Pituitary Disorders - Specific Issues for Women

Pituitary diseases in womenpresent unique challenges in both diagnosis and management. Menstrual disorders are a hallmark of pituitary dysfunction; they may present as hypogonadism or infertility and warrant a full investigation of pituitary function. Understanding of anatomic and physiologic pituitary changes during pregnancy and intrapartum can guide evaluation and diagnosis for peripartum pituitary disorders. The evaluation and management of Cushing disease, acromegaly, prolactinomas, both intra- and postpartum, is different from that in a nonpregnant state or in men; management pearls are offered. New-onset visual symptoms or pituitary deficiencies proximal to pregnancy can signify a potentially fatal pituitary disorder such as lymphocytic hypophystis or Sheehan syndrome and demand early diagnosis and treatment. Psychosocial changes have been documented in a high number of women with pituitary diseases and could persist after treatment, requiring concomitant or ongoing identification and treatment.