Pregnant, PMS, or Something Else?

Patient: I’ve been experiencing some odd symptoms the last week or so. I’m on birth control pills and have not missed any pills, as well as taken them in a timely fashion. My period is not due for about 10 days still. I know it’s very unlikely that I’m pregnant because I’m on bc pills, so should I just chalk it up to PMS or could it be something else entirely? Thank you for your time.

Symptoms: – Menstrual-like cramps two weeks before expected period (a week earlier than normal)
– Frequent headaches in the frontal lobe
– Trouble falling asleep/insomnia
– Both constipation and diarrhea (dark, loose stool consistently, which is not normal for me)
– Frequent urination
– Alternating between extreme hunger and no appetite, even within a short time period
– Mild nausea in the evenings without vomitting
– Extra sensitive nipples
– Occasional pain in breasts, mostly the left
– More emotional than usual

Doctor: Hello,The symptoms are indeed premenstrual or PMS , and quite possible to manifest if you have been through a stressf ul phase during this month which may cause hormonal imbalances and can cause progesterone deficiency even with birth control, so best would be watch for any breakthrough bleeding and you may use NSAIDs FOR PAIN RELIEF and hot fomentation for breast soreness. Try de-stressing exercises, and they would help.I hope i have answered your query ,regards