Causes of abrupt cessation of lactation after childbirth

Every woman, having given birth to a child, wants to breastfeed him for as long as possible. The situation changes when the child refuses to breastfeed for some reason. But it’s much more offensive and unpleasant when a woman’s milk disappears. The reason for the abrupt cessation of lactation after childbirth in a woman may be Sheehan's syndrome. This syndrome appears with a complication of the birth process. What is Sheehan's syndrome and what are the reasons for its development, as well as the manifestations of the syndrome, read on estet-portal.com.

Hypopituitarism is the reduction or complete absence of secretion of tropic hormones by the pituitary gland. Hypopituitarism can develop due to several reasons, among which is massive bleeding after childbirth.

Sheehan's syndrome. Causes of the pathology of the pituitary gland after childbirth

During pregnancy, a woman's endocrine gland, which is located in the brain - the pituitary gland, increases in size. In this case, the blood supply to the pituitary gland is somewhat disturbed. When blood circulation is disturbed, ischemia of the pituitary gland tissues develops. In this case, there are no symptoms, since Sheehan's syndrome develops when two-thirds of the pituitary gland dies due to ischemia. In the postpartum period, with massive blood loss, blood pressure drops in the vessels, which further worsens the blood supply to the pituitary gland. Thus, the cells of the pituitary gland are partially or completely necrotic from tissue hypoxia. First of all, this is manifested by a sharp lack of lactation in the postpartum period.

Sheehan's syndrome was first described in 1937, although the disease has been known since the end of the 19th century. The spread of the syndrome cannot be identified, since the course of the disease may be hidden under hypothyroidism or arterial hypotension. There is a suggested relationship between the volume of blood loss and the likelihood of developing the syndrome. With a blood loss of 800 ml, the probability of developing Sheehan's syndrome is 25%, with a loss of 1000 ml of blood, the syndrome develops in 50% of cases, about 4 liters of blood - the probability is about 70%. Sheehan's syndrome can develop both against the background of postpartum blood loss and after abortions.

Clinical picture of postpartum hypopituitarism. Manifestations of Sheehan's syndrome

Postpartum hypopituitarism is divided into forms, based on the tropism of hormones, the secretion of which is impaired. There is a global (lack of ACTH and TSH), partial (hypofunction of HTH, TSH and ACTH) and combined forms (various combinations of forms). Also, the clinical picture depends on the hormones, the release of which is impaired. With the development of ischemia and necrosis in the adenohypophysis, lactation abruptly stops or disappears early. In the future, with postpartum hypopituitarism, there is a violation of the menstrual cycle, weight loss and weakness. Due to the deficiency of sex hormones, the female genital organs atrophy, the hair in the genital area and armpits fall out, and sometimes there is baldness on the head. Later, violations of the function of the adrenal cortex appear - arterial hypotension, drowsiness, severe fatigue.

There are 3 stages during postpartum hypopituitarism:

Mild course - fatigue, headache, regular hypotension. The functions of the adrenal cortex and the thyroid gland are reduced, there is a tendency to increase body weight.
Moderate severity - decreased function of the thyroid gland and ovaries, a tendency to fainting, brittle nails, swelling of the whole body.
Severe form - malnutrition of the mammary and sex glands, no menstruation, decreased intelligence and memory, drowsiness, weight loss, anemia.

At the first suspicion of postpartum hypopituitarism in a woman, a doctor should be consulted immediately.

How is Sheehan's syndrome treated? Is it possible to restore pituitary tissue?

Sheehan's syndrome should be treated as soon as it is diagnosed. If such complaints are found in a woman, it is necessary to check the levels of such hormones - follicle-stimulating, luteinizing, thyrotropic, adrenocorticotropic, somatotropic, luteotropic, oxytocin, vasopressin. It is necessary to identify certain hormones depending on the symptoms.

Sheehan's syndrome is treated with hormonal drugs in combination with a complete, fortified, balanced diet. Food should be well salted. If the function of the gonads is damaged, treatment is carried out with estrogenic hormones in courses of 3-4 months. This restores the nutrition of the tissues of the genital organs, although it does not restore the ovulatory cycle. With such violations, a woman can no longer become pregnant. In accordance with the clinic, the therapy is carried out with replacement hormones of a certain group.

The function of the adenohypophysis is not restored after necrosis. Hormone replacement therapy in Sheehan's syndrome significantly improves the condition and quality of life of a woman.