Imaginary pregnancy symptoms

False Pregnancy (Pseudocyesis): Causes, Symptoms, and Tests

Written by Stephanie Watson

Reviewed by Traci C. Johnson, MD on August 12, 2022

False pregnancy, clinically termed pseudocyesis, is the belief that you are expecting a baby when you are not really carrying a child. People with pseudocyesis have many, if not all, symptoms of pregnancy -- with the exception of an actual fetus. Some men experience a related phenomenon known as couvade, or sympathetic pregnancy. They will develop many of the same symptoms as their pregnant partners, including weight gain, nausea, and backache.

What Causes False Pregnancy?

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, their 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.

Some researchers have suggested that poverty, a lack of education, childhood sexual abuse, or relationship problems might play a role in triggering false pregnancy. Having a false pregnancy is not the same as claiming to be pregnant for a benefit (for example, to profit financially), or having delusions of pregnancy (such as in patients with schizophrenia).

Symptoms of False Pregnancy

Women with pseudocyesis have many of the same symptoms as those who are actually pregnant, including:

Interruption of the menstrual period
Swollen belly
Enlarged and tender breasts, changes in the nipples, and possibly milk production
Feeling of fetal movements
Nausea and vomiting
Weight gain

These symptoms can last for just a few weeks, for nine months, or even for several years. A very small percentage of patients with false pregnancy will arrive at the doctor's office or hospital with what feels like labor pains.

Tests for False Pregnancy

To determine whether a woman is experiencing a false pregnancy, the doctor will usually evaluate their symptoms, perform a pelvic exam and abdominal ultrasound -- the same tests used to feel and visualize the unborn baby during a normal pregnancy.

In a case of false pregnancy, no baby will be seen on the ultrasound, and there won't be any heartbeat. Sometimes, however, the doctor will find some of the physical changes that occur during pregnancy, such as an enlarged uterus and softened cervix. Urine pregnancy tests will always be negative in these cases, with the exception of rare cancers that produce similar hormones to pregnancy.

Certain medical conditions can mimic the symptoms of pregnancy, including ectopic pregnancy, morbid obesity, and cancer. These conditions may need to be ruled out with tests.

Treating False Pregnancy

When women believe they are pregnant, especially for a period of several months, it can be very upsetting for them to learn that they are not. Doctors need to gently break the news, and provide psychological support, including therapy, to help the patient with pseudocyesis recover from their disappointment.

What Is a False Pregnancy?

A woman’s intuition is a funny thing. Most women know they are pregnant before they are even far enough along to take a test; we know our bodies and when something is different we can just feel it. What about a phantom pregnancy? There are times when even a woman’s intuition is off and our body tells us we are pregnant when in fact, we are not. This is a phenomenon called Pseudocyesis or a false pregnancy.

Pseudocyesis is the medical term for a false pregnancy or what some people refer to as a phantom pregnancy. False pregnancy is characterized by the typical pregnancy symptoms including weight gain, growing belly, morning sickness, irritability, and backache; all the signs of being pregnant without carrying an actual baby.
Contrary to what many people believe, false pregnancy is not only found in women but men as well. When a man suffers a false pregnancy, it is usually called Sympathetic Pregnancy.

This is more common when his significant other is pregnant and is dealing with the normal aches and pains that are associated with pregnancy. The medical term when men experience this is called Couvade.

What Causes Pseudocyesis?

Pseudocyesis is extremely rare in both men and women so doctors are still trying to piece together the root cause of the condition. Some believe the cause is physical while others believe it is psychological.
Some believe that the cause comes from trauma, either a physical or mental trauma, while others believe it is a chemical imbalance.

Issues that may create a false pregnancy or Pseudocyesis include:

Miscarriage (usually more than one)
Infertility
Loss of a child
Mental breakdown

In addition, there are also real physical causes as well which include ovarian tumors and a chemical imbalance in the brain that in a way “tricks” the body into thinking it is pregnant.

Out of all of the causes listed above, the most common documented cause is simple – a woman wants to get pregnant so badly that she mentally convinces herself that she is pregnant. There are many reasons why she is not getting pregnant including infertility or simply coming up to menopause.
In fact, many women about to enter menopause will go through some form of depression that can lead to a false pregnancy.

When a woman suffers from pseudocyesis, she will develop just as she would during a regular pregnancy; starting out with things like morning sickness and frequency in urination and then it will develop into swollen and sore breasts and eventually into a swollen belly and the look of being pregnant. The only real difference is that there is no real baby and no labor, but possibly the feel of being in labor.
There are also cases where it has been shown that patients who suffer from this condition have also experienced some kind of sexual abuse, poverty or other type of emotional trauma. Creating a pregnancy is their brain’s way of coping with the experience.

Signs of Pseudocyesis or a False Pregnancy

Most women who suffer from a false pregnancy truly believe they are pregnant because they experience the same pregnancy symptoms. The signs of false pregnancy are the same as a typical pregnancy.

missed periods
swollen belly
weight gain
frequent urination
changes in skin and hair
swollen breasts
sensations of fetal movement and contractions
morning sickness

Additionally, just being generally uncomfortable is also a very common symptom. The only way to ensure they are not actually pregnant is to run tests and complete a physical examination. It is important to remember that a false pregnancy differs greatly from a false pregnancy test.

Tests For Pseudocyesis or False Pregnancy

Since Pseudocyesis mimics every detail of pregnancy, it is important that a doctor ensures that it is actually a fake pregnancy and not a real one. The same tests to confirm an actual pregnancy are done to diagnose a false pregnancy.
These tests start with a physical exam including a pelvic exam to determine if there has been any type of conception. Then a urinalysis is completed to verify the findings. A urinalysis will usually come back negative unless the woman is suffering from an illness like a very rare cancer that releases the same hormones as pregnancy.

Ultrasound is another test that will determine if a pregnancy is true or false. This will show, in the event of a false pregnancy that there is no fetus but in some severe cases, the ultrasound may show a softening of the cervix, just as it would in a true pregnancy.
An ultrasound is the only test that will 100% disprove or prove a pregnancy.

How To Treat a False Pregnancy or Pseudocyesis

Pregnancy, whether true or false, is an exciting time for an expectant mother. For those who really are pregnant, they enjoy the 9 months they have to bond with their unborn baby, prepare a nursery and get ready to become a parent.
That said, those who think and feel like they are pregnant are also feeling that same excitement for the next 9 months and beyond. They are looking forward to raising their baby in their home – watching him or her have their first bath, take their first steps and grow like a typical kid.

Now she is about to find out that what she is feeling, what she is looking forward to, is not going to happen. It is all in her head. Now imagine being the bearer of this news and attempting to treat her; knowing that she had this excitement built up just to have it crushed.

Treating a false pregnancy is very difficult since it is a delicate situation, it is not necessarily a medical problem but more psychological where symptoms can last anywhere from a few weeks to the whole 9 months, to even years.
After a doctor has proven for a fact that this is indeed a false pregnancy, they will then conduct some psychological exams to ensure that there is no underlying psychological or neurological condition. After this, they will provide psychological therapy and emotional support as these are the only way to treat pseudocyesis.

Want to Know More?

Am I Pregnant? FAQs on Early Pregnancy
Am I Pregnant, Or is It Something Else
Getting Pregnant

Compiled using information from the following sources:

1. Datta, S., ed., Anesthetic and Obstetric Management of High-Risk Pregnancy, third ed., New York, Springer, 2004.

2. Tarin JJ, et al. 2013. Endocrinology and physiology of pseudocyesis. Reproductive Biology and Endocrinology 11(1):39.

https://rbej.biomedcentral.com/articles/10.1186/1477-7827-11-39

3. Gabbe S.G., Niebyl, J.R., Simpson, J.L., eds. Obstetrics: Normal and Problem Pregnancies, fifth ed. , Philadelphia, Churchill Livingstone Elsevier; 2007.

"False pregnancy" in women. What's this?

Home/About clinic/Useful/ "False pregnancy" in women. What's this?

July 25, 2019

False (imaginary) pregnancy has been described by doctors since the time of Hippocarat. In Latin, this phenomenon is called pseudocyesis. In this case, a woman can feel all the signs of pregnancy, but in fact there is no developing fetus in the uterus. Most often, this condition appears in women who are suspicious and susceptible, with a mobile psyche, an overly excitable central nervous system, who have experienced stress or shock.

False pregnancy sometimes occurs in those women who strongly want to have a child. It may be the other way around - the fear of motherhood becomes the ground for its development. Patients who suffer from infertility for many years and undergo long-term treatment for this often feel falsely pregnant. Reaching despair, they begin, through self-hypnosis, to look for symptoms in themselves that indicate pregnancy.

A false pregnancy can be caused by a hormonal imbalance. Regular stress causes the body to produce a lot of pituitary hormones, the increase in which is also observed during real pregnancy.

Women may lag behind in the development of the mammary glands or uterus ("baby uterus"). Under these conditions, doctors may prescribe a long course of taking hormonal drugs that lead to menstrual irregularities. The absence of menstruation is often taken by a woman as a sign of pregnancy.

False pregnancy manifests itself in the same way as a real one.

Main (doubtful) signs of false pregnancy:

- Morning sickness or vomiting

- Increases the perception of smells, changes in taste sensations and preferences
- Mood swings occur
- In rare cases, a woman even feels the movements of a non-existent fetus

The above signs are considered doubtful because the woman herself talks about them. The situation becomes more convincing if there are likely signs. These include the following:

- Cessation of menses, long delays
- Enlargement and engorgement of the mammary glands, sometimes there is the appearance of characteristic pigmentation in the area of the halo and nipples
- There may be a discharge from the nipples similar to colostrum
- Belly increases in size

The condition of a false pregnancy is so similar to a real pregnancy that the woman is firmly convinced that she is expecting a child. Claiming her interesting position, she does not deceive anyone!

The most surprising thing is that a test for the presence of hCG in the urine can also show a positive result. This fact will further convince the woman of a real pregnancy. However, hCG can also increase if there is a cyst, a pelvic tumor, or some other pathology.

Women may sometimes see two lines on the test during a false pregnancy. This is possible if they take a course of hormonal fertility drugs that contain hCG. It is also impossible to exclude the situation in which the test is damaged (marriage or improper storage).

Obstetrician-gynecologists of the IVF and reproductive health clinic "Genome-Don" recommend to confirm the presence of pregnancy with the help of transvaginal ultrasound, starting from the 1st week
menses delay.

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False pregnancy: symptoms and causes

Consultation with a specialist:

Causes of false pregnancy

The exact mechanisms and causes of the development of a false pregnancy are unknown, but scientists have several assumptions. It is believed that this phenomenon is based on psycho-emotional changes in a particular personality, which lead to hormonal, vegetative and somatic disorders. As a rule, women who have been diagnosed with a false pregnancy actually want a child very much and dream of becoming a mother. Sometimes scientists also find an inverse relationship. Those girls who are very afraid of getting pregnant, there are signs of a false pregnancy. They can also occur at a time when a close friend or relative is carrying a child.

Risk factors for false pregnancy have also not been established. However, it is known that this condition is more often detected in women with high suspiciousness and associated psycho-emotional disorders (neurosis, hysteria, psychosis, etc.). With regular exposure to stressful situations, as well as if a woman constantly experiences anxiety or other vivid emotions, the secretion of pituitary hormones increases. Exactly the same hormones are released during natural pregnancy. Therefore, these conditions can also be related to predisposing factors. Finally, the risk group for false pregnancy includes women aged 35-40 years and older who have:

diagnosed with infertility;
there is a panic fear of pregnancy;
lost a child as a result of termination of pregnancy at different times;
they really want to have children.

In some cases, signs of a false pregnancy may develop due to various endocrine or gynecological diseases, for example, with uterine fibroids or ovarian cysts.

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Symptoms of false pregnancy

With a false pregnancy, the same symptoms are noted as with a natural one. These include:

cessation of menstruation;
an increase in the size of the abdomen;
breast enlargement;
secretion of milk from the nipples;
weight gain;
sensation of fetal movement;
nausea in the morning;
a sharp change in mood;
craving for inedible;
fatigue and constant weakness.

In addition, if you take a pregnancy test, it may turn out to be false positive, and in some cases, a woman may even develop false contractions. All these symptoms can be present for several months, so the woman has no doubt that she is carrying a child. However, if you do an ultrasound, then the developing fetus in the uterus will not be visible.

All these signs of a false pregnancy can be explained from a medical point of view. For example, fetal movements are the result of active peristalsis, and an increase in the size of the abdomen is associated with excessive deposition of subcutaneous fat and increased gas formation in the intestines. A false pregnancy test and some other symptoms are explained by hormonal disruptions.

Diagnosis of false pregnancy

Women with suspected false pregnancy should consult a gynecologist. Already after a routine examination on the chair, the doctor may suspect the disease. The fact is that with an imaginary pregnancy there are no characteristic changes in the genital and reproductive organs. With a true pregnancy, the uterus increases in size and acquires a softer texture, and moderate cyanosis (“blueness”) is noted in the cervical and vaginal mucosa. In the case of an empty pregnancy, there will be no such changes.

An ultrasound of the uterus and laboratory tests (determination of hCG in the urine or in the blood) can put a point in the diagnosis of the disease. But even with convincing evidence, a woman may still continue to think that she is actually pregnant.

On the other hand, the gynecologist should also not always be skeptical about the words of the patient. Other diseases, such as an ectopic pregnancy or abdominal tumors, may look like a false pregnancy. Therefore, in each case, it is necessary to conduct a comprehensive examination and exclude similar diseases.

Treatment of false pregnancy

In most cases, specific treatment for false pregnancy is not required. It is enough for a gynecologist to talk to a woman, show the results of examinations, explain why she developed this disease. To improve the psycho-emotional state, the help of a psychologist may be required. In this case, you can eliminate internal experiences and other risk factors, as well as find a way out of existing psychological problems. After a woman realizes that she is not pregnant, all existing symptoms will gradually disappear. After some time, her menstrual cycle normalizes, signs of toxicosis disappear, body weight decreases and the size of the abdomen returns to its original value.

If this approach proved to be ineffective, then another approach is used, which involves the appointment of non-drug and drug treatments. the first group includes:

Relaxing massage. It can be performed manually or on special devices. Massage helps to improve overall well-being, helps to get rid of stress and irritation.
Reflexology. It implies an impact on biologically active points. For this, classical acupuncture or alternative methods may be prescribed. Reflexology can affect the condition of almost all organs, including the organs of the reproductive system.
Aromatherapy. Another non-drug treatment that has a calming effect, helps relieve tension and anxiety, and eliminate the effects of stress.
Electrosleep. It affects the nerve connections in the structures of the brain. It is used to normalize the function of the organs of the endocrine system, improve metabolism, and normalize the psychological state.

Drug therapy involves the appointment of various drugs. In this case, the treatment plan is selected individually and involves a stepwise approach. If a woman is shown sedatives, then herbal preparations are first prescribed. They have a minimal risk of side effects and at the same time help to effectively deal with anxiety, sleep disturbance and psycho-emotional stress. If such drugs were ineffective, then more "strong" drugs from the group of tranquilizers are prescribed. With their help, you can eliminate fear and anxiety, as well as other psychological disorders. Tranquilizers are quite serious drugs, so they should not be used uncontrollably. If a false pregnancy has developed against the background of depression or anxiety disorders, then antidepressants are included in the treatment plan. At the same time, various methods of psychotherapy are used.

You can restore the menstrual cycle with the help of various hormonal drugs. The most popular of these are combined oral contraceptives. Also, the gynecologist may prescribe other medications, depending on the characteristics of the hormonal background of the patient.

After the treatment, some women wonder if a false pregnancy can be repeated? This disease is not prone to relapse, therefore, after the treatment, it does not return. Medicine knows only isolated cases of repeated false pregnancy.

Prevention of false pregnancy

It is difficult to carry out effective prevention of false pregnancy in women, since the exact mechanism for the development of this disease has not been established. At the same time, you can follow simple recommendations that will help reduce the risk of developing this condition:

In the presence of violations in the psycho-emotional sphere, it is necessary to seek the help of a psychologist in time. The help of a specialist will not be superfluous for those women who are regularly exposed to stress, have a busy work schedule, or who have experienced psychological trauma.
If a woman has signs of gynecological diseases (irregular menstrual cycle, pain in the lower abdomen, abnormal vaginal discharge, discomfort during intimacy, etc.), you should consult a gynecologist. The specialist will conduct an examination, make an accurate diagnosis and prescribe an effective treatment.
If a woman is terribly afraid of becoming pregnant, then in this case she may need the help of both specialists. The gynecologist will be able to tell you how the process of bearing a child goes, what needs to be done at different stages of pregnancy, how childbirth goes, etc.
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