The Neuroendocrine & Pituitary Tumor Clinical Center at Massachusetts General Hospital provides multidisciplinary care and specializes in the diagnosis, evaluation and treatment of pituitary tumors and disorders of the hypothalamus and pituitary.Schedule an appointment or referral
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The Neuroendocrine Surgical Service at Massachusetts General Hospital evaluates, treats and manages care for patients with pituitary and hypothalamic tumors and other complex disorders. Treatment for adenomas sometimes includes transsphenoidal surgery.Request an appointment
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What is hypopituitarism?
Hypopituitarism happens when your pituitary gland is not active enough. As a result the gland does not make enough pituitary hormones.
The pituitary is a small gland at the base of your brain. It is one of several glands that make hormones. Hormones are chemicals that send information and instructions from one set of cells to another. The pituitary gland makes many types of hormones. These hormones affect many things, including bone and tissue growth, your thyroid gland, and sexual development and reproduction.
What causes hypopituitarism?
Causes can directly affect the pituitary gland. Or they can indirectly affect the gland through changes in the hypothalamus. This is a part of the brain that is just above the pituitary gland.
Direct causes include:
- Pituitary tumors
- Poor blood supply to the pituitary gland
- Infections or inflammatory diseases
- Radiation treatment
- Surgery to remove pituitary tissue
- Autoimmune diseases
- Head injury
- Genetic diseases
- Rare diseases, such as sarcoidosis and amyloidosis
Indirect causes include:
- Hypothalamus tumors
- Inflammatory disease or a disease that spreads to the pituitary, 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 women who have not gone through menopause. They 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
- 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, inability to handle the cold, weight gain, constipation, and dry skin.
- Not enough ACTH (adrenocorticotropin hormone). This is rare. 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.
These symptoms may look like other health problems. Always see your healthcare provider for a diagnosis.
How is hypopituitarism diagnosed?
Your healthcare provider will ask about your medical history. You will also need an exam. Other tests you may need include:
- 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 hormone levels in your body.
How is hypopituitarism treated?
Your healthcare 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 certain medicines, treatments, or therapies
- How long the condition is expected to last
- Your opinion or preference
Treatment depends on what is causing the condition. The treatment goal is to 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 healthcare provider?Tell your healthcare 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.
- It can be caused by things that directly affect the pituitary gland. Or it can be caused by things that indirectly affect the gland through changes in the hypothalamus.
- Symptoms depend on which hormones the pituitary gland is not making enough of.
- The treatment goal is to return the pituitary gland to normal function. Treatment may include hormone replacement therapy, surgery to remove a tumor, or radiation therapy.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- 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 name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- 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.