Definition

What is Sheehan’s syndrome?

Sheehan’s syndrome is a condition that affects women who lose a life-threatening amount of blood in childbirth or who have severe low blood pressure during or after childbirth, which can deprive the body of oxygen. In Sheehan’s syndrome, the lack of oxygen can damage your pituitary gland.

Sheehan’s syndrome causes the pituitary gland to not produce enough pituitary hormones (hypopituitarism). Also called postpartum hypopituitarism, Sheehan’s syndrome is rare in industrialized nations, largely due to improved obstetrical care. But it’s a major threat to women in developing countries.

How common is Sheehan’s syndrome?

The incidence of Sheehan’s syndrome is not known. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of Sheehan’s syndrome?

The common symptoms of Sheehan’s syndrome are:

  • Difficulty breast-feeding or an inability to breast-feed
  • No menstrual periods (amenorrhea) or infrequent menstruation (oligomenorrhea)
  • Inability to regrow shaved pubic hair
  • Slowed mental function, weight gain and difficulty staying warm as a result of an underactive thyroid (hypothyroidism)
  • Low blood pressure (hypotension)
  • Low blood sugar (hypoglycemia)
  • Fatigue
  • Irregular heartbeat
  • Breast shrinkage

Signs and symptoms of Sheehan’s syndrome typically appear slowly, after a period of months or even years. But sometimes problems appear right away, such as the inability to breast-feed.

Signs and symptoms of Sheehan’s syndrome occur because of having too little of the hormones the pituitary gland controls: thyroid, adrenal, breast milk production and menstrual function hormones.

For many women, Sheehan’s syndrome symptoms are nonspecific and often thought to be caused by other things. Fatigue, for instance, goes hand in hand with being a new mother. You might not realize you have Sheehan’s syndrome until you need treatment for thyroid or adrenal insufficiency.

It’s also possible to remain relatively symptom-free with Sheehan’s syndrome, depending on the extent of damage to the pituitary gland. Some women live for years not knowing their pituitary isn’t working properly. Then an extreme physical stressor, such as severe infection or surgery, triggers an adrenal crisis.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes Sheehan’s syndrome?

Sheehan syndrome is caused by severe blood loss or extremely low blood pressure during or after childbirth. Blood loss at delivery can be particularly damaging to the pituitary gland, which enlarges during pregnancy. This damage destroys the hormone-producing tissue so that the gland cannot function properly. Women who are carrying multiples (twins, triplets, etc.) and those who have problems with the placenta have an increased risk for bleeding during childbirth and Sheehan syndrome.

Risk factors

What increases my risk for Sheehan’s syndrome?

Any condition that increases the chance of severe blood loss (hemorrhage) or low blood pressure during childbirth, such as being pregnant with multiples or having a problem with the placenta, can increase your risk of Sheehan’s syndrome.

Hemorrhage is a rare childbirth complication, however, and Sheehan’s syndrome is even more uncommon. Both risks are greatly reduced with proper care and monitoring during labor and delivery.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is Sheehan’s syndrome diagnosed?

Diagnosing Sheehan’s syndrome can be difficult. Many of the symptoms overlap with those of other conditions. To diagnose Sheehan’s, your doctor likely will:

  • Collect a thorough medical history. It’s important to mention any childbirth complications you’ve had, no matter how long ago you gave birth. Also, be sure to tell your doctor if you didn’t produce breast milk or you failed to start menstruating after delivery — two key signs of Sheehan’s syndrome.
  • Run blood tests. Blood tests will check your pituitary hormone levels.
  • Request a pituitary hormone stimulation test. You might need stimulation testing of the pituitary hormones, which involves injecting hormones and running repeated blood tests to see how your pituitary responds. This test is typically done after consulting a doctor who specializes in hormonal disorders (endocrinologist).
  • Request imaging tests. You might also need imaging tests, such as an MRI scan or CT scan, to check the size of your pituitary and to look for other possible reasons for your symptoms, such as a pituitary tumor.

How is Sheehan’s syndrome treated?

Treatment involves replacement of the hormones produced by the pituitary gland. The following may be recommended, depending on individual circumstances:

  • Estrogen alone (if the uterus has been removed) or estrogen and progesterone in combination. This should be taken at least until the normal age of menopause.
  • Levothyroxine to replace thyroid stimulating hormone. This will need to be taken throughout the lifetime.
  • Corticosteroids to replace adrenal hormones. These must also be taken throughout the lifetime.

Growth hormone may also be suggested, as this may help normalize the body’s muscle-to-fat ratio, maintain bone mass, lower cholesterol levels, and/or improve overall quality of life.

The levels of these hormones should be monitored on a regular basis and may need to be adjusted periodically based on factors such as stress level, illness, pregnancy, or changes in weight.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage Sheehan’s syndrome?

Please discuss with your doctor for further information.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: December 13, 2017 | Last Modified: December 13, 2017

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