Period problems. (2018).
https://www.womenshealth.gov/menstrual-cycle/period-problems - Premenstrual dysphoric disorder (PMDD). (2018).
https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome/premenstrual-dysphoric-disorder-pmdd - Premenstrual syndrome (PMS). (2018).
https://www.womenshealth.gov/menstrual-cycle/premenstrual-syndrome - What are some common signs of pregnancy? (2017).
https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/signs
Signs Your Period Is Coming
Women usually start noticing physical and mood changes about 1-2 weeks before period bleeding starts. Ninety percent of women have premenstrual syndrome (PMS) symptoms at some point in their reproductive life. Some women have more severe PMS signs and symptoms than others.
Changing hormones are to blame for many uncomfortable or unpleasant period signs and symptoms like cramps and tender breasts. Brain chemicals are also involved, but it’s unclear to what extent.
Period signs and symptoms usually end about 3-4 days after bleeding begins.
Common signs that your period is approaching are:
- You’re breaking out.Acne is a common problem at this time of the month. Adult women get acne much more than men do, and it’s all because of hormones. Period-related breakouts are called cyclical acne. Rising hormone levels kickstart oil (called sebum) production, which clogs pores and causes pimples as your period is about to start. Before or during your period, you may notice breakouts on your chin and jawline area.
- Yourbreastsare sore or heavy.Breast pain linked to periods is called cyclical breast pain. Your breasts may feel tender or swollen right after ovulation until a few days after period bleeding starts. Changes in the hormones estrogen, progesterone, and prolactin, the breastfeeding hormone, may play a role.
- You’re tired but you can’tsleep.Fatigue is a vicious cycle for many women at this point in their cycle. Shifting hormones disturb your sleep patterns and make you feel tired. Changes in estrogen and progesterone may also increase core body temperature, especially when sleeping. You’re more likely to get good sleep when your core body temperature decreases.
- You have cramps. Cramps in your lower belly are the most frequent menstrual complaint. Cramps that occur before or during your period are called primary dysmenorrhea. Unlike many other symptoms, which begin 1-2 weeks before your period and end when bleeding starts, cramps usually show up right before your period and last for 2-3 days.
- You’reconstipatedor havediarrhea. When your period is coming, digestive symptoms tend to fall to the extremes. Some women get constipated. Others have diarrhea.
- You’re bloated and gassy. Water retention is another major complaint. It’s also hormonal, but you can curb premenstrual bloat by cutting out salt, eating more fruits and vegetables, and exercising regularly.
- You have aheadache. Changes in estrogen levels are to blame if you get headaches before your period. If you’re prone to migraines, you’ll probably find that you get them before your period.
- You’re having mood swings. The shift in hormones that cause physical period signs can also affect your emotions. You may have crying spells or feel angry and irritable.
- You’re anxious and depressed.Depression and anxiety are commonly linked to PMS. About half the women who seek help for period signs have some type of depression or anxiety disorder. A history of either condition could make your premenstrual symptoms worse.
- Your lower back hurts. Period cramps don’t just affect the belly. Changes in natural chemicals called prostaglandins that line the uterus cause contractions that you could also feel in your back or thighs.
Show Sources
Medscape: “Premenstrual Syndrome.”
Office on Women’s Health: “Premenstrual syndrome (PMS) fact sheet,” “Menstruation, Menopause, and Mental Health,” “Menstrual Cycle.”
American Academy of Dermatology: “Hormonal factors key to understanding acne in women.”
National Women’s Health Resource Center: “Ask the Expert.”
Mayo Clinic: “Water retention: relieve this premenstrual symptom,” “Chronic daily headaches.”
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