What Is Sheehan Syndrome?

Sheehan Syndrome is a rare endocrine disorder that exclusively affects women, typically resulting from significant blood loss during or after childbirth. This condition manifests as a substantial deficiency in pituitary gland function, leading to hormonal imbalances and various health complications. Your doctor might also refer to this condition as postpartum hypopituitarism.

Symptoms

There are several common symptoms of Sheehan Syndrome.

Sheehan Syndrome Symptoms include:

• Difficulty breastfeeding
• Fatigue
• Weakness
• Body hair loss
• Facial hair loss
• Low blood pressure
• Weight loss
• Decreased sex drive
• Mood changes
• Depression
• Dry skin
• Dry hair
• Frequent urination
• Increased thirst
• Loss of menstrual periods

Causes

Sheehan Syndrome typically results from severe blood loss during or immediately after childbirth. This extensive loss of blood can drastically reduce the oxygen supply to the body's organs, including the pituitary gland. Given its high sensitivity to changes in blood supply, the pituitary gland may be significantly damaged or destroyed, leading to its decreased functionality and the onset of Sheehan Syndrome. Therefore, a damaged pituitary gland is considered one of the Sheehan Syndrome causes.

Risk Factors

Risk factors for Sheehan Syndrome primarily revolve around complications during childbirth. Women who experience significant blood loss or have low blood pressure during or after delivery are at a higher risk. Those with a history of difficult or complicated pregnancies and deliveries, including cases of multiple births, are more susceptible to developing this condition.

How to Diagnose Sheehan Syndrome

Diagnosing Sheehan Syndrome can be a complex process due to the varied presentation of symptoms. The diagnosis involves a combination of thorough medical history evaluation, imaging tests, and blood tests to assess hormonal levels.

Sheehan Syndrome diagnosis includes:

• Routine medical exam/history assessment—This involves the physician conducting a comprehensive evaluation of your medical history, particularly focusing on any complications during childbirth, such as excessive bleeding. The physician will also look for signs of hormonal imbalance, such as changes in menstruation and lactation patterns.
• Imaging tests—Magnetic resonance imaging (MRI) of the pituitary gland is typically performed. This noninvasive test allows your doctor to visualize the pituitary gland and identify any structural changes, such as shrinkage or damage, which could be indicative of Sheehan Syndrome.
• Blood tests—Blood tests measure the levels of hormones produced by the pituitary gland. Reduced levels of these hormones may signal the presence of Sheehan Syndrome.
• Stimulation tests—These tests involve the administration of certain substances that normally stimulate the pituitary gland to produce hormones. The body's response is then measured to assess whether the pituitary gland is functioning normally. A low hormonal response can indicate damage to the pituitary, as seen in Sheehan Syndrome.

Treatment

The goal of Sheehan Syndrome treatment is to restore normal hormone levels and alleviate symptoms. Treatment often requires a lifelong commitment to medication and consistent monitoring.

Treatment options:

• Thyroid Hormone Replacement Therapy—This involves taking synthetic thyroid hormone to compensate for the underproduction of thyroid hormones. These hormones are crucial for regulating metabolism and maintaining body temperature.
• Cortisol Replacement Therapy—A synthetic version of cortisol is administered to replace the cortisol deficiency commonly seen in Sheehan Syndrome. Cortisol is vital for stress response, maintaining blood pressure, and metabolizing glucose, protein, and fats.
• Growth Hormone Replacement—Growth hormone deficiency is usually managed with injections of synthetic growth hormone. Growth hormones help you maintain muscle mass, bone health, and metabolic processes.

In addition to these primary treatments, regular medical follow-ups are necessary to monitor hormone levels and adjust medication dosages as needed.

Prevention

It is not possible to directly reduce the risk of Sheehan Syndrome. Careful management of childbirth is crucial. Ensuring the presence of a skilled delivery team can help mitigate excessive blood loss during delivery, which is the primary factor leading to this condition. Monitor and promptly address any Sheehan Syndrome complications to prevent serious health problems.