Nervous pregnancy, pregnancy without a baby

The symptoms are present, but the baby is not. Nervous pregnancy (or pseudocyesis) is a phenomenon that triggers all the classic manifestations of pregnancy in a woman who is not pregnant. “From a purely medical point of view, there is no such thing as a nervous pregnancy. This term also takes on an often pejorative sound. These are mainly women with a significant delay in menstruation (amenorrhea), accompanied by signs that may suggest pregnancy (swelling of the breasts, weight gain, etc.) but not being pregnant.“, explains Doctor Teddy Linet, obstetrician-gynecologist in Challans (Vendée). The diagnosis of this disorder consists simply in carrying out a pregnancy test (urine or blood) or an ultrasound that will confirm or rule out the presence of a fetus. “If the test is negative, you may have to look for causes, especially if the delays are long (eg less than eight period episodes per year)“emphasizes the gynecologist.

Hormones often involved in nervous pregnancy

And precisely, what factors can trigger such symptoms? First and most likely cause: hormonal imbalances. Among them, the premenstrual syndrome, a very common hormonal problem after 35 years, possibly blamed. “It gives tense breasts, nausea, weight gain that can be significant, mood disorders … all signs that suggest pregnancy. It does not necessarily lead to a late period, but when it is there too, difficult to distinguish between things with a real pregnancy!“explains Dr. Linet. Still in the category of hormonal causes, certain diseases can trigger false alarms of pregnancy. This is the case of the syndrome. polycystic ovaries, a hormonal imbalance which leads to absence of ovulation, or a dysfunction of the areas of the brain which regulate the menstrual cycle (hypothalamus and pituitary gland). This is why nervous pregnancy can affect all women, “especially women over 35 and in premenopause who may experience premenstrual syndromes and long cycles, several times a year“warns the gynecologist. Finally, the most extreme hormonal case: that of hyperprolactinemia which consists of an overproduction of prolactin by the pituitary gland.”Prolactin is a hormone that is used especially during breastfeeding. In too high a quantity, it blocks the menstrual cycle. In some cases, it can cause breast enlargement and sometimes even … milk production“explains Dr. Linet. All these symptoms can then suggest a pregnancy. estrogen-progestogen hormonal contraception (pill, ring, patch), such symptoms remain rare because menstruation, which usually occurs when contraception is stopped, put an end to them. “But under microprogestogens (micropill, IUS – also called hormonal IUD – or implant) it is possible to have periods without periods and a premenstrual syndrome which can give this kind of signs »Confides the gynecologist.

Put an end to deceptive symptoms

In the event of a nervous pregnancy attributable to premenstrual syndrome, “women with more than four cycles per year are normally not at risk of much“. Nevertheless, women with polycystic ovaries should be more closely monitored because” eThey can sometimes have later fertility problems, hairiness, diabetes, of cholesterol but it is not obligatory“reassures Doctor Teddy Linet. But even if the risks to a woman who has a nervous pregnancy are low, it can be important to relieve the discomfort and alleviate the lying symptoms.”The most common case is PMS … and it resolves on its own when the rules arrive“enlightens Doctor Teddy Linet. These women must therefore be patient. To put an end to nerve pregnancies caused by hormonal disorders, there are suitable drugs.”As the problems are essentially hormonal, medication may be necessary if this bothers the patient or if the cycles are really too few.“reveals the gynecologist.

Nervous pregnancy and psychology

In certain contexts, psychological follow-up can also relieve women suffering from a nervous pregnancy. “A woman with fertility problems, marked signs of pregnancy, and frequent period delays will most likely have a harder time going through those times when she believes she is “for real” pregnant. All the more so for the premenstrual syndrome during which the patients can have aggressive or depressive reactions“emphasizes the gynecologist.

In addition, nerve pregnancies can sometimes be associated with psychological disorders such as depressions, from bipolar disorders or schizophrenics. Indeed, in women suffering from such disorders, nervous pregnancy is not uncommon, especially if it is treated with antipsychotic drugs which can in some cases promote symptoms of pregnancy: “by inhibiting the secretion of dopamine [un neurotransmetteur], these medicines can raise prolactin levels to produce amenorrhea, breast swelling or tenderness, and discharge of milk from the nipple, similar to pregnancy. And antipsychotics are associated with weight gain that relaxes the abdomen and adds to the misconception of pregnancy.“said Dr. Mary Seeman, a psychiatrist at the University of Toronto, in a study published in 2014 in the World Journal of Clinical Cases.

Even in the absence of psychological disturbances, conception and pregnancy remain periods rich in emotions and hormonal changes, which can upset more than one woman.

Sources:

• Interview with Teddy Linet, gynecologist in Challans (Vendée)
• Mary V. Seeman, 2014. Pseudocyesis, delusional pregnancy, and psychosis: The birth of a delusion. World Journal of Clinical Cases. 2014 Aug 16; 2 (8): 338-344.
• Levy F., Mouchabac S., Peretti CS., 2014. Etiopathogeny of the delusion of pregnancy using a literature review: Role of hyperprolactinemia and application of the theory of abductive inference. L’Encephale 2014, 40 (2): 154-159

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