Treatment for Sheehan's syndrome is lifelong hormone replacement therapy. Your doctor may recommend one or more of the following medications:
Corticosteroids. These drugs, such as hydrocortisone or prednisone, replace the adrenal hormones that aren't being produced because of an adrenocorticotropic hormone (ACTH) deficiency.
You'll need to adjust your medication if you become seriously ill or experience major physical stress. During these times, your body would ordinarily produce extra cortisol — a stress hormone. The same kind of dosage fine-tuning may be necessary when you have the flu, diarrhea or vomiting, or have surgery or dental procedures.
Adjustments in dosage may also be necessary during pregnancy or with marked weight gain or weight loss. Avoiding doses higher than you need will eliminate the side effects associated with high doses of corticosteroids.
Levothyroxine (Levoxyl, Synthroid, others). This medication boosts deficient thyroid hormone levels caused by low or deficient thyroid-stimulating hormone (TSH) production.
If you change brands, let your doctor know to ensure you're still receiving the right dosage. Also, don't skip doses or stop taking the drug because you're feeling better. If you do, signs and symptoms will gradually return.
Estrogen. This may include estrogen alone if you've had your uterus removed (hysterectomy) or a combination of estrogen and progesterone if you still have your uterus.
Estrogen use has been linked to an increased risk of blood clots and stroke in women who still make their own estrogen. The risk should be less in women who are replacing missing estrogen. And while estrogen replacement is available in either pills or patches, the patches seem to have a lower risk of side effects.
Future pregnancies may be possible with preparations containing luteinizing hormone (LH) and follicle-stimulating hormone (FSH), also called gonadotropins. These can be administered by injection to stimulate ovulation. After age 50, which is around the time of natural menopause, discuss the risks and benefits of continuing to take estrogen or estrogen and progesterone with your doctor.
- Growth hormone. Some studies have shown that replacing growth hormone in women with Sheehan's syndrome — as well as in people with other forms of hypopituitarism — can help normalize the body's muscle-to-fat ratio, lower cholesterol levels and improve overall quality of life. Side effects may include joint stiffness and fluid retention.
Your endocrinologist is likely to test your blood regularly to make sure that you're getting adequate — but not excessive — amounts of any hormones that you take. Generally, hormone levels are checked every few months at the beginning of treatment and then once a year thereafter.
Jan. 02, 2014
- DeCherney AH, et al. Current Diagnosis & Treatment Obstetrics & Gynecology. 11th ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=788. Accessed Oct. 1, 2013.
- Kristjansdottir HL, et al. Sheehan's syndrome in modern times: A nationwide retrospective study in Iceland. European Journal of Endocrinology. 2011;164:348.
- Jain D. A ray of hope for a woman with Sheehan's syndrome. BMJ Case Reports. 2013;Feb.4:1.
- Tessnow AH, et al. The changing face of Sheehan's syndrome. The American Journal of the Medical Sciences. 2010;340:402.
- Generalized hypopituitarism. The Merck Manuals: The Merck Manual for Health Care Professionals. http://www.merckmanuals.com/professional/endocrine_and_metabolic_disorders/pituitary_disorders/generalized_hypopituitarism.html. Accessed Oct. 1, 2013.
- Nieman LK. Clinical manifestations of adrenal insufficiency in adults. http://www.uptodate.com/home. Accessed Oct. 1, 2013.
- Pituitary disorders overview. The Hormone Foundation. http://www.hormone.org/Pituitary/overview.cfm . Accessed Oct. 1, 2013.
- Lockwood CJ. Overview of postpartum hemorrhage. http://www.uptodate.com/home. Accessed Oct. 1, 2013.
- Snyder PJ. Treatment of hypopituitarism. http://www.uptodate.com/home. Accessed Oct. 1, 2013.
- Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. Oct.14, 2013.
- Warren MP. Appropriate use of estrogen replacement therapy in adolescents and young adults with Turner syndrome and hypopituitarism in light of the Women's Health Initiative. Growth Hormone & IGF Research. 2006;16:S98.
- Birth control methods fact sheet. WomensHealth.gov. http://www.womenshealth.gov/publications/our-publications/fact-sheet/birth-control-methods.cfm#h. Accessed Oct. 2, 2013.
- Growth hormone: Use and abuse. The Hormone Foundation. http://www.hormone.org/search-page?q=gorwth+hormone. Accessed Oct. 2, 2013.
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