Hypopituitarism - What are the benefits of hormone treatment(s)?

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The goal of hormone replacement therapy is to enable the patient to live a normal life, feel well and not have the consequences of hormone deficiency (see Table 2). With proper hormone replacement, this goal can be achieved.

Estrogen replacement is advised for premenopausal women with estrogen deficiency who are at risk of developing osteoporosis and who, according to recent studies, may also have increased cardiovascular risk factors.

Men with hypogonadism or testosterone deficiency due to pituitary disease are at risk for developing osteoporosis and sexual dysfunction. Treatment with testosterone may improve sexual function and strengthen bones. Testosterone has also been shown to increase muscle mass and decrease fat mass.

Although there is no cure for hypopituitarism, it is treatable. Successful hormone replacement therapy can enable a patient to live a normal life, feel well and not have the consequences of hormone deficiency.

In adults who are GH-deficient, replacement therapy may improve quality of life and body composition (reduces fat mass, improves bone mass). Some studies have shown improvement in measures of cholesterol, and improved cardiac function.

Several large studies have reported a slight reduction in life span due to vascular causes (heart attacks, strokes), and infections in patients with long-standing hypopituitarism. The reasons for this are not clear —but could be due to untreated or inadequately treated hormone deficiencies or to ill effects of treatment (particularly radiotherapy).

Table 2. Symptoms and Signs of Pituitary Hormone Deficiency
Pituitary Hormone Target Organs Effect of Deficiency
ACTH Adrenal glands: cortisol and DHEA Fatigue, low sodium in blood, weight loss, skin pallor
TSH Thyroid gland: thyroid hormone Fatigue, weight gain, dry skin, sensitivity to cold, constipation
LH and FSH in Women Ovaries: estrogen, progesterone; ovulation Loss of periods, loss of sex drive, infertility
LH and FSH in Men Testes, testosterone, sperm production Loss of sex drive, erectile dysfunction, impotence, infertility
GH in Children & Adolescents Bone, muscle, fat Lack of growth (height); increased body fat, failure to achieve normal peak bone mass
GH in Adults Whole body Poor quality of life, increased body fat, decreased muscle and bone mass
PRL Breast Inability to breast feed
Oxytocin Breast, Uterus Complete deficiency could make breast feeding difficult
Antidiuretic hormone (vasopressin) Kidney Frequent urination (day & night), dilute urine, excessive thirst