Sheehan syndrome

Sheehan syndrome, also known as Simmonds' syndrome or postpartum hypopituitarism or postpartum pituitary necrosis, is hypopituitarism(decreased functioning of the pituitary gland), caused by necrosis due to blood loss and hypovolemic shock during and after childbirth. Pituitary damage unrelated to pregnancy is called Simmonds' disease.


features

• Most common initial symptoms of Sheehan's syndrome are agalactorrhea (absence of lactation) and/or difficulties with lactation.^[2] 
• Many women also report amenorrhea or oligomenorrhea after delivery.^[2] 

• In some cases, a woman with Sheehan syndrome might be relatively asymptomatic, and the diagnosis is not made until years later, with features of hypopituitarism.^[2]

• Such features include secondary hypothyroidism with tiredness, intolerance to cold, constipation, weight gain, hair loss and slowed thinking, as well as a slowed heart rate and low blood pressure.

• Another such feature is secondary adrenal insufficiency, which, in the rather chronic case is similar to Addison's disease with symptoms including fatigue, weight loss,hypoglycemia (low blood sugar levels), anemia and hyponatremia (low sodium levels). 

• Such a woman may, however, become acutely exacerbated when her body is stressed by, for example, a severe infection or surgery years after her delivery, a condition equivalent with an Addisonian crisis.^[2] 

• Gonadotropin deficiency will often cause amenorrhea, oligomenorrhea, hot flushes, or decreased libido.^[2] Growth hormone deficiency causes many vague symptoms including fatigue and decreased muscle mass.