What Is Pseudocyesis?

  • Aleena RajanMaster Of Public Health (MPH) - University of Wolverhampton
  • Helen McLachlanMSc Molecular Biology & Pathology of Viruses, Imperial College London

“Unravel the enigma of phantom pregnancy—an intricate dance between desire and the body's silent symphony, challenging our perception of reality with every heartbeat.”

Introduction

Pseudocyesis is a fascinating and intriguing psychological phenomenon that explores the complex interaction between the mind and the body. It is also known as phantom or fake pregnancy. The potential of this illness to imitate the physical symptoms and indications of pregnancy, even in the absence of a gestating foetus, has captured the attention of the medical community. From the Greek terms "pseudes," which means false, and "kuesis," which means pregnancy, the word "pseudocyesis" is formed. It appears in people who sincerely think they are pregnant and exhibit a variety of symptoms that are quite similar to those of a real pregnancy. Missed menstrual cycles, distended abdomen, breast alterations, and even perceived foetus movements are a few examples of these. The mind tends to put on a convincing show to convince the body that conception has happened, driven by an overpowering desire to become a mother. Pseudocyesis has several different, intricate causes. According to psychologists, there are strong emotional and psychological elements that might cause the mind to produce physical signs of pregnancy, such as a deep-seated desire to become a mother, societal expectations, or unresolved trauma. The development of pseudocyesis may also be attributed to hormonal abnormalities, namely in the control of reproductive hormones such as prolactin. Pseudocyesis has always fascinated societies, as evidenced by allusions found in antiquated medical writings. Formerly thought to be caused by mystical or supernatural powers, modern medicine has shown the psychological basis of the illness.1

Clinically, it might be difficult to differentiate between pseudocyesis and a genuine pregnancy. To investigate the reason for the apparent pregnancy, doctors use imaging scans, laboratory testing, and physical examinations. Pseudocyesis sufferers suffer a great deal emotionally, thus a caring approach to treatment includes both medical intervention and psychological assistance. Pseudocyesis is essentially proof of the complex links between the mind and body, in which the force of conviction may generate significant physiological alterations. Investigating these phenomena reveals the subtleties of human psychology and highlights the mind's enormous impact on the body's physical domain.2

Causes of pseudocyesis

  • Psychological factors: A strong desire for or dread of pregnancy is frequently connected to pseudocyesis. People who fear getting pregnant or who really want to get pregnant may be more likely to experience this illness. Stress, worry, and sadness are examples of emotional variables that may potentially be important
  • Hormonal imbalances: Pseudocyesis may appear because of hormonal swings. Hormonal fluctuations, especially those associated with the menstrual cycle, can affect the body, and imitate the signs of pregnancy
  • Physical conditions: The polycystic ovarian syndrome (PCOS) and obesity are two examples of conditions that may be linked to pseudocyesis. These disorders may influence reproductive health and hormone balance, which may lead to the delusion of pregnancy3
  • Previous pregnancy experiences: Presumption may be more likely among those who have previously been infertile or who have undergone a true pregnancy. The psychological and emotional aspects of a fake pregnancy may be exacerbated by prior reproductive difficulties
  • Cultural and social influences: The development of pseudocyesis may be influenced by societal and cultural norms on parenting and fertility. The psychological features of the disease may be exacerbated by social pressure to adhere to established gender norms and expectations4

Symptoms of Pseudocyesis

A variety of psychological and physical symptoms that resemble those of a true pregnancy are signs of pseudocyesis, also known as fake pregnancy. When these symptoms appear, they can be strong and persuasive, which reinforces the idea that one is pregnant even when one isn't.

  • Abdominal distension: People who have pseudocyesis may noticeably bulge in the abdomen, giving the appearance of a pregnant woman's baby bump
  • Menstrual alterations: People with pseudocyesis frequently experience alterations in their menstrual cycle, even in the absence of pregnancy. This may involve irregular bleeding or skipped periods
  • Breast changes: Common signs of pseudocyesis include breast soreness, swelling, and darkening of the areolas, which are similar to changes seen in actual pregnancies5
  • Nausea and vomiting: People with pseudocyesis may feel nausea and vomiting, which heightens the impression that they are pregnant, just like morning sickness does during pregnancy.
  • Weight gain: The perception of carrying a pregnancy is influenced by a reported gain in body weight, which is often centred in the stomach area.
  • Foetal movement sensations: Some people describe feeling as though they are carrying a foetus. This confirms their belief that they are pregnant.
  • Psychological symptoms: A variety of psychological symptoms, such as a strong belief in pregnancy, maternal instincts, and in certain situations, labour pains, are associated with pseudocyesis.
  • Negative pregnancy test results: People with pseudocyesis frequently get negative pregnancy test results even when they show signs of a regular pregnancy6

Diagnosis of Pseudocyesis

Pseudocyesis, or fake pregnancy, is diagnosed by a thorough evaluation that considers psychological as well as physical variables. A complete physical examination, including pelvic exams and imaging investigations, is usually performed by medical specialists to rule out pregnancy or other reproductive health disorders. To verify that there isn't a true pregnancy, laboratory testing such as blood and urine pregnancy tests are carried out.

However, identifying the psychological components is crucial to diagnosing pseudocyesis. Psychologists and psychiatrists, for example, are vital in assessing a patient's mental condition, medical history, and any underlying psychological reasons that may be causing the incorrect assumption that the patient is pregnant. Together with a steadfast and strong belief that one is pregnant despite objective evidence to the contrary, physical symptoms are frequently included in diagnostic criteria. In order to accurately diagnose patients and create a treatment plan that works, a multidisciplinary approach combining medical and mental health practitioners is necessary.7

Cultural and Societal Influences of Pseudocyesis

Influences from culture and society are important in explaining and demonstrating pseudocyesis, or fake pregnancy. The pressure people feel, that they must fit in with conventional norms, can be attributed to societal expectations concerning gender roles, parenthood, and fertility. When a culture places high importance on having children and starting a family, the urge to get pregnant may grow stronger, which might have an impact on the development of pseudocyesis in individuals who are having trouble getting pregnant or meeting social expectations. Furthermore, societal perspectives on the value of motherhood can lead to emotional pressures that affect psychological health and may even cause the physical signs of a fake pregnancy. To treat pseudocyesis completely, it is imperative to address cultural and societal factors since they affect not only the patient's psychological condition but also the larger context of society's expectations and conventions.8

Treatment and Management of Pseudocyesis

  • Medical evaluation: To rule out any underlying reproductive health conditions and establish the lack of a true pregnancy, a comprehensive medical examination is necessary. This examination should include pelvic examinations, blood tests, and imaging investigations
  • Psychological counselling: When it comes to treating the psychological aspects of pseudocyesis, mental health specialists like psychologists and psychiatrists are essential. Counselling can assist people in examining and comprehending the emotional elements that contribute to the delusional notion of pregnancy
  • Education and support: Giving people correct information about pseudocyesis aids in their understanding of the disorder and its causes. People can get emotional assistance and a secure place to express their experiences in support groups or counselling9
  • Cognitive ehavioural therapy (CBT): CBT is a useful tool for questioning and changing the false ideas and mental processes connected to pseudocyesis. It aids in the development of healthy coping strategies and mental models in people.
  • Medical monitoring: Routine physical examinations can aid in the observation and treatment of physical complaints. Treatment is certain to be thorough when mental and medical health specialists collaborate
  • Medication: To treat concomitant anxiety or depression, doctors may occasionally prescribe medication. Nevertheless, medicine is not the mainstay of treatment for pseudocyesis
  • Family and social support: Including friends and family in the therapeutic process helps build a caring atmosphere that promotes empathy and understanding10

Summary

In conclusion, a variety of psychological, hormonal, cultural, and sociological variables can have an impact on the complicated and uncommon illness known as pseudocyesis, or false pregnancy. The plausible appearance of pregnancy symptoms in the absence of a real pregnancy emphasises the complex interaction between the mind and body. Making a diagnosis requires a thorough assessment that takes into account both psychological and physiological factors. The treatment plan includes psychological counselling to address underlying emotional causes, medical exams to rule out physical disorders, and a multidisciplinary approach including mental health and healthcare providers. The comprehensive management of pseudocyesis involves the engagement of family, social networks, and education. Understanding the larger environment in which pseudocyesis emerges requires acknowledging the significance of cultural and socioeconomic factors. To assist people in understanding and conquering the complexity of this singular and difficult psychological condition, a thorough and caring approach is necessary.

References

  1. Campos SJ, Link D. Pseudocyesis. The Journal for Nurse Practitioners [Internet]. 2016 Jun [cited 2023 Nov 16];12(6):390–4. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1555415516002221
  2. Tarín JJ, Hermenegildo C, García-Pérez MA, Cano A. Endocrinology and physiology of pseudocyesis. Reprod Biol Endocrinol [Internet]. 2013 May 14 [cited 2023 Nov 16];11(1):39. Available from: https://doi.org/10.1186/1477-7827-11-39
  3. A current perspective of pseudocyesis. AJP [Internet]. 1982 Sep [cited 2023 Nov 16];139(9):1140–4. Available from: http://psychiatryonline.org/doi/abs/10.1176/ajp.139.9.1140
  4. Trivedi AN, Singh S. Pseudocyesis and its modern perspective. Aust NZ J Obst Gynaeco [Internet]. 1998 Nov [cited 2023 Nov 16];38(4):466–8. Available from: https://obgyn.onlinelibrary.wiley.com/doi/10.1111/j.1479-828X.1998.tb03114.x
  5. Small GW. Pseudocyesis: an overview. Can J Psychiatry [Internet]. 1986 Jun [cited 2023 Nov 16];31(5):452–7. Available from: http://journals.sagepub.com/doi/10.1177/070674378603100514
  6. Steinberg A, Pastor N, Winheld EB, Segal HI, Shechter FR, Colton NH. Psychoendocrine relationships in pseudocyesis: Psychosomatic Medicine [Internet]. 1946 May [cited 2023 Nov 16];8(3):176–9. Available from: http://journals.lww.com/00006842-194605000-00003
  7. Aldrich CK. A case of recurrent pseudocyesis. Perspectives in Biology and Medicine [Internet]. 1972 [cited 2023 Nov 16];16(1):11–21. Available from: http://muse.jhu.edu/content/crossref/journals/perspectives_in_biology_and_medicine/v016/16.1.aldrich.html
  8. Fried PH. Pseudocyesis: a psychosomatic study in gynaecology. JAMA [Internet]. 1951 Apr 28 [cited 2023 Nov 16];145(17):1329. Available from: http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.1951.02920350023005
  9. Brown E. Pseudocyesis: a paradigm for psychophysiological interactions. Arch Gen Psychiatry [Internet]. 1971 Mar 1 [cited 2023 Nov 16];24(3):221. Available from: http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1971.01750090027004
  10. Nagdive AB, Bhainsora RS, Fernandes R, Behere PB, Sethi S. Pseudocyesis leading to folie-à-deux. JNRP [Internet]. 2021 Mar 24 [cited 2023 Nov 16];12:419–23. Available from: https://ruralneuropractice.com/pseudocyesis-leading-to-folie-a-deux/
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Aleena Rajan

Master Of Public Health (MPH) -University of Wolverhampton

Dr Aleena is an Ayurvedic Physician with extensive experience in hospital and clinical settings. She holds Indian licenses and board certification in Ayurvedic Medicine. She has worked as a consultant doctor for 3 years and also as Medical Officer for 2 years. She has dedicated her career to providing comprehensive medical care and improving the well-being of her patients. Currently, she is pursuing her postgraduation in public health.

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