Hypopituitarism
Hypopituitarism is a rare disorder in which the pituitary gland does not produce an adequate supply of one or more pituitary hormone. Because the pituitary gland, located at the base of the brain, produces hormones that control the functions of many other organs and glands, inadequate hormone production can lead to serious loss of function in one or another system of the body.
Causes of Hypopituitarism
Hypopituitarism, though a rare condition, may have a wide variety of causes. It may be congenital, usually as a result of birth trauma. It may also be the consequence of a metabolic or immune disease, a complication after childbirth (Sheehan's syndrome), or may result from one of the following:
- Head trauma
- Brain tumor
- Brain surgery
- Brain infection
- Radiation
- Stroke
- Hemorrhage
Hypopituitarism may also be caused by a tumor of the pituitary gland. As a pituitary tumor increases in size, it can compress and damage pituitary tissue, and interfere with hormone production.
Symptoms of Hypopituitarism
Symptoms of hypopituitarism vary according to which hormone production is negatively impacted. If the production of growth hormone is diminished, tissue and bone growth will be affected.
If the production of oxytocin or prolactin is lessened, breast development, milk production, or uterine contractions during childbirth may be abnormal. If ACTH (adrenocorticotropic hormone) or thyroid stimulating hormone (TSH) aren't produced in proper quantities, metabolism and blood pressure will suffer. If the production of luteinizing hormone or follicle stimulating hormone (FSH) is affected, sexual function and fertility may be disturbed. While any of the following symptoms may be attributable to other conditions, signs of possible hypopituitarism may include:
- Loss of appetite or weight loss
- Fatigue or weakness
- Headache
- Facial swelling
- Voice changes
- Absence of menses (amenorrhea)
- Failure to produce breast milk
- Decreased sex drive
- Erectile dysfunction
- Infertility
- Abdominal pain
- Hair loss
- Low blood pressure
- Slow bone growth (during childhood)
- Visual difficulties
- Joint stiffness
These symptoms may change fluctuate over a period of time.
Diagnosis of Hypopituitarism
In order to diagnose hypopituitarism, a medical history must be taken and a comprehensive physical examination and blood tests must be administered. Other causes of problems with various glands and organs must be ruled out and levels of various hormones must be checked. If the condition seems to be present in a child, X-rays of the hand will be taken to determine whether bone growth is abnormal. Imaging tests, such as magnetic resonance imaging (MRI) or computerized tomography (CT scan) of the pituitary gland are also part of the diagnostic process.
Treatment of Hypopituitarism
Hypopituitarism is treated by administering the hormones which are being underproduced. Once hormone levels are checked and recorded, patients may be prescribed growth hormones, thyroid hormones, cortisol, testosterone or estrogen to bring their functioning back to normal and to relieve symptoms. In some cases, the medication prescribed may resolve fertility issues. When the hormonal lack is due to a tumor in the pituitary gland itself, surgery and radiation therapy may be necessary to remove abnormal tissue. Normally, such surgery is performed through the nose and sinus cavities, but in some cases a craniotomy, involving surgery through the skull, may be required.
Complications of Hypopituitarism
The most serious complication of hypopituitarism results when it is caused by a tumor and the tumor exerts pressure on the optic nerve. While surgery to excise the tumor is usually successful, there is some danger that the tumor, or the surgery to remove it, will result in blindness. Other complications usually involve the inability to restore the patient's proper hormonal balance. In such cases, hormone replacement will have to be ongoing. There is no reason, however, that a patient can't lead a normal life and have a normal life span when taking prescribed hormones long-term.