Hypogonadotropic Hypogonadism

Hypogonadotropic Hypogonadism

What is the pituitary gland? — The pituitary gland is a small organ that is found at the base of the brain (figure 1). It is called the "master gland" because it controls all the other glands in the body.
The pituitary gland makes many different hormones. Hormones are chemical messengers that turn on and off different processes in the body. Here is a list of some of the hormones made by the pituitary gland and an explanation of what those hormones do:
Corticotropin (also called "ACTH") – Corticotropin tells the adrenal glands to release a hormone called cortisol. Cortisol helps control how the body uses sugar (figure 2).
Thyroid-stimulating hormone (called "TSH") – TSH tells the thyroid gland to release hormones called "T3" and "T4." These hormones control how the body uses and stores energy (figure 3).
Gonadotropins – In women, gonadotropins tell the ovaries to release the hormones estrogen and progesterone. They also tell the ovaries to prepare and release eggs. In men, these hormones tell the testicles to make testosterone and sperm.
Growth hormone – Growth hormone helps children grow to a normal height. In adults, it helps keep the right balance of fat and muscle in the body.
Prolactin – Prolactin helps control the development of breasts in girls. It also tells the breasts to make milk after a woman gives birth.
What is panhypopituitarism? — Panhypopituitarism is the medical term for when the pituitary gland does not make enough of the hormones it is supposed to make. This can happen when the pituitary gland is damaged or when there is a problem higher in the brain (in the part called the "hypothalamus"). The pituitary gland can be damaged by abnormal growths that sometimes form on the gland. Or it can be damaged by the treatment used to control those abnormal growths, such as surgery or radiation. Some people are born without one or more of the pituitary hormones.
When the pituitary gland does not make enough of its hormones, the other glands that the pituitary gland controls also do not make enough of the hormones they are supposed to make. This can cause serious problems.
What are the symptoms of panhypopituitarism? — The symptoms are different, depending on which hormones are most affected by the disorder. In general, the symptoms can include:
Feeling tired
Losing weight
Being bothered by the cold
Decreased appetite
Having less interest in sex
Having trouble getting pregnant or getting a woman pregnant (called infertility)
In women:
•Irregular or missed periods
•Loss of pubic hair
•Being unable to make milk for breastfeeding
In men:
•Decreased facial or body hair
•Testicles that have shrunk
In children:
•Being shorter than other children of the same age
Will I need tests? — Yes, if your doctor suspects you have panhypopituitarism, you will need blood tests to check for different hormone levels. You might also need an imaging test, such as an MRI. These tests can create a picture of the inside of your body. They can show if there is something pressing on or damaging your pituitary gland.
How is panhypopituitarism treated? — Treatment usually involves taking hormone medicines to replace the hormones the body is missing. People who are treated for panhypopituitarism usually must take these medicines for the rest of their life. They also need to have regular blood tests to check their hormone levels.
People who have a tumor or growth on their pituitary gland might also need surgery or other treatments (such as radiation therapy) to remove or destroy the tumor or growth.
What if I want to have children? — If you want to have children, mention that to your doctor or nurse. Parts of your treatment might need to be different while you are trying to have a baby. For example, you might need to get treated with certain hormones that make it possible for a woman to get pregnant and for a man to make a woman pregnant. With the right treatment, most men and women with panhypopituitarism can have children.
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This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83818 Version 6.0
Release: 28.2.2 - C28.105
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