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Sheehan Syndrome: Symptoms, Causes and Treatment
Written by Medicover Team and Medically Reviewed by Dr Kandala Sindhuja Reddy , Endocrinologist
Sheehan Syndrome is a rare condition that happens when the pituitary gland is damaged due to severe blood loss during or after childbirth. This damage leads to low hormone levels, which can cause symptoms like extreme tiredness, missed periods, difficulty breastfeeding, and low blood pressure.
Over time, it may affect a woman's ability to carry out daily tasks unless treated with hormone replacement therapy.
What is Sheehan Syndrome?
Sheehan Syndrome is a rare hormonal condition that occurs when the pituitary gland, a small gland at the base of the brain, gets damaged due to severe blood loss or low blood pressure during or after childbirth.
This damage stops the gland from producing important hormones the body needs, leading to a wide range of symptoms. The effects can appear right after delivery or even years later, making it a condition that is often missed or misdiagnosed.
What are the Causes of Sheehan Syndrome?
The main cause of Sheehan Syndrome is heavy bleeding during childbirth (postpartum hemorrhage) or a sharp drop in blood pressure, both of which reduce blood flow to the pituitary gland.
This lack of blood causes part or all of the gland to die, leading to reduced hormone production.
Other factors that may increase the risk include
- Delayed treatment of childbirth-related bleeding Complicated or prolonged labor.
- Delivery in areas with limited access to emergency care Severe infections or shock after childbirth.
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Get Second OpinionWhat Are the Risk Factors of Sheehan Syndrome?
Women may be at higher risk for Sheehan Syndrome if they experience:
- Excessive blood loss during or after delivery Placental complications like placenta previa or abruption.
- Multiple childbirths (twins or more).
- Home births without proper medical support.
- Pre-existing anemia, which reduces the body's ability to cope with blood loss.
What Are the Symptoms of Sheehan Syndrome?
Symptoms depend on how much of the pituitary gland is affected and which hormones are lacking. Some signs appear soon after childbirth, while others develop slowly over months or years.
Common symptoms include
- Extreme fatigue or feeling unusually weak
- Inability to produce breast milk (lactation failure)
- Loss of menstrual periods or failure to resume menstruation after delivery
- Weight loss or trouble gaining weight
- Low blood pressure and dizziness
- Cold intolerance, even in warm weather
- Dry skin, hair thinning, and depression
Some women may not recognise the symptoms until they are severe or triggered by stress or illness.
How is Sheehan Syndrome Diagnosed?
Diagnosing Sheehan Syndrome can be tricky because symptoms often appear slowly and may resemble other conditions like depression or thyroid disorders.
However, proper testing can reveal the underlying problem:
- Hormone blood tests: These check levels of cortisol, thyroid hormones, prolactin test, estrogen, and others controlled by the pituitary.
- Stimulation tests: These help assess how the pituitary responds to hormone signals (e.g., ACTH stimulation test).
- MRI of the brain: This can show shrinkage (empty sella) or damage to the pituitary gland.
- Patient history: Doctors consider past childbirth complications, especially heavy postpartum bleeding.
What Treatment Involve for a Syndrome Diagnosis?
There is no way to reverse the pituitary damage, but symptoms can be managed very effectively through lifelong hormone replacement therapy:
- Corticosteroids (e.g., hydrocortisone) to replace adrenal hormones
- Thyroid hormone (levothyroxine) to regulate metabolism, Estrogen and progesterone for menstrual cycles and fertility
- Growth hormone in rare cases, if needed
- Calcium and vitamin D supplements, if bone health is affected
Treatment is usually lifelong and must be carefully monitored to ensure hormone levels remain balanced.
Can Sheehan Syndrome Lead to Complications?
If not treated, Sheehan Syndrome can lead to serious and even life-threatening health problems, including:
- Adrenal crisis: A sudden drop in cortisol can cause severe low blood pressure, confusion, or collapse, especially during stress or illness.
- Chronic fatigue and weakness: Due to low thyroid and adrenal hormone levels.
- Low blood sugar and sodium: Hormone imbalances can affect fluid and glucose balance.
- Infertility or irregular menstrual cycles: From low estrogen levels.
- Mental health effects: Depression, poor concentration, and emotional instability.
- Inability to breastfeed: Due to a lack of prolactin production.
Early detection and hormone therapy can prevent most complications and allow women to live normal, healthy lives.
When Should You See a Doctor?
If you've had heavy bleeding during or after childbirth and notice symptoms like extreme fatigue, missed periods, trouble breastfeeding, dizziness, or feeling unusually cold, it's important to see a doctor.
These may be signs of Sheehan Syndrome. Early diagnosis and treatment can prevent serious complications and help you feel better faster.
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What's the Outlook for Women With Sheehan Syndrome?
With the right hormone therapy, most women experience significant improvement in energy, mood, and daily function. Early diagnosis and treatment are key to avoiding complications and maintaining long-term health.
Most patients will need lifelong hormone replacement, but can lead full and productive lives with medical guidance.
| Aspect | Details |
|---|---|
| What is it? | A condition where the pituitary gland is damaged due to severe blood loss during or after childbirth. |
| Main Cause | Postpartum hemorrhage (severe bleeding after delivery) |
| Affected Area | Pituitary gland (base of the brain) |
| Key Symptoms | Fatigue, inability to produce breast milk, absent periods, low blood pressure |
| Risk Factors | Complicated delivery, multiple births, poor access to emergency care, severe anemia |
| Diagnosis | Blood hormone tests, MRI brain scan, pituitary stimulation tests |
| Treatment | Lifelong hormone replacement therapy (thyroid, adrenal, sex hormones) |
| Complications | Adrenal crisis, infertility, severe fatigue, low blood sugar, depression |
| Prognosis | Good with early detection and proper hormone therapy |
Our Experience in Treating Sheehan Syndrome
At Medicover Hospitals, we help diagnose and treat rare conditions like Sheehan Syndrome. Our team of specialists works together to find and manage postpartum problems early and effectively. We use advanced diagnostics, compassionate care, and personalised treatment plans to help women regain their strength and hormonal balance.
