Pseudocyesis Or Psychological Pregnancy

Psychological pregnancy is also known as pseudocyesis. It was John Mason Good who introduced this term in 1823, and it has been considered the most distressing psychosomatic condition reported in medical literature. Its knowledge dates back to the times of Hippocrates.

Of all psychosomatic conditions, pseudocyesis is the only one whose psychological etiology is beyond doubt. On the other hand, it can occur in men, although with much less frequency and almost always associated with the pregnancy of his wife, as well as in pets. Pseudocyesis has historically been grouped into different categories such as conversion disorder or conversion hysteria.

Currently, pseudocyesis is part of somatomorphic disorders, that is, in which there is some hidden emotional need, such as anguish, anxiety or lack of affection, which manifests itself through symptoms in the body.

What is pseudocyesis?

Pseudocyesis occurs when a woman thinks she is pregnant without actually being pregnant; in fact, she has the early signs and symptoms of pregnancy. That is, there are physical manifestations similar to those that occur in early pregnancy. They are as real as the changes that occur in a normal pregnancy.

It is an important feature of somatomorph disorders. They occur with people who have difficulty identifying their feelings and talking about them (alexithymia). For this reason, they are externalized through a hidden language. In this particular case, in a psychological pregnancy.

Who is affected by pseudocyesis?

According to some experts in psychiatry, pseudocyesis is a real disorder that usually affects between 1 and 6 of every 22,000 women. Paddock groups women with pseudocyesis or psychological pregnancy into three categories:

• Young, newly married or single women who have illicit relationships. In this case, the origin of pseudocyesis is the fear of pregnancy, especially in young single women.
• Older women with strong desires to get pregnant. Or infertile women who, from the third decade of life onwards, begin to become aware of their disability. The inability to be a mother fuels this desire, which becomes an obsession as a woman ages and approaches menopause.

• Women of a certain age who present pseudocyesis due to a case of amenorrhea of tumor origin, menopause, etc. In these cases, the unconscious idea that she is still fertile is almost always underlying.

The clinical picture and its manifestations

Barglow and Brown, after studying a wide range of reported cases, summarize the clinical picture of pseudocyesis as follows:

• Disorder of the menstrual cycle, which varies between amenorrhea and hypomenorrhea. Its duration is approximately 9 months, that is, the duration of a real pregnancy.
• Increased abdominal volume, without effacement of the umbilicus, caused by the position of lordosis that the woman presents and by the distension of the abdominal muscles. The inverted umbilicus makes it possible to establish the differential diagnosis with the true pregnancy.
• Consistent changes in the mammary glands such as turgor, secretion of milk and colostrum, pigmentation and enlargement of the nipples.

• Subjective sensation of fetal movements.
• Loosening of the cervix, accompanied by signs of congestion. Increased uterine volume, whose size ranges from a 6 week pregnancy to 8 months.
• Nausea and vomiting. There may be constipation and changes in appetite.
• Weight gain, usually greater than in true pregnancies.
• Some patients may have elevated gonadotropin levels.

Sometimes the symptomatology is so complete and so realistic that even experts are misled.

pseudocyesis treatment

It’s not easy to convince a woman who’s thought she’s been pregnant for months that she really isn’t pregnant. It is often difficult to make her see that she is experiencing an illusion created in her head. Pseudocyesis is often the escape valve the brain has found to deal with psychological adversities.

It is convenient to detect the problem as soon as possible and to carry out different tests (blood tests, ultrasound) to convince the person that they are not really pregnant. Treatment in these cases is more psychological than pharmacological. It must be analyzed why the woman invented this pregnancy, what internal reasons or conflicts led her to this situation.

As for the gynecological aspect, no treatment is necessary to attend to an imaginary pregnancy or pseudocyesis, only for the patient to internalize the idea that he is not expecting a child. Only then will you be able to reduce tension and restore balance to your body.