Menstrual Symptoms: PMS or Early Pregnancy Signs?

Premenstrual symptoms, ovulation period calculation?

Hello Doctor: On March 1st, I took emergency contraception once, and my period started on March 18th, lasting until March 26th.
On April 21st, I experienced headaches, lower abdominal discomfort, and increased vaginal discharge.
I thought these were premenstrual symptoms, but the next day my period did not arrive.
I had sexual intercourse with my boyfriend, and since the condom was too small, he was concerned about possible leakage, so I took emergency contraception again.
Now, my period is five days late, and I am experiencing body aches, fever, abdominal discomfort, and a small amount of brown discharge.
I would like to know if this is a sign of impending menstruation or early pregnancy symptoms.
Since I took emergency contraception last month, I am unsure if this month's ovulation would occur at the usual estimated time.
Could the symptoms I experienced on April 21st be related to ovulation rather than premenstrual syndrome?

jennie, 10~19 year old female. Ask Date: 2019/04/27

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On March 1st, I took emergency contraception, and my period started on March 18th, lasting until March 26th.
On April 21st, I experienced headaches, lower abdominal discomfort, and increased vaginal discharge.
I thought it was premenstrual discomfort, but the next day my period did not arrive.
I had sexual intercourse with my boyfriend, and since the condom was too small, he was concerned about potential leakage, so I took emergency contraception again.
Now, my period is five days late, and I am experiencing body aches, fever, abdominal discomfort, and a small amount of brown discharge.
I would like to know if these are signs of premenstrual syndrome or early pregnancy symptoms.

Answer: It would be advisable to take a pregnancy test since I took emergency contraception the previous month, and I'm unsure if this month's ovulation date aligns with the typical calculations.
I would like to ask the doctor if the symptoms I experienced on April 21st could be indicative of ovulation rather than premenstrual syndrome.

Answer: It is possible that these symptoms are related to ovulation.

Reply Date: 2019/04/27

More Info

When it comes to understanding menstrual symptoms, distinguishing between premenstrual syndrome (PMS) and early pregnancy signs can be quite challenging, especially when hormonal fluctuations are involved. Based on your description, there are several factors to consider regarding your symptoms and the potential for pregnancy.

Firstly, it’s important to note that PMS typically occurs in the luteal phase of your menstrual cycle, which is the time between ovulation and the start of your period. Symptoms of PMS can include headaches, abdominal discomfort, mood swings, fatigue, and changes in appetite. These symptoms are primarily driven by hormonal changes, particularly fluctuations in estrogen and progesterone.

On the other hand, early pregnancy symptoms can overlap significantly with PMS. Common early signs of pregnancy include missed periods, breast tenderness, fatigue, nausea, and abdominal cramping. The presence of brownish discharge or spotting can also occur in early pregnancy, often referred to as implantation bleeding, which happens when a fertilized egg attaches to the uterine lining.

In your case, you mentioned experiencing symptoms such as headaches, abdominal discomfort, increased white discharge, and a delay in your period. The fact that you have taken emergency contraception (the morning-after pill) can also complicate your cycle. Emergency contraception can cause temporary hormonal changes that may lead to irregularities in your menstrual cycle, including delayed periods and unexpected symptoms.

Given that your period is five days late and you are experiencing systemic symptoms like body aches and mild fever, it is advisable to take a home pregnancy test. These tests are designed to detect the hormone hCG (human chorionic gonadotropin), which is produced shortly after a fertilized egg attaches to the uterine lining. If the test is positive, it would indicate pregnancy. If it is negative and your period does not arrive soon, you may want to consult a healthcare provider for further evaluation.

Regarding your question about whether the symptoms on April 21 were related to ovulation or PMS, it’s possible that they could be attributed to either. Ovulation can cause mild cramping and changes in cervical mucus, while PMS symptoms can also begin a week or so before your expected period. The timing of your symptoms, particularly after taking emergency contraception, makes it difficult to pinpoint the exact cause without further testing.

In summary, while your symptoms could suggest either PMS or early pregnancy, the delay in your period and the nature of your symptoms warrant a pregnancy test. If you continue to experience unusual symptoms or if your period remains absent, it would be wise to seek medical advice for a comprehensive evaluation. This will help clarify your situation and ensure that any underlying issues are addressed appropriately.

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