False expectations

Salina Pradhan (name changed), 29, was over the moon. Married for just two months, she had missed a period and was eagerly looking forward to sharing the news about her pregnancy with her family. But she wanted to wait until she confirmed it with her doctor.

Unfortunately, that day never came. After missing her periods twice in a row, her doctor told her that she was not pregnant.

This condition, when the body falsely believes itself to be pregnant, is called pseudocyesis. Though it is rare, it happens to women who are either infertile and wish to conceive, or women who do not want to conceive at all.

Dr. Heera Tuladhar, Head of Department of Obstetrics and Gynecology at KIST Medical College Teaching Hospital, relates that she has seen many such cases during her 20-year career. “This happens more to unmarried women who are terrified of conceiving,” she says.

All the apparent symptoms of pregnancy are displayed in these cases. Periods stop, breasts swell and become tender, there is nausea, weight is gained, and constipation occurs, and even the abdomen bloats. The woman concerned is completely assured of her pregnancy. Sometimes the symptoms may be so severe that the doctors themselves are confused, and have to take further tests to confirm that there is no pregnancy. While this becomes a matter of relief to those who do not want a child, there are also some women who find out they are infertile.

Dr. Tuladhar explains that this symptom has its roots in psychology. Since the mind is stronger than the body, subconscious desires or fears are manifested on the body in this way. There are many other ways in which the body deceives the mind, leading a woman to believe she is pregnant.

The symptoms of pregnancy, like nausea, swelling of breasts and weight gain, are caused by the rise in a hormone called progesterone, and most cases of false pregnancy occur because of over-secretion of the progesterone.

Sometimes their periods resume in a few months, but in extreme cases, the symptoms may carry on into the ninth month. Women have been known to experience labor pains, but of course, do not give birth. This can happen in cases where the woman has no way of confirming pregnancy, like blood test or ultrasound, until the final month.

Delayed periods

Progesterone is naturally secreted by the body in the second half of the menstruation cycle, which is just before menstruation. Hence symptoms like nausea, swelling of breasts and abdomen, etc are mildly manifested in all menstruating women at this time. For any reason, if there is a hormonal fluctuation and your menstruation is delayed, then these symptoms become aggravated.

Hormone intake

Pills that can delay periods are also available these days. Since these pills are based on hormones, they increase the secretion of progesterone which aggravates the symptoms of pregnancy. Dr. Tuladhar advises that these hormones should not be taken because they disturb the natural menstrual cycle. Sometimes, a woman may be taking hormone pills for other diseases, which has the same effect.

Depo-Provera

Many contraceptives available today are based on hormones. Depo-Provera, a contraceptive that is injected into the body every three months, is based on progesterone. At first, it stops a woman’s periods and all the symptoms of pregnancy are manifested. Dr. Tuladhar informs that many patients become concerned and come to her, believing they are pregnant. So it is important to be educated about the effects that each contraceptive is going to have on your body.

Pre-menopause

When a woman has crossed her forty years of age, symptoms of pre-menopause are manifested. Periods may be delayed for one or two months or even more and the woman may believe herself to be pregnant. Such irregular periods may continue for many years.

Tumor/Thyroid disease

Certain kinds of tumors also secrete hormones that delay your periods and manifest the symptoms of pregnancy. Endocrine disorders caused by thyroid diseases are also known to tamper with the menstrual cycle.

Chemical pregnancy

In some cases, fertilization occurs but the embryo fails to implant itself in the uterus. In this case, called chemical pregnancy, the embryo falls down and the woman’s normal menstruation cycle resumes. But if a pregnancy test is conducted before the embryo falls down, it will be positive. However, since the menstruation cycle is not overdue, there is no reason to test for pregnancy, and most women are not aware that they were pregnant for a short time. Only if a woman is highly sensitive to her body and notices the symptoms, she will she realize that she has had a brief pregnancy.

*****

Pregnancy and childbirth are a sensitive and meaningful time in a woman’s life. But at the same time, they are also highly complicated. Any woman who wants to conceive (or does not), must be very careful about her health, and take any symptom of pregnancy seriously. Most importantly, since each kind of test is fallible, a pregnancy must be confirmed through multiple tests before any further steps are taken or plans are made.

Some tips when testing for pregnancy

• Whether or not you get the correct result often depends on the quality of the pregnancy kit. So make sure to choose your kit with care. Also, a pregnancy test kit only works after five weeks of the last menstruation.
• When taking pregnancy tests with a test kit, always test the first urine midstream, in early morning. This has the highest concentration of hormones.
• A blood test is the most sensitive, and can give accurate results from six days of conception. But if the body is secreting similar hormones for other reasons, like illness or tumor, then blood test may be falsely positive too.
• An ultrasound rarely gives false positive. Trans-vaginal ultrasound can be done from four weeks of conception while abdominal ultrasound can be done after five weeks. However, sometimes, an ultrasound may give a false negative, which means that conception may not be visible for a few months.
• The morning-after pill, which is taken to avoid pregnancy immediately after having sexual contact, is also harmful if taken regularly. Though it is 80-90% effective if taken occasionally, regular use dulls its impact, and there is high chance of pregnancy. Hence, if you have taken this pill, make sure through multiple methods that you did not conceive.