Hysterical pregnancy (pseudocyesis)

A false pregnancy presents the typical symptoms of pregnant women including (also) morning sickness, increased frequency in urination, weight gain, swollen and sore breasts, belly. In the most serious cases, even the perception of fetal movements and the secretion of milk from the nipples.

Hysterical pregnancy

The medical term pseudociesi indicates that condition in which a woman believes she is pregnant, a condition which is also called false pregnancy, hysterical pregnancy, or pseudopregnancy.

A false pregnancy is characterized by the typical  symptoms that the pregnant woman has , including weight gain, growth of the belly, morning sickness, irritability and back pain, changes in the breasts, enlargement of the uterus . Fetal movements are reported in the absence of the fetus, i.e. without the woman carrying a child in her womb.

Pseudocysis is an extremely rare syndrome, and doctors are still trying to “put together” the possible causes that are at the origin.

Some believe that it is mainly due to a physical cause, while others think that it is psychological in origin. Some, that the cause derives from some physical or mental trauma; while others believe it is a chemical imbalance.

However, the most common one is that the woman wants so badly to have a baby that she mentally convinces herself that she is pregnant.

Certainly there are – in addition to the symptoms described above – also psychological implications linked in some way to the fact that a woman’s body “feels” that it is in this condition.

Some of the problems that can be upstream of a false pregnancy and that can lead to this condition can be,

  • a miscarriage ,
  • infertility,
  • the loss of a child,
  • a nervous breakdown,
  • of traumas.

There may also be physical causes, including ovarian tumors and a chemical imbalance in the brain that tricks the woman’s body into thinking she is pregnant.

When a woman suffers from pseudocesis, everything happens just like during a normal pregnancy.

The only real difference is that there is no such thing as a real baby and that there is no labor, even though the woman may feel like she is in labor.

The signs of a false pregnancy

Most women who experience a false pregnancy truly believe that they are pregnant because they have the same symptoms as the real pregnancy. As we have said, the signs of a false pregnancy are the same as for a normal pregnancy:

  • missed menstrual cycles,
  • belly enlargement,
  • weight gain,
  • frequent urination,
  • changes in skin and hair,
  • swollen breasts,
  • sensations of movement and fetal contractions,
  • morning sickness,

The only way to be sure that these women are not actually pregnant is to have specific tests and physical exams.

  • Physical exams.  These begin with a physical examination of the woman, which also includes a pelvic exam to determine if any type of conception has occurred.
  • Urine tests.Physical exams are supplemented with urinalysis: urinalysis will usually be negative, unless the woman has a very rare type of cancer that releases the same hormones as pregnancy.
  • Ultrasound. Ultrasound  is another test with which it is possible to determine if a pregnancy is real, or if it is a pseudo-pregnancy .
    • In the case of a false pregnancy, this test will show that there is no fetus.
    • In some severe cases, ultrasound may also show a softening of the cervix just as it would in a real pregnancy.
    • The ultrasound examination  is the only test that can 100% demonstrate or exclude the presence of a pregnancy.

Also in this regard, it is important to specify that the hysterical pregnancy has nothing to do with the  false positive result of a pregnancy test.

How to treat pseudocyesis

Treating a false pregnancy is very difficult, as it is a rather delicate situation: it is not necessarily just a medical problem since it mainly affects problems of a psychological nature, with symptoms that can last from a few weeks to 9 whole months, up to years.

After the doctor has ascertained that it is a false pregnancy, he will examine the woman’s psychological aspects in order to determine if there is a particular underlying psychological or neurological condition that needs to be treated.

If appropriate, the woman will be provided with psychological therapy and the necessary emotional support, which is currently the only way to treat pseudokinesis.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform, Maternicity.com.

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