What is hypopituitarism?

Hypopituitarism, also called an underactive pituitary gland, is a condition that affects the anterior lobe of the pituitary gland--usually resulting in a partial or complete loss of functioning of that lobe. The resulting symptoms depend on which hormones are no longer being produced by the gland. Because the pituitary gland affects the other endocrine organs, effects of hypopituitarism may be gradual or sudden and dramatic.

What are the symptoms of hypopituitarism?

Symptoms vary depending on what hormones are insufficiently produced by the pituitary gland. The following are common symptoms associated with reduced production of certain hormones:

Insufficient gonadotropins production
(luteinizing hormone and follicle-stimulating hormone)

In premenopausal women, this leads to absent menstrual cycles, infertility, vaginal dryness, and loss of some female characteristics. In men, this deficiency leads to impotence, shriveling of testes, decreased sperm production, infertility, erectile dysfunction, and loss of some male characteristics.

Insufficient growth hormone production

This usually produces no symptoms in adults. However, it can cause loss of bone density and loss of muscle mass in adults. In children, this deficiency can lead to stunted growth and dwarfism.

Insufficient thyroid-stimulating hormone production

This usually leads to an underactive thyroid and may cause confusion, cold intolerance, weight gain, constipation, and dry skin.

Insufficient adrenocorticotropin hormone production

This rare deficiency leads to an underactive adrenal gland, resulting in low blood pressure, a low blood sugar level, fatigue, and a low tolerance for stress.

Insufficient prolactin production

This rare deficiency may cause an inability to produce breast milk after childbirth in some women.

The symptoms of hypopituitarism may resemble other conditions or medical problems. Always consult your doctor for a diagnosis.

What causes hypopituitarism?

Causes of hypopituitarism can directly affect the pituitary gland, or indirectly affect the gland through changes in the hypothalamus.

Causes of primary hypopituitarism (directly affecting pituitary gland)

Causes of secondary hypopituitarism (affecting the hypothalamus)

  • Pituitary tumors

  • Inadequate blood supply to pituitary gland (stroke)

  • Infections and/or inflammatory diseases

  • Sarcoidosis. A rare inflammation of the lymph nodes and other tissues throughout the body

  • Amyloidosis. A rare disease which causes the buildup of amyloid, a protein and starch, in tissues and organs

  • Radiation therapy

  • Surgical removal of pituitary tissue

  • Autoimmune diseases

  • Head trauma

  • Genetic diseases

  • Tumors of the hypothalamus

  • Inflammatory disease or a disease that spreads, such as cancer 

  • Head injuries

  • Surgical damage to the hypothalamus and/or blood vessels or nerves leading to it

How is hypopituitarism diagnosed?

Symptoms of several underactive glands may help a doctor diagnose hypopituitarism. In addition to a complete medical history and medical examination, diagnostic procedures for hypopituitarism may include:

  • Computed tomography (CT or CAT scan). A noninvasive diagnostic procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images of the body to detect any abnormalities that may not show up on an ordinary X-ray.

  • Magnetic resonance imaging (MRI). A noninvasive procedure that produces two-dimensional views of an internal organ or structure.

  • Blood and urine tests. These tests will measure various hormone levels.

What is the treatment for hypopituitarism?

Treatment of hypopituitarism depends on its cause. The goal of treatment is to restore the pituitary gland to normal function when possible, or to replace or substitute for inadequate hormones when necessary.

Treatment may include replacement hormone therapy, surgical tumor removal, and/or radiation therapy.