Patient's question:
After giving birth, my body lost weight significantly. Sometimes I want to eat more, but I feel very full. I also have insomnia and nightmares at night. I'm losing hair.Doctor's answer:
This is a syndrome discovered over a hundred years ago by Sheehan. When severe postpartum hemorrhage occurs and the shock lasts for an extended period, it can lead to hypopituitarism, resulting in the following sequelae: loss of appetite, fatigue, hair loss, aversion to cold, amenorrhea, breast atrophy, and in severe cases, it can be fatal. Clinically, it is known as Sheehan's syndrome. The anterior lobe of the pituitary gland secretes many trophic hormones, such as gonadotropin, thyrotropin, adrenocorticotropic hormone, prolactin, and growth hormone. The anterior lobe of the pituitary gland is connected to the hypothalamus via portal veins, receiving neuro-peptide substances secreted by the hypothalamus. Postpartum hemorrhage easily causes thrombosis in these portal veins, ultimately leading to necrosis of the anterior lobe of the pituitary gland. The levels of various trophic hormones decrease significantly, resulting in the decline of thyroid, adrenal cortex, and ovarian functions, as well as the symptoms mentioned earlier. This is a serious disease, and the key is to prevent postpartum hemorrhage. If postpartum hemorrhage occurs, it is important to promptly replenish blood volume to avoid shock. The treatment of Sheehan's syndrome is challenging. If the necrotic portion of the pituitary gland is not extensive and there are still many functional gland cells remaining, the function of the anterior lobe of the pituitary gland can be promoted by neuro-peptides secreted by the hypothalamus. LHRH (the domestic drug name is Gonalin) is a type of such medication. Generally, drug replacement therapy is used, involving the administration of thyroxine, adrenal cortex hormones, estrogen, and progesterone to replace various hormones. This can help control and significantly improve symptoms.