Pms perimenopause or pregnant?

Patient: I am 42 and usually have a period lasting 7 or 8 days and heavy this month i only hhad a 2 day light period. now 2 weeks later my breasts feel full are larger, my lowand nauteaus back aches terrible, im constipated and have nausea bouts throughout the day. is this perimenopausal symptoms or could i be pregnant?

Doctor: