Pregnancy or period? How the symptoms compare

Is my period starting or could I be pregnant? When your period is due and hasn’t arrived yet, every cramp and twinge can feel like a clue. Here’s how period and early pregnancy symptoms compare, and what to do while you wait.

Why it’s so hard to tell

Your period and early pregnancy both come with hormone changes, and they happen at the same point in your cycle. Early pregnancy symptoms usually start around 4 to 6 weeks of pregnancy, which is around the day your period is due. So in the day or two before, the two can feel almost the same.

Cramps: the most confusing symptom

Period pain usually starts just before or at the start of your period. It can be painful cramps that spread to your back and thighs, a sharp pain or a dull ache, and it usually lasts up to 3 days.

Early pregnancy can bring cramping a bit like period pains too. Mild tummy pain in pregnancy can be caused by things like stretching ligaments, constipation or trapped wind. If it goes away when you change position or rest, it’s probably nothing to worry about.

The difference is what happens next. With a period, bleeding starts and the pain usually eases within a few days. If the cramps carry on and no period comes, take a test.

If you could be pregnant, get urgent advice if the pain is severe, on one side, or hasn’t eased after resting for 30 to 60 minutes.

Easing cramps while you wait

A warm bath or shower, a hot water bottle wrapped in a tea towel, gentle exercise like walking or swimming, and massaging your tummy and back can all help with period pain. If you might be pregnant, paracetamol is usually the best painkiller to use. Check with a pharmacist before taking anything else, such as ibuprofen.

The other symptoms, side by side

Sore breasts: common with both.
Tiredness: common with both.
Mood changes: common with both.
Bloating and headaches: common before a period, and headaches can be common in early pregnancy too.
Feeling or being sick: more likely to be pregnancy, usually from around 4 to 6 weeks, at any time of day.
Needing to pee more often, without pain: more likely to be pregnancy.
A metallic taste, being sensitive to smells, or going off foods: more likely to be pregnancy.
More vaginal discharge, without soreness: more likely to be pregnancy. See pregnancy vs period discharge.
Constipation: on the NHS list of early pregnancy signs.

For a fuller comparison, symptom by symptom, see pregnancy or PMS?

Signs your period is on its way

your usual pre-period symptoms, at the usual point in your cycle
pain that starts just before or as the bleeding starts
bleeding that becomes a normal flow for you, usually heaviest in the first 2 days
PMS symptoms that get better once the bleeding starts

Bleeding: the biggest clue

Whether your period actually arrives, and whether it’s normal for you, tells you more than any other symptom. If it doesn’t come, or it’s much lighter or shorter than usual, take a test. Some people have light spotting around the time their period is due in early pregnancy. Our guide to implantation bleeding explains how it compares with a period, and pregnancy-like symptoms during your period covers other bleeding, including bleeds on hormonal contraception.

What to do while you wait

If your period is due today or is late, take a test.

Some early tests can be used from 5 days before your period is due (the packet may say ‘6 days before your missed period’), but they won’t pick up every pregnancy that early. Testing from the day your period is due is more reliable, though a negative can still be wrong if there isn’t enough hCG yet. If your period doesn’t come, test again a few days later.

If you’ve had two negative tests and your period still hasn’t come, speak to your GP. See when is a period late? and pregnancy or a late period?

If you bleed after a positive test

If you’ve had a positive test and then start bleeding or spotting, don’t assume it’s your period. Contact your maternity unit, an early pregnancy unit or NHS 111 for advice. You’ll be asked about your symptoms and how many weeks pregnant you are, and you may be offered checks such as a scan or blood tests. Call 999 if the bleeding is heavy or you have severe pain.

If you’re having fertility treatment

Period-like cramps in the two weeks after treatment are very hard to read, so try not to judge the result by them. If you’re having fertility treatment, test on the date your clinic gives you. Testing early may give a false result. Don’t stop any medicines your clinic has prescribed unless they tell you to. If you have any bleeding or a brown, watery discharge, contact your fertility clinic or NHS 111 as soon as possible.

Questions people ask

Can you have period cramps and no period and be pregnant?

Yes. Early pregnancy can bring cramping a bit like period pains. If your period is due or late and you have cramps but no bleeding, take a test.

Can early pregnancy feel like your period is about to start?

Yes. Mild cramps and sore breasts are common in both, which is why so many people only find out when their period doesn’t arrive.

How long after period-like cramps should my period start?

Period pain usually starts just before or at the start of your period. If you’ve had cramps for a day or two and your period still hasn’t come, it’s worth taking a test.

My period is lighter than usual. Could I be pregnant?

It’s possible. Some people have light bleeding around the time their period is due in early pregnancy. Take a test, and see pregnancy-like symptoms during your period.

When to get help

Mild cramps that ease with rest are usually nothing to worry about. But if you’re pregnant, or think you could be, get urgent advice from your maternity unit, an early pregnancy unit or NHS 111 if you have:

any bleeding or spotting, even if it’s light
tummy pain that’s severe, on one side, or hasn’t eased after resting for 30 to 60 minutes
pain in the tip of your shoulder

Call 999 if you have bleeding along with severe tummy pain, pain in your shoulder, or feeling sick, faint or dizzy, or if the bleeding is heavy (soaking a pad soon after putting it on). Also call 999 if you have sudden, sharp and intense tummy pain and you feel very dizzy or faint, feel sick or look very pale. These can be signs of an ectopic pregnancy or a miscarriage that need treating straight away.