Sheehan syndrome is a very rare disorder that affects some women who lose massive amounts of blood while giving birth. Problems occur when blood pressure drops very low and blood supply to the brain is limited. When the pituitary gland at the base of the brain does not receive enough new blood, it quickly and permanently stops functioning. As a result, women who experience Sheehan syndrome may have major hormone deficiencies that prevent them from producing breast milk, having menstrual periods, or maintaining normal blood pressure. Most sufferers need to take hormone replacement drugs for the rest of their lives to avoid serious complications.
Doctors believe the pituitary gland is especially susceptible to problems during pregnancy because it becomes enlarged and requires a sizable, steady blood supply. Major hemorrhaging during childbirth robs the gland of precious oxygen and nutrients, causing it to atrophy. The damaged gland may stop producing adequate levels of prolactin, thyroid-stimulating hormone, adrenal hormones, or other important chemical signals.
Many patients begin to experience symptoms in the first few days after giving birth, though the severity of complications can vary depending on which hormones are involved. If the prolactin supply is depleted, a woman cannot start to make breast milk. Deficiencies in other hormones might prevent her from having regular periods and growing hair in the pubic region, underarms, and elsewhere on her body. More serious symptoms can develop several months or even years later, such as chronic fatigue, low blood pressure, cognitive deficits, depression, and joint pains. Very rarely, a lack of adrenal hormones can cause a sudden circulatory system crash that may lead to a coma or result in death.
Most cases of Sheehan syndrome can be diagnosed based on facts about the delivery and the patient's symptoms. Imaging scans may be taken of the pituitary gland to confirm that it is scarred and to rule out other potential causes of symptoms, such as tumors. Blood tests are performed to determine which hormones have been depleted and to what degree.
The standard treatment for Sheehan syndrome is lifelong hormone replacement therapy. A patient may be given drugs to take at home or be scheduled for regular clinical visits at a doctor's office to receive hormone injections. When women are careful to stick with their treatment plans, they can usually avoid all potential health problems related to their conditions.
Fortunately for women who live in developed countries, the risk of experiencing Sheehan syndrome is very low. Modern medical facilities and advances in pre- and postnatal care have all but eliminated the problem in most areas. Doctors can assess patients' risks of heavy bleeding before they even give birth and take steps to avoid hemorrhaging during delivery with drugs and clinical techniques.