I was driving home from a horseback riding lesson when I noticed how sore my chest was – despite my supportive exercise bra. A quick glimpse in the rearview mirror showed a scattering of breakouts along my chin. "Yeah," I thought, "I've been a tad emotional lately, too." Three of the signs I was to start my period were firmly in place. But one (OK, OK, four) pregnancy tests later made it abundantly clear my cycle wouldn't be starting anytime soon.

How could I have missed it? How could I not distinguish the subtle symptoms that signified a little one was on the way? Well, mainly because the signs of pregnancy can closely mirror the signs of a pending menstrual cycle. So how can you tell the difference?

"In my experience, many women experience breast tenderness that tends to be more than the usual premenstrual tenderness," says Margaret Buxton, a certified nurse-midwife at the West End Women's Health Center in Nashville, Tenn. "Nausea doesn't typically crop up until five to six weeks after the missed period. But there are many women who have irregular periods and don't find it unusual to go six to eight weeks between cycles – or they may be breastfeeding and not having cycles at all. For these women, the nausea can alert their suspicion to pregnancy."

A few other, usually subtle, signs can include pelvic cramping, acid reflux, increase in vaginal secretions or even increase in salivation, says Dr. Alice Shen from the Small Miracles Family Center at Caritas Norwood Hospital in Norwood, Mass. "Often symptoms of early pregnancy can mimic some premenstrual symptoms, though they're usually more pronounced."

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