False pregnancy
Encyclopedia
False pregnancy or hysterical pregnancy, most commonly termed pseudocyesis in humans and pseudopregnancy in other mammals, is the appearance of clinical and/or subclinical signs and symptoms associated with pregnancy
when the person or animal is not pregnant. Clinically, false pregnancy is most common in veterinary medicine (particularly in dogs and mice). False pregnancy in humans is less common, and may sometimes be purely psychological. It is generally estimated that false pregnancy is caused due to changes in the endocrine system
of the body, leading to the secretion
of hormones which translate into physical changes similar to those during pregnancy. The underlying cause is often mental
.
gave the first written account around 300 B.C. when he recorded 12 cases of women with the disorder. Mary I
(1516–1558), Queen of England, was perhaps the most famous of western historical examples, who believed on two occasions that she was pregnant, when she was in fact not. Other medical historians believe that the queen's physicians mistook fibroid tumors in her uterus for a pregnancy. John Mason Good
coined the term pseudocyesis from the Greek words
pseudes (false) and kyesis (pregnancy) in 1923.
More recently, pseudocyesis has received attention in popular culture.
, morning sickness
, tender breasts, and weight gain may all be present. Many health care professionals can be deceived by the symptoms associated with pseudocyesis. Research shows that 18% of women with pseudocyesis were at one time diagnosed as pregnant by medical professionals.
The hallmark sign of pseudocyesis that is common to all cases is that the affected patient is convinced that she is pregnant.
Abdominal distension
is the most common physical symptom of pseudocyesis (60–90%). The abdomen expands in the same manner as it does during pregnancy, so that the affected woman looks pregnant. These symptoms often resolve under general anesthesia and the woman's abdomen returns to its normal size.
The second most common physical sign of pseudocyesis is menstrual irregularity (50–90%). Women are also reported to experience the sensation of fetal movements known as quickening
, even though there is no fetus present (50–75%). Other common signs and symptoms include gastrointestinal symptoms, breast changes or secretions, labor pains, uterine enlargement, and softening of the cervix
. One percent of women eventually experience false labor.
To be diagnosed as true pseudocyesis, the woman must actually believe that she is pregnant. When a woman intentionally and consciously feigns pregnancy, it is termed a simulated pregnancy
.
Symptoms of pseudocyesis can also occur in men who have couvade syndrome.
, constipation
, weight gain, and the movement of intestinal gas.
for the treatment of these problems. It is important at the same time, however, for the treating professional not to minimize the reality of the patient's physical symptoms. The treatment that has had the most success is demonstrating to the patient that she is not really pregnant by the use of ultrasound
or other imaging techniques. There have been reports of patients being cured of pseudocyesis by hypnosis
, purgatives, massage
, opioid
s, or after nine months of symptoms, by experiencing "hysterical childbirth," but there are few data available on the effectiveness of these or similar procedures.
(the remains of an ovulated ovarian follicle
) is responsible for the development of maternal behavior and lactation
, which are mediated by the continued production of progesterone
by the corpus luteum through some or all of pregnancy. In most species the corpus luteum is degraded in the absence of a pregnancy. However, in some species, the corpus luteum may persist in the absence of pregnancy and cause "pseudopregnancy", in which the female will exhibit clinical signs of pregnancy.
, and build nest
s to varying degrees depending on breed. Although bitches usually only cycle once or twice per year, pseudopregnancy is common. Spay will prevent subsequent pseudopregnancies.
become pseudopregnant following an estrus in which the female is bred by an infertile male, resulting in "sterile mating". Like dogs, mice are spontaneous ovulators. However, they will not become pseudopregnant following an estrus in which the female is not bred because the corpus luteum will degrade rapidly in the absence of coitus. When the female is bred by an infertile male, the corpus luteum persists without an embryo, leading to pseudopregnancy. The female will develop mammary glands, lactate
, and build nests in the pseudopregnant state. Pseudopregnancy in mice is somewhat common in laboratory mice because it is often induced for the purpose of implanting embryos into a surrogate dam
, but is uncommon in wild mice because most wild males are fertile and will genuinely impregnate the female.
Pregnancy
Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
when the person or animal is not pregnant. Clinically, false pregnancy is most common in veterinary medicine (particularly in dogs and mice). False pregnancy in humans is less common, and may sometimes be purely psychological. It is generally estimated that false pregnancy is caused due to changes in the endocrine system
Endocrine system
In physiology, the endocrine system is a system of glands, each of which secretes a type of hormone directly into the bloodstream to regulate the body. The endocrine system is in contrast to the exocrine system, which secretes its chemicals using ducts. It derives from the Greek words "endo"...
of the body, leading to the secretion
Secretion
Secretion is the process of elaborating, releasing, and oozing chemicals, or a secreted chemical substance from a cell or gland. In contrast to excretion, the substance may have a certain function, rather than being a waste product...
of hormones which translate into physical changes similar to those during pregnancy. The underlying cause is often mental
Hysteria
Hysteria, in its colloquial use, describes unmanageable emotional excesses. People who are "hysterical" often lose self-control due to an overwhelming fear that may be caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part, or,...
.
History
Cases of pseudocyesis have been documented since antiquity. HippocratesHippocrates
Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...
gave the first written account around 300 B.C. when he recorded 12 cases of women with the disorder. Mary I
Mary I of England
Mary I was queen regnant of England and Ireland from July 1553 until her death.She was the only surviving child born of the ill-fated marriage of Henry VIII and his first wife Catherine of Aragon. Her younger half-brother, Edward VI, succeeded Henry in 1547...
(1516–1558), Queen of England, was perhaps the most famous of western historical examples, who believed on two occasions that she was pregnant, when she was in fact not. Other medical historians believe that the queen's physicians mistook fibroid tumors in her uterus for a pregnancy. John Mason Good
John Mason Good
John Mason Good , English writer on medical, religious and classical subjects, was born at Epping, Essex.John Good's parents were the Nonconformist minister Revd Peter Good and Sarah Good, the daughter of another Nonconformist minister, Revd Henry Peyto of Great Coggeshall...
coined the term pseudocyesis from the Greek words
Greek language
Greek is an independent branch of the Indo-European family of languages. Native to the southern Balkans, it has the longest documented history of any Indo-European language, spanning 34 centuries of written records. Its writing system has been the Greek alphabet for the majority of its history;...
pseudes (false) and kyesis (pregnancy) in 1923.
More recently, pseudocyesis has received attention in popular culture.
Signs and symptoms
The symptoms of pseudocyesis are similar to the symptoms of true pregnancy and are often hard to distinguish from it. Such natural signs as amenorrhoeaAmenorrhoea
Amenorrhoea , amenorrhea , or amenorrhœa, is the absence of a menstrual period in a woman of reproductive age. Physiological states of amenorrhoea are seen during pregnancy and lactation , the latter also forming the basis of a form of contraception known as the lactational amenorrhoea method...
, morning sickness
Morning sickness
Morning sickness, also called nausea gravidarum, nausea, vomiting of pregnancy , or pregnancy sickness is a condition that affects more than half of all pregnant women. Related to increased oestrogen levels, a similar form of nausea is also seen in some women who use hormonal contraception or...
, tender breasts, and weight gain may all be present. Many health care professionals can be deceived by the symptoms associated with pseudocyesis. Research shows that 18% of women with pseudocyesis were at one time diagnosed as pregnant by medical professionals.
The hallmark sign of pseudocyesis that is common to all cases is that the affected patient is convinced that she is pregnant.
Abdominal distension
Abdominal distension
Abdominal distension is a sensation of elevated abdominal pressure and volume. It is estimated that close to 25% of the US population has some degree of abdominal distension on a regular basis. Some describe it as belching, others claim they feel nausea and yet others say they pass excessive gas...
is the most common physical symptom of pseudocyesis (60–90%). The abdomen expands in the same manner as it does during pregnancy, so that the affected woman looks pregnant. These symptoms often resolve under general anesthesia and the woman's abdomen returns to its normal size.
The second most common physical sign of pseudocyesis is menstrual irregularity (50–90%). Women are also reported to experience the sensation of fetal movements known as quickening
Quickening (medical)
In pregnancy terms, the moment of quickening refers to the initial motion of the fetus in the uterus as it is perceived or felt by the pregnant woman...
, even though there is no fetus present (50–75%). Other common signs and symptoms include gastrointestinal symptoms, breast changes or secretions, labor pains, uterine enlargement, and softening of the cervix
Cervix
The cervix is the lower, narrow portion of the uterus where it joins with the top end of the vagina. It is cylindrical or conical in shape and protrudes through the upper anterior vaginal wall...
. One percent of women eventually experience false labor.
To be diagnosed as true pseudocyesis, the woman must actually believe that she is pregnant. When a woman intentionally and consciously feigns pregnancy, it is termed a simulated pregnancy
Simulated pregnancy
A simulated pregnancy is a deliberate attempt to create the false impression of pregnancy.It should not be confused with false pregnancy, where the woman mistakenly believes that she is pregnant.- Techniques :...
.
Symptoms of pseudocyesis can also occur in men who have couvade syndrome.
Causes
There are various explanations, none of which is universally accepted because of the complex involvement of cortical, hypothalamic, endocrine, and psychogenic factors. Psychodynamic theories attribute the false pregnancy to emotional conflict. It is thought that an intense desire to become pregnant, or an intense fear of becoming pregnant, can create internal conflicts and changes in the endocrine system, which may explain some of the symptoms of pseudocyesis. Another theory concerns wish fulfillment. It holds that if a woman desires pregnancy badly enough she may interpret minor changes in her body as signs of pregnancy. Proposed biological mechanisms include the effect of stress on the hypothalamo-pituitary-adrenal axisHypothalamic-pituitary-adrenal axis
The hypothalamic-pituitary-adrenal axis , also known as thelimbic-hypothalamic-pituitary-adrenal axis and, occasionally, as the hypothalamic-pituitary-adrenal-gonadotropic axis, is a complex set of direct influences and feedback interactions among the hypothalamus, the pituitary gland ,...
, constipation
Constipation
Constipation refers to bowel movements that are infrequent or hard to pass. Constipation is a common cause of painful defecation...
, weight gain, and the movement of intestinal gas.
Demographics
The rate of pseudocyesis in the United States has declined significantly in the past century. In the 1940s there was one occurrence for approximately every 250 pregnancies. This rate has since dropped to between one and six occurrences for every 22,000 births. The average age of the affected woman is 33, though cases have been reported for women as young as 6 and as old as 79. More than two-thirds of women who experience pseudocyesis are married, and about one-third have been pregnant at least once. Women who have been victims of incest may be at greater risk for developing pseudocyesis.Treatment
Because pseudocyesis is not known to have a direct underlying physical cause, there are no general recommendations regarding treatment with medications. In some cases, however, the patient may be given medications for such symptoms as the cessation of menstruation. When some patients with pseudocyesis have underlying psychological problems, they should be referred to a psychotherapistPsychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
for the treatment of these problems. It is important at the same time, however, for the treating professional not to minimize the reality of the patient's physical symptoms. The treatment that has had the most success is demonstrating to the patient that she is not really pregnant by the use of ultrasound
Ultrasound
Ultrasound is cyclic sound pressure with a frequency greater than the upper limit of human hearing. Ultrasound is thus not separated from "normal" sound based on differences in physical properties, only the fact that humans cannot hear it. Although this limit varies from person to person, it is...
or other imaging techniques. There have been reports of patients being cured of pseudocyesis by hypnosis
Hypnosis
Hypnosis is "a trance state characterized by extreme suggestibility, relaxation and heightened imagination."It is a mental state or imaginative role-enactment . It is usually induced by a procedure known as a hypnotic induction, which is commonly composed of a long series of preliminary...
, purgatives, massage
Massage
Massage is the manipulation of superficial and deeper layers of muscle and connective tissue to enhance function, aid in the healing process, and promote relaxation and well-being. The word comes from the French massage "friction of kneading", or from Arabic massa meaning "to touch, feel or handle"...
, opioid
Opioid
An opioid is a psychoactive chemical that works by binding to opioid receptors, which are found principally in the central and peripheral nervous system and the gastrointestinal tract...
s, or after nine months of symptoms, by experiencing "hysterical childbirth," but there are few data available on the effectiveness of these or similar procedures.
In other mammals (pseudopregnancy)
The corpus luteumCorpus luteum
The corpus luteum is a temporary endocrine structure in mammals, involved in production of relatively high levels of progesterone and moderate levels of estradiol and inhibin A...
(the remains of an ovulated ovarian follicle
Ovarian follicle
Ovarian follicles are the basic units of female reproductive biology, each of which is composed of roughly spherical aggregations of cells found in the ovary. They contain a single oocyte . These structures are periodically initiated to grow and develop, culminating in ovulation of usually a single...
) is responsible for the development of maternal behavior and lactation
Lactation
Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process occurs in all female mammals, however it predates mammals. In humans the process of feeding milk is called breastfeeding or nursing...
, which are mediated by the continued production of progesterone
Progesterone
Progesterone also known as P4 is a C-21 steroid hormone involved in the female menstrual cycle, pregnancy and embryogenesis of humans and other species...
by the corpus luteum through some or all of pregnancy. In most species the corpus luteum is degraded in the absence of a pregnancy. However, in some species, the corpus luteum may persist in the absence of pregnancy and cause "pseudopregnancy", in which the female will exhibit clinical signs of pregnancy.
Dogs
Dogs become pseudopregnant following an estrus phase in which the bitch is not bred, or in which she is bred by an infertile male. Most species require signals from an embryo (such as IFN-τ in ruminants) to alert the female's body of a pregnancy. This maternal recognition of pregnancy will cause persistence of the corpus luteum and the development of characteristics and behaviors necessary to care for offspring. Limited research suggests that progesterone secretion is similar in pregnant and non-pregnant bitches, so veterinary researchers hypothesize that they may not require molecular factors from the embryo for maternal recognition of pregnancy, and instead the corpus luteum persists regardless of pregnancy. Since the corpus luteum is not degraded, it will cause the development of maternal characteristics in the absence of pregnancy. Pseudopregnant dogs will develop their mammary glands, lactateLactation
Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process occurs in all female mammals, however it predates mammals. In humans the process of feeding milk is called breastfeeding or nursing...
, and build nest
Nest
A nest is a place of refuge to hold an animal's eggs or provide a place to live or raise offspring. They are usually made of some organic material such as twigs, grass, and leaves; or may simply be a depression in the ground, or a hole in a tree, rock or building...
s to varying degrees depending on breed. Although bitches usually only cycle once or twice per year, pseudopregnancy is common. Spay will prevent subsequent pseudopregnancies.
Cats
Cats become pseudopregnant following an estrus in which the queen is bred by an infertile male. Queens are induced ovulators, meaning that they will only ovulate and produce a corpus luteum if they are bred. As in dogs, the corpus luteum persists as if the cats is uncommon as the queen must be bred by an infertile male to become pseudopregnant, compounded by the fact that cats are seasonal breeders.Mice
MiceMICE
-Fiction:*Mice , alien species in The Hitchhiker's Guide to the Galaxy*The Mice -Acronyms:* "Meetings, Incentives, Conferencing, Exhibitions", facilities terminology for events...
become pseudopregnant following an estrus in which the female is bred by an infertile male, resulting in "sterile mating". Like dogs, mice are spontaneous ovulators. However, they will not become pseudopregnant following an estrus in which the female is not bred because the corpus luteum will degrade rapidly in the absence of coitus. When the female is bred by an infertile male, the corpus luteum persists without an embryo, leading to pseudopregnancy. The female will develop mammary glands, lactate
Lactation
Lactation describes the secretion of milk from the mammary glands and the period of time that a mother lactates to feed her young. The process occurs in all female mammals, however it predates mammals. In humans the process of feeding milk is called breastfeeding or nursing...
, and build nests in the pseudopregnant state. Pseudopregnancy in mice is somewhat common in laboratory mice because it is often induced for the purpose of implanting embryos into a surrogate dam
Surrogacy
Surrogacy is an arrangement in which a woman carries and delivers a child for another couple or person. This woman may be the child's genetic mother , or she may carry the pregnancy to delivery after having an embryo, to which she has no genetic relationship whatsoever, transferred to her uterus...
, but is uncommon in wild mice because most wild males are fertile and will genuinely impregnate the female.
External links
- Pseudopregnancy
- Canine Pregnancy and Pseudopregnancy
- Early Pregnancy Signs (seems not authenticated)