• Shruti GOCHHWAL

Women, Here’s Why You Should Know About Sheehan Syndrome

Sheehan syndrome is a rare condition that occurs due to a large amount of blood loss during childbirth or due to low blood pressure during or after delivery. The low blood pressure brings down the oxygen levels in the body, which may cause damage to the pituitary gland. This condition was first described by the British pathologist Harold Learning Sheehan in 1937.

What Causes Sheehan Syndrome?

Sheehan’s syndrome

Pregnancy enlarges Pituitary gland, Credits: pixabay


The increased amount of estrogen during pregnancy may slightly enlarge the pituitary gland. In such a case, if severe blood loss or oxygen deficiency occurs, it can cause damage to the pituitary gland and its hormone production and regulation abilities.

The pituitary hormones that become affected by Sheehan’s Syndrome include:

  1. Thyroid-stimulating hormone (TSH): It is responsible for regulating metabolism. Doctors often diagnose patients with hypothyroidism (shortage of TSH) if the medical history of the patient during childbirth is unknown to them.

  2. Follicle-stimulating hormone (FSH): It helps regulate the menstrual cycle and ovulation. It works together with the LH.

  3. Luteinizing hormone (LH): It helps in estrogen regulation.

  4. Prolactin: It helps in the production of breast milk.

  5. Adrenocorticotropic hormone (ACTH): It helps the adrenal gland stimulate hormones like cortisol. Cortisol is necessary to help the body deal with stress. It influences other bodily functions like blood pressure, of the heart, and the immune system.

  6. Growth Hormone (GH): It controls and maintains organ and tissue growth.

There are various reasons why excessive blood loss could occur during childbirth:

  1. High blood pressure during pregnancy (preeclampsia)

  2. Placenta detached from the unborn baby (placental abruption)

  3. Giving birth to a large baby or multiple babies, like twins

  4. When the placenta partly or completely obstructs the cervix (placenta previa)

Symptoms

Mom bottle feeding the child

Difficulty with breastfeeding, Credits: pixabay


Sheehan’s syndrome can show its symptoms immediately after childbirth or after a few months to a few years. The earliest sign of this syndrome is the inability to breastfeed.

Other symptoms, caused as a result of low hormone release from the pituitary glands, are:

  1. Difficulty or inability to breastfeed

  2. Irregular or no menstruation

  3. Slow mental function

  4. Weight gain

  5. Fatigue

  6. Low blood pressure

  7. Low blood sugar

  8. Inability to re-grow shaved pubic hair

  9. Decreased sex drive

  10. Difficulty staying warm

  11. Irregular heartbeat

A woman may not show any symptoms at all due to minimum or little damage to the pituitary gland. But after a few years, some stressful situations may trigger an adrenal crisis which disables the body to produce the required amount of cortisol to help cope up with the stressful situation. It may result in Sheehan’s syndrome by damaging the pituitary gland.

Diagnosis and Treatment

Sheehan’s syndrome diagnosis

Diagnosis of Sheehan syndrome, Credits: pixabay


Any difficulties faced during or after childbirth should be immediately brought to the notice of your medical practitioner. It can help them diagnose the condition better. Excessive blood loss and difficulty in breastfeeding are some conditions that need to be mentioned.

Blood tests, MRIs and CT scans are recommended to test the levels of hormones produced by the pituitary gland and imaging can help detect any damage or presence of a tumour.

If Sheehan syndrome is diagnosed, the treatment will mainly include hormone therapy for the rest of a girl’s life. A woman will be given corticosteroids to replace the adrenal hormones, LH and FSH to regulate the menstrual cycle and help with ovulation, levothyroxine to increase hormones produced by the thyroid gland, and growth hormone to maintain muscle-fat ratio and lower cholesterol.

Sheehan syndrome cannot be prevented. A woman diagnosed with it will have to ensure that treatment is carried out correctly. Many women do not give details of complications during childbirth for which doctors rule it out as hypothyroidism or other similar medical conditions. This makes it crucial to mention your medical history properly to get treated better.

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