Symptoms never had before and some I only get mildly, two weeks before period. Mood swings, break out , fatigue, headache, sore breasts, low back pain, etc followed by shorter lighter period then extreme persistent fatigue. What could it be?

It may be a hormone imbalance, may be enough change to cause Premenstrual symptoms that are unusual for you, may be pregnancy, may be an illness. Any new medications?

If you continue to feel unwell, see your doctor.

No medications. Considered pregnancy or even premenopause. Will wait a couple weeks probably and see how I feel and maybe take a pregnancy test.