Sheehan syndrome

Title

Other Names:

Postpartum hypopituitarism; Postpartum panhypopituitarism; Postpartum panhypopituitary syndrome; Postpartum hypopituitarism; Postpartum panhypopituitarism; Postpartum panhypopituitary syndrome; Postpartum pituitary necrosis; Simmond's disease See More

Categories:

Endocrine Diseases

Summary Summary

Sheehan syndrome affects the function of the pituitary gland. The pituitary gland makes hormones and regulates other glands and many body processes, including reproduction. The cause of Sheehan syndrome is severe blood loss during or after childbirth (postpartum hemorrhage). This leads to lack of blood flow to the front part of the pituitary gland, causing it to gradually stop functioning. The symptoms of Sheehan syndrome occur as a result of the low hormone levels. These may include an inability to produce breast milk, irregular or absent periods, hot flashes, and a decreased sex drive. Other symptoms may include fatigue, headaches, low blood pressure, and hair loss. Symptoms usually do not appear from months to years after the hemorrhage. In some cases, the symptoms occur immediately and may be more severe and sometimes life threatening. Sheehan syndrome is diagnosed based on the symptoms, clinical history and exam, laboratory testing, and imaging studies. Treatment includes hormone replacement therapy, and steroids to help manage early symptoms.^[1]^[2]^[3]^[4]

Last updated: 10/22/2020

Symptoms Symptoms

The following list includes the most common signs and symptoms in people with Sheehan syndrome. These features may be different from person to person. Some people may have more symptoms than others and symptoms can range from mild to severe. This list does not include every symptom or feature that has been described in this condition.

Symptoms of Sheehan syndrome may include:^[1]^[2]^[5]

Inability to produce breast milk
Fatigue
Dizziness
Irregular or absent menstrual periods (amenorrhea)
Hot flashes
Decreased libido
Loss of pubic and underarm hair
Low blood pressure (hypotension)
Slowed mental functioning
Weight gain or loss

In most cases, the symptoms of Sheehan syndrome do not appear until months or even years after severe blood loss after childbirth (postpartum hemorrhage). In rare cases, the symptoms of Sheehan syndrome occur within days and include an inability to produce breast milk, a drop in blood pressure, visual problems, and unconsciousness. These symptoms may be life threatening. In other cases, severe symptoms become apparent when the body is stressed by infection or surgery some period of time after delivery.^[1]^[2]

Last updated: 10/23/2020

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms	Other Names	Learn More: HPO ID
80%-99% of people have these symptoms
Adrenocorticotropic hormone deficiency		0011748
Adrenocorticotropin deficient adrenal insufficiency		0011735
Chronic fatigue	Chronic extreme exhaustion	0012432
Decreased circulating cortisol level	Low blood cortisol level	0008163
Oligomenorrhea	Light or infrequent menstrual periods	0000876
Panhypopituitarism		0000871
Secondary growth hormone deficiency		0008240
30%-79% of people have these symptoms
Abnormal size of pituitary gland		0012504
Amenorrhea	Abnormal absence of menstruation	0000141
Blurred vision		0000622
Breast hypoplasia	Underdeveloped breasts	0003187
Decreased female libido	Decreased female sex drive	0030018
Decreased serum estradiol		0008214
Dry skin		0000958
Dyspareunia		0030016
Gonadotropin deficiency		0008213
Hypoglycemia	Low blood sugar	0001943
Hyposthenuria		0003158
Impotence	Difficulty getting a full erection Difficulty getting an erection [ more ]	0000802
Nausea		0002018
Normochromic anemia		0001895
Orthostatic hypotension	Decrease in blood pressure upon standing up	0001278
Pallor		0000980
Pituitary hypothyroidism	Low thyroid gland function due to abnormal pituitary gland	0008245
Progressive visual field defects		0007987
Reduced circulating prolactin concentration		0008202
Sparse axillary hair	Limited armpit hair Little underarm hair [ more ]	0002215
Sparse pubic hair	Decreased sexual hair	0002225
5%-29% of people have these symptoms
Antinuclear antibody positivity		0003493
Arthralgia	Joint pain	0002829
Bradycardia	Slow heartbeats	0001662
Chills		0025143
Chronic lymphocytic meningitis		0007041
Constipation		0002019
Diplopia	Double vision	0000651
Hashimoto thyroiditis		0000872
Hyponatremia	Low blood sodium levels	0002902
Muscle weakness	Muscular weakness	0001324
Obesity	Having too much body fat	0001513
Palpitations	Missed heart beat Skipped heart beat [ more ]	0001962
Poor appetite	Decreased appetite	0004396
Sensorineural hearing impairment		0000407
Thunderclap headache		0030907
Vertigo	Dizzy spell	0002321
1%-4% of people have these symptoms
Central diabetes insipidus		0000863
Coma		0001259
Psychosis		0000709

Showing of 47 |

Do you have more information about symptoms of this disease? We want to hear from you.

Last updated: 2/1/2021

Cause Cause

Sheehan syndrome is caused by severe blood loss or extremely low blood pressure during or after childbirth. This leads to lack of blood flow to the front part of the pituitary gland, which enlarges during pregnancy. This damages the hormone-producing tissue so that the gland cannot function properly.^[1]^[4]

Last updated: 10/23/2020

Diagnosis Diagnosis

Diagnosis of Sheehan syndrome is based on the symptoms, a clinical exam, blood tests, and imaging studies. Criteria for diagnosis include a history of significant blood loss during or after childbirth, inability to produce breast milk, irregular or absent menstrual periods, and low or absent levels of pituitary hormones.^[1]^[3]

Because the symptoms of Sheehan syndrome may occur long after childbirth and are not specific to any disease, Sheehan syndrome is often difficult to diagnose.^[1]^[3]

Last updated: 10/23/2020

Treatment Treatment

Treatment of Sheehan syndrome involves replacement of the hormones produced by the pituitary gland. Hormone levels should be monitored on a regular basis and may need to be adjusted from time to time.^[1]^[5]

Specialists involved in the care of someone with Sheehan syndrome may include:^[1]

Obstetrician/gynecologist
Endocrinologist
Neurologist

Last updated: 10/23/2020

Statistics Statistics

It has been estimated that Sheehan syndrome may occur in five out of every 100,000 women who give birth. It is rare in developed countries, but may occur more often in developing countries.^[1]

Last updated: 10/23/2020

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Find a Specialist Find a Specialist

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources

The Pituitary Network Association provides a list of pituitary specialists.

Organizations Organizations

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

Adrenal Insufficiency United
Toll-free: 1-855-AIUnite (248-6483)
E-mail: contact@aiunited.org
Website: http://aiunited.org/
American Hair Loss Association
23679 Calabasas Road # 682
Calabasas, CA 91301-1502
E-mail: info-ahla@americanhairloss.org
Website: http://americanhairloss.org
Hormone Health Network
Toll-free: 1-800-HORMONE (1-800-467-6663)
E-mail: hormone@endocrine.org
Website: https://www.hormone.org
Pituitary Network Association
P.O. Box 1958
Thousand Oaks, CA 91358
Telephone: +1-805-499-9973
Fax: +1-805-480-0633
E-mail: info@pituitary.org
Website: https://pituitary.org/
The Pituitary Foundation
86 Colston Street
Bristol BS1 5BB
United Kingdom
Telephone: 0117 370 1320
E-mail: helpline@pituitary.org.uk
Website: https://www.pituitary.org.uk/

Do you know of an organization? We want to hear from you.

Learn More Learn More

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

Mayo Clinic has an information page on Sheehan syndrome.
MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
PubMed is a searchable database of medical literature and lists journal articles that discuss Sheehan syndrome. Click on the link to view a sample search on this topic.

Selected Full-Text Journal Articles

Schrager S, Sabo L. Sheehan Syndrome: A Rare Complication of Postpartum Hemorrhage. J Am Board Fam Med. 2001; 14(5):389-391.

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References References

Schury MP, Adigun R. Sheehan Syndrome. StatPearls. Updated Jul 17, 2020; https://pubmed.ncbi.nlm.nih.gov/29083621/.
Diri H, Karaca Z, Tanriverdi F, Unluhizarci K, Kelestimur F. Sheehan's syndrome: new insights into an old disease. Endocrine. Jan 2016; 51(1):22-31. https://pubmed.ncbi.nlm.nih.gov/26323346/.
Sheehan syndrome. Nat Rev Dis Primers. Dec 22, 2016; 2:16093. https://pubmed.ncbi.nlm.nih.gov/28004658/.
Chanson P. Other Pituitary Conditions and Pregnancy. Endocrinol Metab Clin North Am. Sep 2019; 48(3):583-603. https://pubmed.ncbi.nlm.nih.gov/31345525/.
Karaca Z, Laway BA, Dokmetas HS, Atmaca H, Kelestimur F. Sheehan syndrome. Nat Rev Dis Primers. Dec 22, 2016; 2:https://www.ncbi.nlm.nih.gov/pubmed/28004764.