What Is a False Pregnancy or Pseudocyesis?

Pseudocyesis or phantom pregnancy, also known as false pregnancy, occurs when a woman who is not actually pregnant has many of the typical pregnancy symptoms. In some cases, they can even obtain a positive result in a pregnancy test.

This type of "phantom" gestation usually occurs in women of reproductive age —although it can appear before— who suffer from some psychological problem or are anxious about achieving pregnancy. It usually happens among women suffering from infertility who have been trying to conceive for a long time with no luck so far.

In addition, experts point out that it often occurs in young patients that are afraid of getting pregnant or feeling guilty after having engaged themselves into unsafe sexual intercourse. It also may occur among women suffering from amenorrhea.

Positive pregnancy test

It is only logical to think that a woman with a false pregnancy will get a negative result after taking a pregnancy test. However, sometimes they can even obtain positive results as a consequence of the mind control over the so-called hypothalamic hormones.

Abdominal extension during false pregnancy or pseudocyesis

The fact that we can obtain a positive result after taking a home pregnancy test is due to an increase in the levels of the gonadotrophin-releasing hormone that our body itself produces. It occurs because your emotional state can lead in some cases to the release of pregnancy hormones controlled by the brain.

Pregnancy symptoms

Women suffering from this psychosomatic disorder are capable of experiencing the common symptomatology of pregnancy such as:

• Amenorrhoea (absence of menstruation)
• Nausea
• Right lower abdomen swelling without disappearing belly button
• Menstrual irregularities
• Vomiting
• Weight gain
• Feeling of fetal movement
• Breast growth
• Cervical changes
• Darkening of the skin

Nevertheless, there exist a series of common pregnancy symptoms that do not arise in these cases, given that they are not physically pregnant actually. Such symptoms determine the diagnosis of pseudocyesis.

When there is a false pregnancy, the fetus cannot be seen in an ultrasound scan and there is no way its heartbeat can be heard. Besides, although there is no delivery, some studies ensure that some women can even feel contractions.

Some cases of men who have experienced it can be found in literature as well.

How is false pregnancy diagnosed?

False or phantom pregnancy is diagnosed by firstly confirming that it is not a real gestation. Therefore, the doctor must check the size of the uterus, perform a pregnancy test —which, as mentioned before, in some cases symptoms appear so credible that may lead to confusion— and an ultrasound scan, in addition to a physical examination.

Women experiencing false pregnancy usually show altered levels of the following hormones:

• Low FSH levels, which can lead to anovulation and therefore to the absence of periods (amenorrhea).
• High prolactin and progesterone levels, which can even lead to the onset of lactogenesis (i.e. milk secretion).

The absence of periods together with a mild milk secretion can make the woman be even more convinced that she is pregnant, which may be highly confusing even for the specialist. In fact, in most severe cases, symptoms are so realistic that the specialist can even think the woman is certainly pregnant.

In addition, obesity is a factor that turns the diagnosis into an even more complicated process.

Treatment

The treatment of pseudocyesis is essentially a psychological one, but a physical treatment may be also necessary in some cases.

Psychiatric treatment of false pregnancy

The importance that the psychiatrist takes part in the therapy to treat this type of problem is pointed out by experts. Nevertheless, given that anovulation usually occurs in these patients (hence amenorrhoea), ovulation must be induced by a treatment based on dopaminergics.

It is also essential a psychiatry professional to be present both in the treatment and in the menstruation induction, since the woman may become depressed because she feels that it may lead to an abortion.