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Causes
By Mayo Clinic staff
Although many problems can lead to low pituitary function, Sheehan's syndrome is caused by severe blood loss during or after childbirth. Blood loss at that time can be particularly damaging to the pituitary gland, destroying hormone-producing tissue so that the gland can't function normally.
Experts aren't sure exactly why this is the case. One theory is that since the pituitary gland enlarges during pregnancy, it's more prone to damage. The severe drop in blood pressure (hypotension) that occurs during hemorrhage also could damage the pituitary.
Pituitary hormones regulate the rest of your endocrine system, signaling other glands to increase or decrease production of the hormones that control metabolism, fertility, wound healing and many other vital processes. A lack of any of all of these hormones can cause problems throughout your body — although signs and symptoms may develop so gradually that they escape notice.
Hormones that your pituitary secretes include:
- Growth hormone (GH). This hormone controls bone and tissue growth and maintains the appropriate balance of muscle and fat tissue.
- Anti-diuretic hormone (ADH). By regulating urine production, this hormone manages water balance in your body. A deficiency of ADH results in a condition called diabetes insipidus.
- Thyroid-stimulating hormone (TSH). This hormone stimulates your thyroid gland to produce key hormones that regulate your metabolism. Shortage of TSH results in an underactive thyroid gland (hypothyroidism).
- Luteinizing hormone (LH). In men, LH regulates testosterone production. In women, it fosters production of estrogen.
- Follicle-stimulating hormone (FSH). Working in tandem with LH, FSH helps stimulate sperm production in men, and egg development and ovulation in women.
- Adrenocorticotropic hormone (ACTH). This hormone stimulates your adrenal glands to produce cortisol and other hormones. Cortisol helps your body deal with stress and influences many body functions, including blood pressure, heart function and your immune system. A low level of adrenal hormones is known as Addison's disease.
- Prolactin. This hormone regulates the development of female breasts, as well as the production of breast milk.
- Feinberg EC, et al. The incidence of Sheehan's syndrome after obstetric hemorrhage. Fertility and Sterility. 2005;84(4):975-979.
- Soares DV, et al. Clinical, laboratory and therapeutics aspects of Sheehan's syndrome. Arquivos Brasileiros de Endocrinologia e Metabologia. 2008;52(5):872-878.
- Dokmetas HS, et al. Characteristic features of 20 patients with Sheehan's syndrome. Gynecological Endocrinology: The Official Journal of the International Society of Gynecological Endocrinology. 2006;22(5):279-283.
- Schrager S, et al. Sheehan syndrome: A rare complication of postpartum hemorrhage. The Journal of the American Board of Family Practice. 2001;14(5):389-391.
- Sert M, et al. Clinical report of 28 Patients with Sheehan's syndrome. Endocrine Journal. 2003;50(3):297-301.
- Pham PC, et al. Sodium and water disturbances in patients with
- Sheehan's syndrome. American Journal of Kidney Diseases. 2001;38(3):E14.
- Kelestimur F, et al. Sheehan's syndrome: Baseline characteristics and effect of 2 years of growth hormone replacement therapy in 91 patients in KIMS-Pfizer International Metabolic Database. European Journal of Endocrinology. 2005;152(4):581-587.
- The Pituitary Gland. In: Ganong WF. Review of Medical Physiology. 22nd edition. The McGraw-Hill Companies Inc.; 2005. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=11. Accessed Nov. 28, 2008.
