User:Mr. Ibrahem/Sheehan's syndrome

Sheehan's disease
Other names	Simmond's syndrome, postpartum hypopituitarism, postpartum pituitary gland necrosis
Video explanation
Symptoms	Lack of breast milk, sexual dysfunction, menstrual abnormalities, hypothyroidism, adrenal insufficiency
Usual onset	Often over years
Types	Acute, chronic
Causes	Bleeding after childbirth
Diagnostic method	Based on symptoms and history, confirmed by blood tests
Differential diagnosis	Pituitary apoplexy, Addison syndrome, lymphocytic hypophysitis
Treatment	Hormone replacement therapy
Frequency	Rare (developed world), relatively common (developing world)

Sheehan's syndrome, also known as postpartum pituitary necrosis, is damage to the pituitary gland as a result of low blood pressure from bleeding. The initial symptom is often a lack of breast milk production. Other symptoms may include sexual dysfunction, menstrual abnormalities, low thyroid (tiredness, constipation, and loss of pubic hair), and adrenal insufficiency (weight loss, low blood sugar, and low blood sodium). Rarely diabetes insipidus may occur. Symptoms may not develop until months or years after the evident.

Often the term is used to only refers to cases due to bleeding after childbirth, though less commonly some include those due to bleeding from trauma. The pituitary is at particular risk when enlarged from pregnancy. Other factors that may play a role include vasospasm and blood clotting. Diagnosis is generally suspected based on symptoms and history and confirmed by blood tests or MRI.

Prevention is with good obstetrical care. Treatment is with hormone replacement therapy. Low thyroid can be treated with levothyroxine. Adrenal insufficiency can be treated with prednisone or hydrocortisone. Gonadotropin deficiency can be treated with estrogen and possibly progesterone.

While rare in developed countries, it remains relatively common in the developing world. In Kashmir, India about 3% of women over the age of 20 who have had children are affected. Outcomes can be poor if the diagnosis is not made in a timely manner. It was first described in 1937 by Harold Sheehan.