Pseudocyesis is a false belief of being pregnant that is associated with objective signs and reported symptoms of pregnancy, which may include abdominal enlargement, reduced menstrual flow, amenorrhea, subjective sensation of fetal movement, nausea, breast engorgement and secretions, and labor pains at the expected date of delivery.
Cases of pseudocyesis nowadays are found more frequently in rural undeveloped countries where women usually are not examined by a physician or a midwife until they are in labor or seek medical aid. In developed countries, women visit obstetricians in the first trimester of pregnancy who have more accurate means of diagnosis including pregnancy tests and ultrasonographic examinations.
These diagnostic procedures may help pseudocyetic women to be convinced of their non-pregnant condition that usually leads to resolution of pseudocyesis within minutes or even seconds. Furthermore, women from developed countries in general are more educated and sophisticated, and their emotional conflicts result in a more profound, refined mode of expression than that of pseudocyesis
Ten women from 5 selected studies were analyzed after applying stringent criteria to discriminate between cases of true pseudocyesis simulated or erroneous pseudocyesis. The analysis of the reviewed studies evidenced that pseudocyesis shares many endocrine traits with both polycystic ovarian syndrome and major depressive disorder, although the endocrine traits are more to polycystic ovarian syndrome than to major depressive disorder.
Pseudocyetic women may have increased sympathetic nervous system activity, dysfunction of central nervous system catecholaminergic pathways and decreased steroid feedback inhibition of gonadotropin-releasing hormone. This may lead to the development of pseudocyetic traits including hypomenorrhea or amenorrhea, galactorrhea, nocturnal hyperprolactinemia, abdominal distension and apparent fetal movements and labor pains at the expected date of delivery
What Causes pseudocyesis
Only recently have doctors begun to understand the psychological and physical issues that are at the root of pseudocyesis. Although the exact causes still aren’t known, doctors suspect that psychological factors may trick the body into “thinking” that it’s pregnant.
When a woman feels an intense desire to get pregnant, which may be because of infertility, repeat miscarriages, impending menopause, or a desire to get married, her body may produce some pregnancy signs (such as a swollen belly, enlarged breasts, and even the sensation of fetal movement). The woman’s brain then misinterprets those signals as pregnancy, and triggers the release of hormones (such as estrogen and prolactin) that lead to actual pregnancy symptoms.
When a woman believes she is pregnant, especially for a period of several months, it can be very upsetting for her to learn that she is not. Doctors need to gently break the news, and provide psychological support, including therapy, to help the patient with pseudocyesis recover from her disappointment.
Psychological counseling is usually recommended by psychotherapist in order to treat underlying emotional and psychological causes of false pregnancy, including stress, anxiety and depression.
The treatment that has had the most success is demonstrating to the patient that she is not really pregnant by the use of ultrasound or other imaging techniques.
When a woman believes she is pregnant, especially for a period of several months, it can be very upsetting for her to learn that she is not. Doctors need to gently break the news, and provide psychological support – including therapy – to help the patient with pseudocyesis recover from her disappointment.
Pseudocyesis is not known to have a direct underlying physical cause and there are no general recommendations regarding treatment with medications. In some cases, however, the patient may be given medications for such symptoms as the cessation of menstruation.