Sheehan’s Syndrome Definition, Reason, Symptoms, Treatment & Prevention
Definition
Sheehan’s syndrome is a condition that occurs when the pituitary gland is damaged during labour. This condition is caused by excessive blood loss or a sharp drop in blood pressure during or after delivery. A lack of blood can reduce the supply of oxygen to the pituitary gland, which is needed to maintain its function.
The pituitary gland is located at the bottom of the brain. These glands produce hormones that control the function of other glands in the body. This gland is prone to injury during delivery because it increases in size during pregnancy.
When the pituitary gland is not functioning properly, the other glands it controls, namely the thyroid and adrenal glands, cannot release enough hormones.
Sheehan’s syndrome affects the production of various pituitary hormones, including:
- Thyroid-stimulating hormone (TSH), which directs the thyroid gland to produce thyroid hormone, which regulates the body’s metabolism.
- Luteinizing hormone (LH), which regulates the menstrual cycle and egg production, along with FSH.
- Follicle-stimulating hormone (FSH), which regulates the menstrual cycle and egg production, along with LH.
- Growth hormone (GH), which functions to control the growth of organs and tissues.
- Adrenocorticotropic hormone (ACTH), which stimulates the adrenal glands to release cortisol and other stress hormones.
- Prolactin, which stimulates milk production.
Sheehan’s syndrome is also known as postpartum hypopituitarism.
Sheehan’s Syndrome Symptoms
Signs and symptoms of Sheehan’s syndrome sometimes begin soon after delivery. However, in some other sufferers, signs and symptoms may appear gradually several months to several years later. Women who have very minor injuries to the pituitary gland may not experience signs or symptoms for several years.
Signs and symptoms of Sheehan’s syndrome include:
- Breastfeeding difficulties or inability to breastfeed
- Irregular menstruation, or no menstruation at all
- Weight gain
- Intolerance to cold air
- Decreased mental function
- Loss of pubic or axillary hair
- Fatigue or weakness
- Well-defined wrinkles around the eyes and lips
- Decrease in breast size
- Dry skin
- Joint pain
- Decreased sexual desire
- Low blood sugar
- Low blood pressure
- Irregular heartbeat
Sheehan’s Syndrome Reason
Lack of oxygen supply to the pituitary gland during labor can cause Sheehan’s syndrome. Excessive blood loss or very low blood pressure during labor can limit the supply of oxygen to the pituitary gland, which is needed for proper functioning.
Some factors that increase a person’s chances of experiencing heavy blood loss during labor include:
- Placental abruption, in which the placenta, which provides nutrition to the fetus, separates from the uterus
- Placenta previa, in which the placenta covers the cervix partially or completely
- Giving birth to a large baby, weighing more than 4,000 grams, or having multiple fetuses (twins)
- Preeclampsia, which is characterized by an increase in blood pressure during pregnancy
- Assisted delivery, using forceps or vacuum
Diagnosis
The diagnosis of Sheehan’s syndrome can be determined based on medical interviews, physical examinations, and certain investigations. Sometimes, Sheehan’s syndrome can have signs and symptoms that mimic those of other conditions, especially if they don’t appear until months after delivery. The doctor will ask about the symptoms you are experiencing, including memories of the symptoms you have experienced, such as difficulty producing milk after giving birth.
Some supporting examinations that can help doctors diagnose Sheehan’s syndrome are:
- Blood test. Someone can do an examination to check the levels of hormones produced by the pituitary gland. Pituitary hormone stimulation tests can check how well the pituitary gland responds to different hormones.
- Magnetic resonance imaging (MRI) or computerized tomography (CT). These imaging tests are intended to evaluate the presence of a tumor or other problem in the pituitary gland that can cause the same signs and symptoms.
Sheehan’s Syndrome Treatment
The treatment for Sheehan’s syndrome is the administration of hormones that are no longer produced by the body. Often, these hormones are taken over the long term.
Some of the treatments that are generally prescribed by doctors are corticosteroids to replace adrenal hormones. Levothyroxine may be prescribed to increase production of thyroid hormones, estrogen and progesterone to improve menstrual cycles and growth hormone.
Prevention
Good medical care during labor can prevent heavy bleeding and decreased blood pressure, which can lead to Sheehan’s syndrome.