False pregnancy (or pseudocyesis, ) These changes may be responsible for amenorrhea, galactorrhea, and hyperprolactinemia seen in falsely pregnant women.
About one in six false pregnancies is potentially influenced by concomitant medical or surgical conditions including gallstones, abdominal tumors, hyperprolactinaemia, constipation, tubal cysts, and esophageal achalasia. Other social factors impacting include low educational status, marital issues, unstable relationship patterns, history of partner abuse, social deprivation, poverty, lower socioeconomic status, and unemployment. A pelvic exam can show if conception has occurred, blood and urine can be tested for hormones released in pregnancy, and ultrasound shows the absence of the fetus. An ultrasound can accurately distinguish between a false and true pregnancy.
In some cases, false pregnancy symptoms may mask underlying medical conditions such as abdominal tumors, central nervous tumors, ovarian cysts, or gallstones. Medical tests and imaging are recommended to rule out potentially life-threatening conditions.
The symptoms of false pregnancy can be misinterpreted by the individual as a true pregnancy when the symptoms are actually caused by diseases (like hormone-secreting tumors, alcoholic liver disease, cholecystitis, urinary tract infection, gallstones) or exposure to a substance (like a medication),
There is no direct evidence for treating false pregnancy with pharmacotherapy, but medications may be used to restore hormonal and neurotransmitter imbalances which are implicated in physical manifestations of false pregnancy. and can trigger delusions. When underlying medical conditions or surgical conditions including gallstones, abdominal tumors, hyperprolactinemia, and constipation are identified, treatment may reduce the severity of the delusion.
Women of reproductive age comprise the majority of pseudocyesis occurrences. False pregnancies are more common in societies with certain cultures and religions, particularly in areas where there is a high degree of pressure for women to have multiple children, and for those children to be male.
History
The perception of false pregnancy has evolved over time. In the late 17th century, French obstetrician François Mauriceau believed that the enlarged abdomens of falsely pregnant patients were caused by bad air. Physicians slowly began to acknowledge other potential causes of pseudocyesis, including its origin in the mind and in the body. In 1877, a physician named Joshua Whittington Underhill observed that physical symptoms can convince a woman of pregnancy, or a "disordered brain" can convince her that ordinary abdominal pains or bowel movements are instead fetal movements. The idea that pseudocyesis could result from a woman's perception of herself led to investigation into the role of emotions in cases of pseudocyesis. An investigator in the early 20th century observed that strong emotions can dry a woman's milk supply. The investigator went on to infer that the opposite was also true, and it was believed that strong emotions could bring about its production in women who are not pregnant. Alternatively, some physicians questioned the legitimacy of pseudocyesis as a condition. For instance, French obstetrician Charles Pajot stated in the 19th century, "there are no false pregnancies, only false diagnoses."
Society and culture
In the mid-1960s, a woman who appeared to be in labor was not properly examined because delivery appeared imminent; it was thought that her water broke but the expelled liquid was urine. In 2008, a woman in the United States who was suspected of being in labor was given a C-section but there was no fetus.
Gynecologist John Dewhurst studied the sequence of the supposed miscarriages of Anne Boleyn, second wife of King Henry VIII of England, which followed the birth of her first child, Elizabeth, in September 1533 and the series of reported miscarriages that followed. Excluding the miscarriage of a male child of almost four months' gestation in January 1536, he postulated that, instead of a series of miscarriages, Anne was experiencing pseudocyesis (false pregnancies), a condition "occur[ing] in women desperate to prove their fertility.". Henry's eldest daughter Queen Mary I had a false pregnancy. After coming to terms with it, she reportedly believed that God had not made her pregnant because she had not sufficiently punished heretics. After being diagnosed with hysteria, she believed she was pregnant by Breuer, her therapist. She even believed she was in labor as she was trying to have another session with Breuer.