What is hypopituitarism?

Hypopituitarism happens when your pituitary gland is not active enough. The front lobe of the gland may only partly work. Or it may not work at all. As a result the gland does not make enough hormones.

What causes hypopituitarism?

Causes of hypopituitarism can directly affect the pituitary gland. Or they can indirectly affect the gland through changes in the hypothalamus. Direct causes are:

• Pituitary tumors
• Poor blood supply to the pituitary gland
• Infections or inflammatory diseases
• Sarcoidosis, a rare inflammation of the lymph nodes and other tissues throughout the body
• Amyloidosis, a rare disease that causes a buildup of protein and starch (amyloid) in tissues and organs
• Radiation therapy
• Surgery to remove pituitary tissue
• Autoimmune diseases
• Head trauma
• Genetic diseases

Indirect causes are:

• Tumors of the hypothalamus
• Inflammatory disease or a disease that spreads, such as cancer 
• Head injuries
• Surgical damage to the hypothalamus or blood vessels or nerves leading to it

What are the symptoms of hypopituitarism?

Symptoms are different for each person. They may happen over time or right away. They depend on which hormones the pituitary gland is not making enough of. These hormone deficiencies, and the symptoms they cause, include:

• Not enough gonadotropins (luteinizing hormone and follicle-stimulating hormone). This affects men and women who have not gone through menopause. Women may not have a menstrual period. They may have problems with fertility, vaginal dryness, and loss of some female traits. Men may have problems with fertility, sexual function, and loss of some male traits. Children will not go through puberty.

• Not enough growth hormone. Adults with this problem may lose bone and muscle mass. In children, it can lead to stunted growth and dwarfism.

• Not enough thyroid-stimulating hormone. This often leads to an underactive thyroid. It may cause lack of energy (fatigue), confusion, problems with cold temperatures, weight gain, constipation, and dry skin.

• Not enough ACTH (adrenocorticotropin hormone). This is rare. Your pituitary gland may not secrete ACTH if you have been taking adrenal steroid hormones and stop taking them suddenly. It leads to an underactive adrenal gland. You may have low blood pressure, low blood sugar, feel tired, and be easily stressed.

• Not enough prolactin. This is rare. Women who lack this hormone may not be able to make breastmilk after childbirth.

• Not enough antidiuretic hormone (also called vasopressin). This leads to increased urine output and thirst.

These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.

How is hypopituitarism diagnosed?

Your health care provider will ask about your past health. You will also need an exam. Other tests you may need:

• CT scan. This test uses X-rays and computer technology to make images of your body.
• MRI. This test makes 2-dimensional views of your organs or body structures.
• Blood and urine tests. These tests measure levels of hormones in your body.

How is hypopituitarism treated?

Your health care provider will figure out the best treatment for you based on:

• How old you are
• Your overall health and past health
• How sick you are
• How well you can handle specific medicines, procedures, or therapies
• How long the condition is expected to last
• Your opinion or preference

Treatment of hypopituitarism depends on what is causing it. The goal of treatment is have the pituitary gland work as it should. Treatment may include:

• Hormone replacement therapy
• Surgery to remove a tumor
• Radiation therapy

When should I call my health care provider?

Tell your health care provider if your symptoms get worse or you have new symptoms.

Key points about hypopituitarism

• Hypopituitarism happens when the pituitary gland is not active enough. It does not make enough hormones.
• Hypopituitarism can directly affect the pituitary gland. Or it can indirectly affect the gland through changes in the hypothalamus.
• Symptoms depend on which hormones the pituitary gland is not making enough of.
• The goal of treatment is to return the pituitary gland to normal function. Treatment may include hormone replacement therapy, surgery to remove a tumor, or radiation therapy.

Next steps

Tips to help you get the most from a visit to your health care provider:

• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.