It may be the size of a pea, but the pituitary gland is responsible for producing a variety of hormones essential for the body to function. This “master gland” is responsible for a range of processes that regulate blood pressure, reproduction, metabolism, and other vital functions. Hypopituitarism is a condition in which the pituitary gland functions improperly, producing too little of one or more hormones. In some cases, it may completely fail to produce a specific hormone.
The pituitary gland is located behind the bridge of the nose, in a hollow bony area at the base of the brain. It is an essential part of the endocrine system, a network of glands the produces and secretes hormones for many reactions from respiratory function to sensory perception. The pituitary gland has two areas that produce different hormones. The anterior pituitary connects to the brain through blood vessels, and the posterior pituitary, which is a part of the brain, secretes hormones into the bloodstream. The hypothalamus controls the pituitary gland and is located just above it.
Hypopituitarism is considered a progressive disorder, meaning the symptoms appear suddenly in most cases, but develop at a slower pace. Because the pituitary gland controls a variety of hormones in the body, the symptoms of this rare condition are numerous and varied, depending on which hormone is affected. Weakness and fatigue are common symptoms. Weight loss, decreased sex drive, anemia, hot flashes, stomach pain, and facial puffiness may also occur. Pituitary dysfunction can also cause cognitive issues and depression. Men may experience hair loss or impotence.
Inflammation of the pituitary can lead to its failure to produce hormones. Severe head trauma may also lead to a pituitary gland issue. However, the primary cause of this rare disorder is a tumor called an adenoma. In most cases, these growths are not malignant. Despite the tumor being benign, it continues to grow, putting pressure on the gland and preventing it from producing the hormones needed for the body’s processes. It can also cause an overproduction of hormones. Other types of tumors may invade the tissue around the pituitary gland, and there are additional causes of hypopituitarism.
Women who have experienced a severe uterine hemorrhage during childbirth, often those having multiple births can develop Sheehan’s syndrome. Also known as postpartum hypopituitarism, the condition develops when large amounts of blood are lost, causing the pituitary gland tissues to die. Without blood, the pituitary is unable to function as it should, leading to lactation and breastfeeding difficulties. Sheehan's syndrome can also cause low blood pressure, irregular heartbeat, dizziness, and hypoglycemia.
This disorder also causes hypopituitarism in pregnant women and is due to immune cells that cause inflammation in the pituitary. The condition generally occurs in late pregnancy or during the postpartum period, but it can also happen after menopause and in pre-puberty. Men can also develop with the condition. The reason lymphocytic hypophysitis occurs is unknown, but experts believe lymphocytes -- a type of white blood cell -- infiltrate the pituitary gland, causing it to enlarge and interfering with its function. Lymphocytic hypophysitis is more common than Sheehan’s syndrome, due to better obstetrics care in modern-day medical facilities.
At the base of the brain, there is a depression in the sphenoid bone called the sella turcica. This is where the pituitary gland resides. Sometimes, however, an anatomical abnormality causes pressure to build up inside the sella turcica and flatten the pituitary gland. That is the primary form of empty sella syndrome. In the secondary form, the pituitary gland is no longer inside the sella turcica, due to an injury, surgery, or radiation treatments. The condition can cause infertility, fatigue, lack of stress tolerance, and infection.
This congenital disorder occurs due to a non-cancerous tumor or cyst putting pressure on the hypothalamus. Craniopharyngioma can cause vision problems and headaches, and can also affect sleep, hunger, and thirst patterns. In children, the tumors tend to grow more quickly than those affecting adults. Children between five and ten years of age are most likely to develop craniopharyngioma. The condition can impair growth hormone (HGH) production in both children and adults, and in children, it may impede the hormones that control the onset of puberty.
Osteoporosis causes bones to lose mass and become brittle or fragile. People diagnosed with hypopituitarism have a higher chance of developing this form of arthritis and face an increased risk of fractures resulting from even minor injuries. It is important to increase vitamin D and calcium intake, and establish a routine of weight-bearing exercises. Both men and women can develop osteoporosis, though it is more common in women who have reached menopause and are above 50 years old.
Depending on the cause of hypopituitarism and which hormones are deficient, treatment varies. However, in most cases, doctors begin by restoring the hormone levels through medication. If hypopituitarism has an underlying cause, symptoms generally recede once treatment has addressed the condition. Hormone replacement is a safe and effective option for most people. If a tumor is causing the hormone issues, surgery and radiation treatments can help, but there is the possibility of the tumor growing back.
Most people diagnosed with hypopituitarism will likely require treatment for the rest of their lives. Some may experience a level of impairment, while others can have a normal quality of life with a healthy diet that controls weight, and efforts to maintain physical activity. Most people require regular medical checkups due to the higher risk of heart disease and strokes.
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