Pseudocyesis: Why It Happens and How to Treat It

What is pseudocyesis?

Pseudocyesis is a rare somatic symptom disorder where a non-pregnant and non-psychotic woman thinks she is pregnant. Women with this condition experience all the typical symptoms of pregnancy, such as weight gain, morning sickness, a growing belly, irritability, urinary frequency, breast changes, and breast tenderness, without actually carrying a baby.

How common is phantom pregnancy?

The concept of pseudocyesis isn’t new. The first written account of a false pregnancy was given by Hippocrates in 300 BC. A famous example of a woman from history with pseudocyesis is Mary Tudor. However, instances of phantom pregnancy have reduced significantly in the United States over the past century.

In the 1940s, 1 out of every 250 pregnant women reported a false pregnancy. This number has reduced to between 1 and 6 out of 22,000 pregnant women reporting pseudocyesis. 

The incidence of false pregnancy has become very rare in countries where women have easy access to reliable pregnancy tests. Certain cultures associate a woman’s worth with her potential to conceive, and the incidence of pseudocyesis is higher in these regions.

Causes of phantom pregnancy 

There’s currently no clear answer to explain the causes of pseudocyesis. Some people believe that the cause is psychological, while others believe it is physical. According to some, the cause may be a mental or physical trauma, and still others think it may be caused by a chemical imbalance.

Some of the issues or conditions that may cause pseudocyesis are:

• Multiple miscarriages
• Loss of a baby or child
• Infertility
• Mental breakdown

Among all the causes, the most common is that the woman has such an intense desire to be pregnant that she convinces herself she is. This may affect the endocrine system, causing symptoms and signs of pregnancy. If you haven’t been able to get pregnant, there are multiple potential reasons why, such as entering menopause or infertility. Many women who are in their menopausal years may develop a type of depression that could result in false pregnancy.

In some cases, women who have phantom pregnancy have experienced some type of emotional trauma, poverty, or sexual abuse in the past. Their brain may create a pregnancy to cope with that experience.

Symptoms of pseudocyesis

A phantom pregnancy looks very similar to a normal one, the only exception being the absence of a fetus. In all cases, a woman is entirely sure that she is carrying a baby.

The most common physical symptom is a swollen or distended abdomen resembling a baby bump. During pseudocyesis, the growing belly isn’t due to a developing baby. Instead, it may be an accumulation of gas, feces, fat, or urine.

The second common symptom of pseudocyesis is irregularity of menstrual cycles. Between 50 and 66 percent of women with false pregnancy also feel that their baby is moving. Many women feel phantom baby kicks, even though no baby is present. Women with pseudocyesis may also experience other pregnancy-like symptoms including:

• Tender breasts
• Missed periods
• Morning sickness (nausea and vomiting)
• Changes in pigmentation and size of breasts
• Weight gain
• Lactation
• Increased appetite
• Inverted belly button
• Frequent urination
• Changes in hair and skin
• Enlarged uterus
• False labor
• Softening of the cervix

Ways to diagnose false pregnancy

Since a phantom pregnancy mimics almost all the details of a normal pregnancy, a doctor needs to differentiate between the two. The tests that are used to determine pregnancy are also used to diagnose a false pregnancy. The doctor will perform a pelvic examination to determine whether conception has occurred. Then they will do a urinalysis to verify their findings. In cases of false pregnancy, the urinalysis is usually negative, except in cases when women have certain illnesses such as a very rare type of ovarian tumor that secretes HCG, a hormone secreted by the placenta.

Another test that can determine if a woman is pregnant is an ultrasound. In a phantom pregnancy, an ultrasound will show that there’s no fetus; however, in certain severe cases, cervical softening may be visible on the ultrasound, similar to an actual pregnancy. An ultrasound examination is the test that can definitively prove or disprove a pregnancy.

Treating phantom pregnancy

It may be difficult to treat a false pregnancy because it is considered to be a psychological condition. One of the successful methods of ending pseudocyesis is to show women evidence of the absence of a fetus with the help of imaging techniques such as an ultrasound. After a physician has proved that the pregnancy is indeed a false one, they may conduct certain psychological examinations to rule out any underlying neurological or psychological conditions. They may suggest emotional support and/or psychotherapy to help treat pseudocyesis.

Pseudocyesis is a rare occurrence. Symptoms and signs of a typical pregnancy and a false pregnancy may be quite similar, except for one significant difference. In pseudocyesis, there is no fetus as no conception has taken place. If you think you might be pregnant and have any concerns, it’s always best to talk to your doctor.