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Treatments and drugs
By Mayo Clinic staffTreatment 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.
- Levothyroxine (Levoxyl, Synthroid, others). This medication boosts deficient thyroid hormone levels caused by low or deficient thyroid-stimulating hormone (TSH) production.
- 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 replacement can be administered with either pills or patches. If you've become infertile, preparations containing luteinizing hormone (LH) and follicle-stimulating hormone (FSH), also called gonadotropins, can be administered by injection to stimulate ovulation.
- 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 weight, lower cholesterol levels and improve overall quality of life.
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 weeks or months at the beginning of treatment and then once a year thereafter.
- Feinberg EC, et al. The incidence of Sheehan's syndrome after obstetric hemorrhage. Fertility and Sterility. 2005;84(4):975-979.
- Soares DV, et al. Clinical, laboratory and therapeutics aspects of Sheehan's syndrome. Arquivos Brasileiros de Endocrinologia e Metabologia. 2008;52(5):872-878.
- Dokmetas HS, et al. Characteristic features of 20 patients with Sheehan's syndrome. Gynecological Endocrinology: The Official Journal of the International Society of Gynecological Endocrinology. 2006;22(5):279-283.
- Schrager S, et al. Sheehan syndrome: A rare complication of postpartum hemorrhage. The Journal of the American Board of Family Practice. 2001;14(5):389-391.
- Sert M, et al. Clinical report of 28 Patients with Sheehan's syndrome. Endocrine Journal. 2003;50(3):297-301.
- Pham PC, et al. Sodium and water disturbances in patients with
- Sheehan's syndrome. American Journal of Kidney Diseases. 2001;38(3):E14.
- Kelestimur F, et al. Sheehan's syndrome: Baseline characteristics and effect of 2 years of growth hormone replacement therapy in 91 patients in KIMS-Pfizer International Metabolic Database. European Journal of Endocrinology. 2005;152(4):581-587.
- The Pituitary Gland. In: Ganong WF. Review of Medical Physiology. 22nd edition. The McGraw-Hill Companies Inc.; 2005. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=11. Accessed Nov. 28, 2008.
