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Cramping, bloating, headaches, and fatigue: all of these symptoms are often a part of PMS right before you get your period. But if your period doesn’t arrive when it’s meant to, you could also be pregnant—even if you didn’t plan on it. Around half (or 49%) of all pregnancies in the United States are unintended, resulting in about three million births and around 1.1 million abortions each year. Getting the care you need as soon as possible is vital to your health.

Whether you’ve tested yet or not, it is crucial that you recognize the telltale early warning signs of pregnancy, many of which can seem indistinguishable from premenstrual syndrome, or PMS. Here are some of the early pregnancy signs and symptoms you may be experiencing:

Cramps: Cramping is among the most common signs of PMS, but it can also be an indicator of a pregnancy. You may feel cramps in your stomach, pelvic region, back, or even legs. Cramping is the result of the pelvic muscles opening in order to prepare your body for a pregnancy—whether or not you actually are pregnant. This symptom can usually be relieved with over-the-counter medications. If you experience cramping but do not get a period, you may be pregnant.

Bloating: Abdominal bloating is another common symptom of both PMS and pregnancy. Your body may be retaining extra water weight. This can make you feel like you’ve gained weight, even if you haven’t.

Fatigue: Feeling tired all the time? If you find yourself needing more sleep than normal, then what you’re feeling is fatigue. Fatigue can make your whole body sluggish, so you could find yourself napping or sleeping in more than usual. You may or may not experience this regularly with PMS, but if you notice anything unusual, it may be time to take a pregnancy test.

Various Aches and Pains: Headaches, tender or swollen breasts, and other aches and pains may appear either before your period or if you get pregnant. Again, keep an eye on anything that may seem unusual for the time of the month. In addition to physical pain, the hormones produced by your body can skyrocket during pregnancy and PMS, which can lead to mood swings and irritability. Make sure to take care of yourself mentally as well as physically, no matter what the outcome of your pregnancy test.

A Missed Period: Finally, the most obvious of the early warning signs of pregnancy is that your period will not arrive when it is meant to. If it’s been more than a week, you may benefit from testing for pregnancy at home or in a clinical setting. However, it is important to remember that a typical menstrual cycle can last anywhere from 21 to 40 days, so it’s natural to see fluctuations from time to time. Be sure to speak to your gynecologist if you have concerns about early, late, or missing periods, as these can be indications of other conditions if you are not pregnant.

Should you experience any of these or other early warning signs of pregnancy, but you’re unsure of what to do, know that free pregnancy help is available. Many adult and teen pregnancy centers help women of all ages receive free pregnancy tests and get access to information on pregnancy. If you think you may be a part of the 4% of American women who are pregnant right now, make sure to get the guidance you need from medical professionals and compassionate staff members at a pregnancy help center.

The information provided here is general in nature.  It is not a substitute for a consultation with a medical professional. Before any medical procedure, it is imperative that you discuss your personal medical history, risks, and concerns with your doctor. If you have questions during or after a procedure, your doctor should be immediately contacted. Avenue Women’s Center is not an emergency center.  If you are experiencing severe symptoms, such as bleeding and/or pain, seek immediate medical attention.  Contact your physician, go to an emergency room, or call 911.