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Sheehan Syndrome

Sheehan syndrome is a condition where the pituitary gland is damaged during childbirth, usually due to excessive blood loss or low blood pressure. This can occur when the pituitary gland does not receive enough oxygen. The pituitary gland controls other glands through hormones, so its damage can disrupt hormone production including thyroid, adrenal, reproductive, growth, and lactation hormones. Symptoms may include difficulty breastfeeding, irregular periods, fatigue, and changes to skin and hair. Treatment requires lifelong hormone replacement therapy monitored by an endocrinologist. While rare in developed nations, Sheehan syndrome can be prevented with good medical care during delivery to avoid severe bleeding and low blood pressure.

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280 views6 pages

Sheehan Syndrome

Sheehan syndrome is a condition where the pituitary gland is damaged during childbirth, usually due to excessive blood loss or low blood pressure. This can occur when the pituitary gland does not receive enough oxygen. The pituitary gland controls other glands through hormones, so its damage can disrupt hormone production including thyroid, adrenal, reproductive, growth, and lactation hormones. Symptoms may include difficulty breastfeeding, irregular periods, fatigue, and changes to skin and hair. Treatment requires lifelong hormone replacement therapy monitored by an endocrinologist. While rare in developed nations, Sheehan syndrome can be prevented with good medical care during delivery to avoid severe bleeding and low blood pressure.

Uploaded by

Arvie Tagnong
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Sheehan Syndrome

 Symptoms

 Causes and risk factors

 Diagnosis

 Treatment
 Complications

 Outlook
Overview
Sheehan syndrome is a condition that happens when the pituitary gland is
damaged during childbirth. It’s caused by excess blood loss (hemorrhage) or
extremely low blood pressure during or after labor. A lack of blood deprives
the pituitary of the oxygen it needs to work properly.

The pituitary gland sits at the base of the brain. It produces hormones that
oversee the function of your body’s other glands. That’s why it’s nicknamed
“the master gland.” This gland is more vulnerable to injury in labor, because it
grows bigger during pregnancy.

When the pituitary doesn’t work as well as it should, the glands it controls —
including the thyroid and adrenal glands — can’t release enough of their
hormones. Sheehan syndrome affects production of these pituitary hormones:

 Thyroid-stimulating hormone (TSH) directs your thyroid gland to


produce its hormones, which regulate your metabolism.
 Luteinizing hormone (LH) helps regulate your menstrual cycle and
egg production, together with FSH.

 Follicle-stimulating hormone (FSH) helps regulate your menstrual


cycle and egg production, together with LH.

 Growth hormone (GH) controls organ and tissue growth.

 Adrenocorticotropic hormone (ACTH) stimulates your adrenal glands


to release cortisol and other stress hormones.

 Prolactin stimulates milk production.

Sheehan syndrome is also called postpartum hypopituitarism.

Symptoms
The symptoms of Sheehan syndrome sometimes start right after childbirth.
Or, they can come on gradually months or even years later. Women who have
very little damage to their pituitary gland might not develop symptoms for
several years.

Symptoms of Sheehan syndrome include:

 difficulty breastfeeding or an inability to breastfeed


 irregular menstrual periods (oligomenorrhea) or no periods
(amenorrhea)
 weight gain
 intolerance to cold
 slowed mental function
 loss of pubic and underarm hair
 fatigue or weakness
 fine wrinkles around the eyes and lips
 breast shrinkage
 dry skin
 joint pain
 decreased sex drive
 low blood sugar
 low blood pressure
 irregular heartbeat

What are the causes and risk


factors?
A lack of oxygen to the pituitary gland during childbirth causes Sheehan
syndrome. Excess blood loss or very low blood pressure in labor can deprive
the pituitary of the oxygen it needs to function.

Sheehan syndrome is most common in developing nations like India. Today


it’s rare in the United States and other developed nations, thanks to better
medical care during delivery.

Factors that make you more likely to have severe blood loss include:

 placental abruption, when the placenta that nourishes the unborn baby
detaches from the uterus

 placenta previa, when the placenta partly or totally covers the cervix
(the bottom part of the uterus that connects to the vagina)
 giving birth to a large baby, who weighs more than 8.8 pounds (4,000
grams), or having multiples, like twins

 preeclampsia, high blood pressure during pregnancy

 assisted labor, a forceps or vacuum-assisted delivery

How is it diagnosed?
Sheehan syndrome can easily be confused with other conditions that cause
similar symptoms — especially if the symptoms don’t start for many months
after you deliver.

Your doctor will start by asking about your symptoms. Your memory of related
symptoms — like trouble producing breast milk after delivery — will help your
doctor diagnose you.

Tests that help your doctor diagnose Sheehan syndrome include:

 Blood tests. You’ll have tests to check levels of hormones that your
pituitary gland makes. The pituitary hormone stimulation test checks
how well your pituitary gland responds to different hormones.

 Magnetic resonance imaging (MRI) or computed tomography (CT)


scans. These imaging tests check for tumors or other problems with
your pituitary gland that can cause similar symptoms.
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Treatment
Treatment for Sheehan syndrome is to take the hormones your body no
longer produces. You’ll need to stay on most of these hormones for life:

 Corticosteroids. Prednisone or hydrocortisone replaces adrenal


hormones.

 Levothyroxine (Levoxyl, Synthroid). This medication increases the


levels of the hormones your thyroid gland makes.

 Estrogen plus progesterone (or estrogen alone, if your uterus has


been removed). These female hormones help normalize your
menstrual cycle. You can stop taking them once you reach the age of
menopause.

 LH and FSH. These hormones stimulate ovulation and can help you get
pregnant.

 Growth hormone. This hormone helps maintain bone density,


improves your body’s ratio of muscle to fat, and lowers cholesterol
levels.

A specialist called an endocrinologist will oversee your treatment. You’ll have


regular blood tests to check your hormone levels.

Can it be prevented?

Good medical care during childbirth can prevent severe bleeding and low
blood pressure. Once severe bleeding happens, Sheehan syndrome isn’t
preventable.

Complications
Complications of Sheehan syndrome include:
 adrenal crisis, a life-threatening condition in which your adrenal glands
don’t produce enough of the stress hormone, cortisol

 low blood pressure

 unexpected weight loss

 irregular periods

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