Health condition
Sheehan's syndrome
Sheehan's syndrome is pituitary failure caused by major blood loss during childbirth - failure to breastfeed and absent periods are the early clues, but the diagnosis is often missed for years.
Why trust this guide
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Editorial team
Written by our editorial team from the UK sources listed on each page.
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Sourced from guidance
Checked against current NHS and UK specialist society guidance at the time of review.
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Current for 2026
Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.
Key facts
The essentials at a glance.
The symptoms to recognise, when to seek help, which specialist to see, and what treatment usually involves.
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Follows severe postpartum haemorrhage with a drop in blood pressure
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Earliest clues: inability to produce breast milk, then periods failing to return
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Later: fatigue, weight change, low blood pressure, loss of body hair and features of hypothyroidism and cortisol deficiency
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Diagnosis: pituitary hormone profile including 9am cortisol and a short synacthen test, plus MRI showing a shrunken (empty sella) gland
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Treatment is replacement of the missing hormones - hydrocortisone first, then thyroxine and sex hormones
Understanding the condition
What it is and what happens next.
What causes it, how it is diagnosed, and the treatment routes available in the UK.
What it is and how it feels
The pituitary doubles in size during pregnancy and its blood supply becomes precarious; catastrophic haemorrhage at delivery can infarct it. The classic story is a difficult delivery with transfusion, then no milk (prolactin lost), no return of periods (gonadotrophins lost), and years of unexplained exhaustion, weight change and fragility as thyroid and cortisol axes quietly fail. Milder partial forms are underdiagnosed - some women are told they simply have depression or the demands of motherhood.
Diagnosis and treatment routes
Testing is straightforward once thought of: a full anterior pituitary profile with 9am cortisol, synacthen testing where results are borderline, and MRI, which typically shows an atrophic gland. Replacement transforms wellbeing - hydrocortisone before thyroxine, oestrogen replacement until natural menopause age, and growth hormone considered where deficiency persists. If your symptoms date from a haemorrhagic delivery and have never been fully investigated, an endocrine review is worthwhile; private appointments are typically available within about two weeks, against NHS waits often of 20-45+ weeks.
Seeing a specialist
Who to see, and how quickly you can be seen.
The specialist for this condition is usually a consultant endocrinologist. Your GP can refer you on the NHS, or you can arrange a private consultation directly.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any of the emergency symptoms described above.
Frequently asked
Common questions about Sheehan's syndrome.
Quick, plain-English answers to what people ask us most.
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What is Sheehan's syndrome?
Sheehan's syndrome is pituitary failure caused by major blood loss during childbirth - failure to breastfeed and absent periods afterwards are the early clues, but the condition can also present in more subtle, delayed ways.
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What causes Sheehan's syndrome?
Severe blood loss during or after childbirth can damage the pituitary gland, which enlarges and becomes more vulnerable to reduced blood flow during pregnancy, leading to varying degrees of hormone deficiency afterwards.
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What are the symptoms of Sheehan's syndrome?
Early symptoms include failure to produce breast milk and absent periods after birth, while other symptoms - fatigue, low blood pressure, and other hormone deficiencies - can develop more subtly over subsequent months or years.
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Is Sheehan's syndrome dangerous?
Yes, untreated pituitary hormone deficiency can cause significant health problems, including adrenal insufficiency, which can be life-threatening, so recognition and hormone replacement are important.
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How is Sheehan's syndrome diagnosed?
Diagnosis involves blood tests to assess pituitary hormone levels, sometimes with specific stimulation tests, alongside a relevant history of significant blood loss during childbirth.
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How is Sheehan's syndrome treated?
Treatment is with hormone replacement for whichever pituitary hormones are deficient, tailored to the specific pattern of deficiency identified, and typically needed long-term.
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When should I see a specialist about possible Sheehan's syndrome?
See a doctor if you failed to breastfeed or your periods didn't return after a birth complicated by significant blood loss, so hormone testing can be arranged. A private consultant endocrinologist can typically be seen within about two weeks.