What Is Phantom Pregnancy?

The causes, symptoms, and treatment for pseudocyesis

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Phantom pregnancy, also known as pseudocyesis or false pregnancy, is a condition in which a person believes that they are pregnant when they are not. Pregnancy symptoms, such as the absence of their period, feeling phantom fetal movements, and a growing abdomen, occur in people with pseudocyesis even though they are not pregnant.

Phantom pregnancy is a rare disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies the condition under Somatic Symptom Disorders, a group of disorders that are characterized by physical symptoms.

Phantom pregnancy is especially rare in developed countries where people seek prenatal care early. In those cases, phantom pregnancy usually resolves quickly when a person learns from taking a pregnancy test or from their doctor that they are not pregnant.

Here is an overview of phantom pregnancy, including the signs and symptoms, how it is diagnosed, and the options available for treatment.

Person holding their hands over a swollen abdomen

Satoshi-K / Getty Images

Signs/Symptoms

People experiencing a phantom pregnancy have many of the same physical signs and symptoms as people who are pregnant. The symptoms may last a few weeks or for as long as nine months.

The most common signs are changes in menstruation, as well as changes in breast size and shape. Other possible signs and symptoms of a phantom pregnancy include:

  • Amenorrhea (no periods) or light periods
  • Abdominal distention 
  • Phantom fetal movements
  • Breast changes (increase in size, darkening of areola) 
  • Milk secretion
  • Weight gain
  • Nausea and vomiting
  • Uterine and cervical changes

Causes

It’s not clear why phantom pregnancy occurs. However, certain people—especially those who have experienced pregnancy loss or who are undergoing fertility treatments—seem to be more at risk for developing the condition.

Researchers have noticed there are certain endocrinologic similarities in people who have phantom pregnancies.

In a 2013 literature review of people who experienced phantom pregnancy, the researchers noted shared endocrine traits in people who had polycystic ovarian syndrome (PCOS) and people with major depressive disorder.

The study also found a deficit in brain dopamine activity and dysfunction of the sympathetic nervous system and central nervous system in people experiencing a phantom pregnancy.

The researchers suggested that these shared traits may lead to endocrine changes that cause the symptoms that arise—such as abnormal periods, protruding abdomen, phantom fetal movements, and labor pains—in people who experience phantom pregnancy.

Diagnosis

Several conditions can mimic phantom pregnancy. The first step in diagnosing a phantom pregnancy is ruling out other conditions that could explain a person’s symptoms.

One of the key ways that a phantom pregnancy differs from other disorders is that it is the only condition in which the physical symptoms of pregnancy develop.

Before making a diagnosis of a phantom pregnancy, a doctor needs to rule out other conditions including:

  • Delusion of pregnancy: A delusional disorder in which a person falsely believes that they are pregnant even in the absence of pregnancy symptoms.
  • Deceptive/simulated pregnancy: A disorder in which a person says that they are pregnant even though they know they are not.
  • Erroneous pseudocyesis: A disorder in which a person misinterprets symptoms from another disease as those of pregnancy.

The diagnosis of a phantom pregnancy hinges on the presence of physical symptoms of pregnancy plus clinical evidence, such as a negative pregnancy test or ultrasound, that shows no evidence of a pregnancy.

Treatment

There is no universal clinical treatment for phantom pregnancy. A doctor needs to evaluate each case individually to determine which treatment or combination of treatments will be the most beneficial.

Since phantom pregnancy involves physical and mental health symptoms, effective treatment requires cooperation between medical and mental health professionals.

Possible treatments for phantom pregnancy include:

  • Psychotherapy 
  • Clinical tests that disprove pregnancy
  • Medications such as antidepressants or antipsychotics
  • Hormonal therapy
  • Uterine dilation and curettage (D&C)

Often, clinical confirmation that a person is not pregnant is enough for the symptoms of pregnancy to go away. However, more treatment might be necessary to help the person make a complete physical and emotional recovery.

In some cases, a person may reject the diagnosis and continue to believe that they are pregnant, despite evidence to the contrary. In these situations, the care of a mental health professional is crucial.

Risk Factors

The incidence of phantom pregnancy is extremely low, and rates have declined significantly in the United States over the last several decades. In 1940, the rate was one in 250 pregnancies. By 2007, the rate had dropped to between one and six cases in 22,000 pregnancies.

Rates in Less Developed Countries

In other parts of the world, phantom pregnancy is more common. For example, in Nigeria, the rate is as high as one in 344 pregnancies. In Sudan, the condition affects one in 160 people who have undergone fertility treatments.

Phantom pregnancy occurs more frequently in less developed countries. In countries with ready access to health care and where people receive prenatal care early, it happens less often, likely because people can see clinical evidence early on that they are not pregnant.

The rates of phantom pregnancy tend to be higher in cultures that place a high value on pregnancy and motherhood.

Mental Health and Sociodemographic Factors

Research has shown that people who experience phantom pregnancy have some predisposing traits in common, including depression, anxiety, a desire to be pregnant, or a fear of becoming pregnant.

There are also other sociodemographic factors that make a person more likely to have a phantom pregnancy. Risk factors include:

  • Lower socioeconomic status
  • Limited education
  • Infertility
  • Relationship instability
  • Having an abusive partner

About 80% of people who experience a phantom pregnancy are married.

Coping

Having a phantom pregnancy can be a traumatic experience. Realizing that you are not pregnant can feel like a devastating loss. Grief is a common response to learning that you are not pregnant when you believed that you were. It can also be unnerving to realize that the physical symptoms that you were having were not being caused by pregnancy.

Talking to your doctor and a mental health professional, as well as reaching out to trusted people in your life for support, is crucial in getting through the process of being diagnosed with phantom pregnancy, treating the condition, and recovering from the experience.

A Word From Verywell

If you have experienced a phantom pregnancy, you may feel shame or embarrassment for thinking that you were pregnant when you were not. It’s important to remember that a phantom pregnancy is an actual condition with real symptoms and not something to be ashamed of.

Even if your symptoms go away once you get a clinical diagnosis, you may still benefit from additional support. Talk to your doctor about whether medication or psychotherapy would be a helpful part of your recovery.

As you recover, turn to people in your life who can support you, like your family and friends. In-person or online support groups for people who have also experienced a phantom pregnancy are another option that might help you feel less alone.

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