Hypopituitarism

Definition - What does Hypopituitarism mean?

Hypopituitarism is a rare disorder in which the pituitary gland either fails to produce adequate amounts of hormones or doesn't produce at all. The pituitary gland is a small bean-shaped gland located at the base of the brain, which produces hormones that affect several parts of the body. Therefore, symptoms of hypopituitarism vary with the type of hormone or hormones lacking. In addition to other hormones, the pituitary gland produces gonadotropins, namely follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones are vital for reproduction function. Thus, women with an underactive pituitary gland are prone to infertility.

FertilitySmarts explains Hypopituitarism

Hypopituitarism can occur due to various factors, including:

  • Pituitary tumors
  • Inflammation of the pituitary gland
  • Destruction of the pituitary due to an infection or radiation therapy
  • Sheehan’s syndrome: A condition that follows severe bleeding during childbirth, causing damage to the pituitary gland due to the lack of oxygen
  • Surgical removal of the pituitary

The hormones released from the pituitary gland include:

  • Adrenocorticotropic hormone (ACTH)
  • Thyroid-stimulating hormone (TSH)
  • Follicle-stimulating hormone (FSH)
  • Leutenizing hormone (LH)
  • Growth hormone (GH)
  • Prolactin (PRL)
  • Antidiuretic hormone (ADH)
  • Oxytocin

The symptoms of an underactive pituitary gland usually develop gradually. These may be non-specific and therefore go unnoticed for years. The symptoms usually depend on the type and severity of pituitary hormone deficiency as follows:

  • Symptoms due to ACTH deficiency: Fatigue, weight loss, low blood pressure
  • Symptoms due to TSH deficiency: Increased sensitivity to cold, dry and pale skin, reduced appetite, facial puffiness, constipation, and high blood cholesterol levels.
  • Symptoms due to the lack of FSH and LH: In women: Irregular or no periods, impaired ovulation and infertility, poor sex drive, menopausal symptoms like hot flashes, vaginal dryness, and bone loss and fractures suggesting osteoporosis. In men: Low sexual drive, difficulty achieving and maintaining an erection, infertility due to a low sperm count, and features of osteoporosis
  • Symptoms due to the lack of PRL and oxytocin: Inability to breastfeed due to impaired production of milk from the breasts
  • GH deficiency: Short stature in children, decreased muscle mass and strength in adults
  • ADH deficiency: Frequent urination and excessive thirst

In women presenting with the above signs and symptoms, the doctor orders hormonal studies in pairs of the affected pituitary hormones and their corresponding target glands.

Treatment includes appropriate hormone replacement and correction of the underlying cause. Glucocorticoid steroids are life-saving medications in ACTH deficiency. Infertility requires LH and FSH injections to stimulate ovulation in women and sperm production in men. If this doesn’t help, assisted reproduction/IVF may be considered.

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