It's normal for your body to feel tired and different after having a baby. As a new mom, you're probably busy with a thousand things. But in the meantime, if you're having a hard time breastfeeding, your period hasn't started again, or your body is feeling strangely sluggish, don't just dismiss it as "this is just how it is for new moms." It could be a rare condition caused by a complication during childbirth. Today, we're talking about one such condition.
Simply put, what is Sheehan Syndrome?
Sheehan Syndrome is a very rare condition that causes excessive bleeding during childbirth. It affects a small gland located at the base of your brain called the pituitary gland.
Think of this pituitary gland as the 'master gland' of our body's hormonal system. It's the one that tells the other glands in the body, "Okay, now you produce this hormone," "You produce that hormone." So if this 'boss' isn't working properly, the entire hormonal system can go haywire.
During pregnancy, this pituitary gland becomes slightly enlarged. During childbirth, if for some reason you bleed too much or your blood pressure drops too low, this enlarged gland does not get the amount of oxygen it needs. Just like a plant withers when it lacks water, when it lacks oxygen, some of the tissues in this gland are damaged and die. That's what we call Sheehan Syndrome , or postpartum hypopituitarism .
What happens when the pituitary gland is damaged?
Because the 'boss' is not working, the other glands under its control are not working properly either. This means that the production of a number of hormones essential to our body is reduced or completely stopped. This can affect many things in your body. Let's take a look at what these hormones are decreasing and what happens to them.
| Hormone | Role in the Body |
|---|---|
| Prolactin (Prolactin - PRL) | Stimulates the production of breast milk to feed the baby. |
| Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) | It regulates the monthly menstrual cycle and ovulation, which are essential for getting pregnant again. |
| Thyroid-stimulating hormone (TSH) | The thyroid gland in the neck is stimulated and produces hormones that control the body's metabolism, energy, and nervous system. |
| Adrenocorticotropic hormone (ACTH) | When the body experiences stress, it helps produce a hormone called cortisol, which helps it cope. It is also important for controlling blood pressure and sugar levels. |
| Growth Hormone (GH) | Helps maintain bone density, muscle mass, and body fat distribution. |
What are the symptoms of Sheehan Syndrome?
The special thing about this is that for some people, symptoms appear immediately after giving birth. For others, symptoms start to appear months, even years later. Therefore, it is very important to be aware of this.
These are the symptoms that can be seen in general:
- Difficulty breastfeeding or a lack of milk after delivery is one of the first signs.
- The cessation of menstruation (amenorrhea) or its irregularity.
- Feeling unusually tired , lifeless, and unable to concentrate on anything.
- Low blood pressure .
- Decreased sexual desire.
- Hair loss in the armpits and private areas and breast shrinkage.
- Dry skin.
- Vaginal atrophy is a condition that causes vaginal walls to become thin and dry, making intercourse painful.
Sometimes, symptoms may not appear until the body is exposed to a major stressor, such as surgery or an infection. At such times, the body may suddenly experience severe symptoms because it lacks the stress hormone (cortisol). This is called an 'Adrenal Crisis' , and it is a medical emergency.
Who is at increased risk for this condition?
Sheehan Syndrome is a very rare condition these days. Because our hospitals have advanced methods to manage emergencies like excessive bleeding during childbirth. However, there are some situations where excessive bleeding can occur during childbirth. In such cases, there may be a slight risk of this condition.
- Having twins and triplets.
- The baby's weight gain is too much (a high birth weight baby).
- Placental abruption.
- Placenta previa (low position of the placenta in the uterus).
- High blood pressure during pregnancy (Preeclampsia).
- Instrumental delivery (forceps or vacuum extraction).
How do you find this, Doctor?
When you go to see your doctor about these symptoms, he or she will run several tests if they suspect this condition.
1. Talking about your medical history: Your doctor will definitely ask you questions like, "Did you bleed a lot when you had the baby?", "Were you able to breastfeed the baby?", "Did your period start again?" It's very important to clearly explain everything you're feeling.
2. Blood tests: A sample of your blood is taken to check the levels of hormones controlled by the pituitary gland (such as TSH, cortisol, FSH, LH).
3. Imaging tests: Sometimes an MRI (Magnetic Resonance Imaging) scan may be done to check for other causes, such as a pituitary tumor.
What are the treatments for this?
Don't be alarmed when you hear this. Sheehan Syndrome is a condition that can be managed well. The treatment for this is hormone replacement therapy.
Simply put, it's about giving your body the hormones it's not currently making, either through pills or other methods. This is something you have to do for the rest of your life.
- Corticosteroids: Medications such as hydrocortisone are given to replace the decreased ACTH hormone.
- Thyroid hormone: Thyroxine (levothyroxine) tablets can correct TSH deficiency.
- Sex hormones: Estrogen and progesterone can help regulate the monthly menstrual cycle.
- Growth hormones: These help maintain muscle and bone strength.
Your treatment is usually supervised by an endocrinologist, who will test your blood at regular intervals and adjust your hormone dosage to your exact needs.
Are there times when you suddenly need to go to ETU?
Yes, this is very important. If you experience the condition called Adrenal Crisis that we talked about earlier, it can be life-threatening. Therefore, it requires emergency treatment. If you experience any of the following symptoms, go to the Emergency Department (ETU) of the nearest hospital immediately.
- Headache , blurred vision
- Pain in the abdomen, lower chest, or back
- Fever
- Severe weakness
- Nausea and vomiting
- Confusion or loss of consciousness
If your doctor diagnoses you with Sheehan Syndrome, they may also advise you to wear a medical alert bracelet to receive prompt treatment in the event of an emergency like this.
Take-Home Message
- Sheehan Syndrome is a very rare condition caused by damage to the pituitary gland due to excessive bleeding during childbirth.
- Be aware of symptoms like difficulty breastfeeding, missed periods, and excessive fatigue. Don't just ignore these.
- This is a condition that can be very well controlled with lifelong hormone therapy. With proper treatment, you can live a completely normal life.
- If you have any doubts about this, don't be afraid to talk openly with your doctor. He or she will give you the guidance you need.
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