Sheehan's syndrome

Medical condition

Sheehan's syndrome, also known as postpartum pituitary gland necrosis, occurs when the pituitary gland is damaged due to significant blood loss and hypovolemic shock usually during or after childbirth leading to decreased functioning of the pituitary gland (hypopituitarism). Classically, the patient is unable to breastfeed their baby, due to failure of the pituitary to secrete the hormone prolactin, and also has no more periods, because FSH and LH are not secreted. Unlike postmenopausal women, patients with Sheehan's syndrome do not experience hot flashes, because the pituitary fails to secrete FSH. These symptoms of Sheehan's syndrome are attributed to the pituitary failing to secrete 3-5 of the 9 hormones that it normally produces (the anterior pituitary produces FSH, LH, prolactin, ACTH ,TSH and GH ; the posterior pituitary produces ADH and Oxytocin, i.e. the pituitary is involved in the regulation of various other hormones. This gland is located on the undersurface of the brain, the shape of a cherry and the size of a chickpea and sits in a pit or depression of the sphenoid bone known as the sella turcica. The pituitary gland works in conjunction with the hypothalamus, and other endocrine organs to modulate numerous bodily functions including growth, metabolism, menstruation, lactation, and even the "fight-or-flight" response. These endocrine organs release hormones in very specific pathways, known as hormonal axes. For example, the release of a hormone in the hypothalamus will target the pituitary to trigger the release of a subsequent hormone, and the pituitary's released hormone will target the next organ in the pathway. Hence, damage to the pituitary gland can have downstream effects on any of the aforementioned bodily functions.

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