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Pseudocyesis, Delusion of Pregnancy, Ovarian Cancer, Fibroids, and Cushing's Syndrome

 

            Not every woman who shows the signs of having a cryptic pregnancy will turn out to be pregnant.  There are other possible explanations that should be considered, even if it is only to rule them out.  The first option is a physical condition called pseudocyesis.   Pseudocyesis (greek pseudçs, false + kyçsis, meaning pregnancy) is a condition in which the patient has all signs and symptoms of pregnancy except the presence of a fetus.  In the case of pseudocyesis, i.e., phantom pregnancy or pseudopregnancy, there is abdominal distention, enlargement of the breasts, enhanced pigmentation, absence of menstrual cycle, morning sickness and vomiting, typical lordotic posture on walking, inverted umbilicus, increased appetite, weight gain, feeling of fetal movement and sometimes positive HCG tests.  This is one of the most common misdiagnosis when analyzing a cryptic pregnancy because almost all of the symptoms of phantom pregnancy and cryptic pregnancy are the same including negative ultrasounds.  Because many physicians are unaware of the nature of a cryptic pregnancy and its possibility, a woman that insists that she is pregnant without HCG in her system (especially repeated visits), is deemed to be mentally unstable and delusional, however there is a difference between phantom pregnancy and the delusion of pregnancy.  A phantom pregnancy is caused by an over stimulated pituitary gland.  That gland secretes an overabundance of estrogen, progesterone, and prolactin which cause physical changes to the body that mimic pregnancy.  This, so far, is the only difference in symptoms from phantom pregnancy and cryptic pregnancy.  In cryptic pregnancy, the pregnancy hormones remain normal to low throughout the pregnancy, or until the cryptic pregnancy becomes normal.  Because of the increased hormone levels of a phantom pregnancy and the symptoms that those hormones produce, the woman then is convinced of pregnancy, and because HCG test are not 100% reliable and it has been proven that pregnancies can happen with negative ultrasounds, negative HCG tests, negative pelvic exams and negative belly exams with no felling of the fundus, the woman is then left unsure of what to believe.  It is a case of the body tricking the mind.  Phantom pregnancies can happen to any woman even if she has a stable frame of mind and absolutely no history of mental problems because the cause is rooted in the physical changes created by the pituitary gland first. 

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         Delusion of pregnancy, however, is a case of the mind tricking the body. By definition, delusions are false firm ideas that cannot be corrected by reasoning and are out of keeping with patient's educational and cultural background.  Phantom pregnancies are rooted in the psychotic aspect.   It stems from the overwhelming desire to be pregnant, the fear of being pregnant, a traumatic loss such as the loss of a child, drug related delusion or a previous psychological diagnosis such as schizophrenia.  Delusion of pregnancy can take place with no symptoms at all, or can be accompanied by pregnancy symptoms due to the mind tricking the body into producing pregnancy hormones.

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          Some women may truly be experiencing a phantom pregnancy, but it is a much more common occurrence to actually be going through a viable cryptic pregnancy.  The statistics say that phantom pregnancy occurs in roughly 1-6 pregnancies per 22,000, and cryptic pregnancies occur in roughly 1 out of every 450 pregnancies. Until cryptic pregnancies are researched and medical personnel are educated about their existence, women will continue to be treated as if there is something psychologically wrong with them instead of figuring out what the true cause of their symptoms are from.

 
         Some other possible alternative explanations are fibroids and ovarian cancer. Fibroids are the most frequently seen tumors of the female reproductive system. Fibroids, also known as uterine myomas, leiomyomas, or fibromas, are firm, compact tumors that are made of smooth muscle cells and fibrous connective tissue that develop in the uterus. It is estimated that between 20 to 50 percent of women of reproductive age have fibroids, although not all are diagnosed. In more than 99% of fibroid cases, the tumors are benign (non-cancerous). They may range in size, from the size of a pea to the size of a softball or small grapefruit.   In my research I came across one woman who had a fibroid that was 9 inches across.  

 

Some of the symptoms of fibroids are:


•    Heavy or prolonged menstrual periods
•    Abnormal bleeding between menstrual periods
•    Pelvic pain (caused as the tumor presses on pelvic organs)
•    Frequent urination
•    Low back pain
•    Pain during intercourse
•    A firm mass, often located near the middle of the pelvis, which can be felt by the physician


     These fibroids can resemble pregnancy in many ways.  They can be pushed through the abdomen and can move with an outside force, but they are not capable of moving on their own.


     Unlike the generally benign fibroids, ovarian cancer if left unchecked, can be deadly.  It also can have the same symptoms as pregnancy including a positive HCG test and abdominal growth.  One in 58 women will get ovarian cancer each year in the United States—that's about 23,000 a year.  Around 14,000 women will die from ovarian cancer in the United States each year.

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      Cushing’s Syndrome is another possible explanation for a few symptoms that mimic pregnancy. It is a condition caused by the overproduction of cortisol.  Common symptoms of this condition are:

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  • weight gain

  • obesity

  • fatty deposits, especially in the midsection, the face (causing a round, moon-shaped face) and between the shoulders and the upper back (causing a buffalo hump)

  • purple stretch marks on the breasts, arms, abdomen, and thighs

  • thinning skin that bruises easily

  • skin injuries that are slow to heal

  • acne

  • fatigue

  • muscle weakness

  • glucose intolerance

  • increased thirst

  • increased urination

  • bone loss

  • high blood pressure

  • a headache

  • cognitive dysfunction

  • anxiety

  • irritability

  • depression

  • an increased incidence of infections

 

Women may also notice extra facial and body hair, as well as absent or irregular menstruation.  One cause of Cushing’s Syndrome is from tumors that can be benign or malignant.

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