Pituitary Gland Disorders
Located at the base of the brain, the pituitary gland is a vital organ that regulates key hormones responsible for growth, metabolism, reproduction, and stress response. It influences various bodily functions by controlling hormone production in other endocrine glands. When the pituitary gland malfunctions, hormonal imbalances can occur, affecting aspects such as energy levels and reproductive health etc.
Fortunately, many pituitary gland disorders, including pituitary adenomas and prolactinomas, can be effectively managed through treatment. Book a consultation with us today.
Types of Pituitary Gland Disorders
Disorders affecting the pituitary gland can result in excessive or insufficient hormone production, leading to various health conditions. These are some conditions related to the pituitary gland.
Pituitary adenomas
Pituitary adenomas are noncancerous tumours that develop in the pituitary gland. Some of these tumours produce excessive hormones, leading to conditions such as Cushing’s disease (caused by excess cortisol). Others may grow large enough to disrupt normal hormone production, resulting in deficiencies such as adrenal insufficiency, hypothyroidism, or hypogonadism.
Causes
The exact cause of pituitary adenomas is unknown, though genetic mutations may trigger abnormal cell growth in the gland. In rare cases, pituitary adenomas are linked to inherited conditions such as Multiple Endocrine Neoplasia type 1 (MEN 1). However, most individuals with these tumours have no family history, and environmental or lifestyle factors do not appear to influence risk.
Symptoms
Symptoms of a pituitary adenoma can vary widely depending on the type of adenoma. Some common symptoms include:
- Menstrual irregularities e.g. absent periods
- Milky discharge from the breasts
- Low sex drive
- Erectile dysfunction in men
- Gradual enlargement of hands, feet, and jaw
- Weight gain
- High blood pressure
- Muscle weakness
- Fragile bones
- Fatigue
- Rapid and excessive growth in children
- Enlarged head in children
Larger adenomas can also press on nearby structures, particularly the optic nerves, leading to vision disturbances, headaches, or other neurological symptoms.
Prolactinomas
A prolactinoma is a benign tumour that causes excessive production of prolactin, the hormone responsible for stimulating milk production. It is the most common type of pituitary adenoma and is more frequently diagnosed in premenopausal females, though it can also affect males.
Elevated prolactin levels can lead to hormonal imbalances that disrupt reproductive function. In women, excess prolactin suppresses oestrogen, while in men, high prolactin reduces testosterone levels.
Causes
The exact cause of prolactinomas remains unclear. However, they typically occur when a normal prolactin-producing cell in the pituitary gland undergoes a mutation, leading to uncontrolled growth and excessive prolactin production.
Most prolactinomas are sporadic, occurring randomly without a clear genetic cause. However, in rare cases, prolactinomas can be associated with genetic conditions such as MEN 1.
Symptoms
Women and men experience different symptoms of prolactinomas. Common symptoms include:
| Symptom | Details |
|---|---|
Women |
|
Men |
|
Acromegaly
Acromegaly occurs when the pituitary gland produces excessive growth hormone in adulthood, leading to progressive enlargement of the hands, feet, and facial bones. It tends to develop slowly and may go unrecognised for years.
In children, excess growth hormone results in gigantism, whereas in adults, it causes bone thickening rather than height changes. Without treatment, it can lead to severe health complications, but appropriate management can improve symptoms and reduce long-term risks.
Causes
The most common cause of excessive growth hormone production in adults is a tumour in the pituitary gland, such as a pituitary adenoma.
In rare cases, acromegaly may be caused by non-pituitary tumours located in other parts of the body, such as the lungs or pancreas. These tumours may secrete growth hormone directly or produce another stimulatory hormone to increase growth hormone production from the pituitary gland.
Symptoms
Acromegaly signs and symptoms vary between individuals. Some common symptoms include:
- Enlarged hands, feet and facial features (jaw, nose, lips, tongue, bones)
- Coarse, thickened skin
- Excessive sweating and body odour
- Skin tags
- Fatigue and muscle weakness
- Joint pain and limited mobility
- Deepened voice
- Severe snoring
- Vision problems
- Persistent headaches
- Menstrual irregularities (women)
- Erectile dysfunction (men)
- Loss of sex drive
Hypopituitarism
Hypopituitarism is a rare condition where the pituitary gland fails to produce one or more essential hormones or produces them in insufficient amounts. This can affect various bodily functions, including growth, metabolism, blood pressure regulation, and fertility etc.
Causes
Hypopituitarism can be caused by various factors that interfere with the pituitary gland’s function. These causes range from tumours and genetic conditions to infections and trauma.
- Pituitary tumours: Tumours can grow and press on pituitary tissue, disrupting hormone production and potentially affecting the optic nerves, leading to vision problems.
- Stroke or haemorrhage: Lack of blood flow to the brain or pituitary, or bleeding into the pituitary gland, can cause damage.
- Medications: Certain drugs, such as narcotics, high-dose steroids, and cancer treatments like checkpoint inhibitors, can interfere with pituitary function.
- Genetic causes: Inherited genetic changes can affect the pituitary’s ability to produce hormones, often starting at birth or early childhood.
- Infections: Meningitis, tuberculosis, or syphilis can infect the brain and spread to the pituitary, causing damage.
- Hypophysitis: Inflammation of the pituitary gland due to an immune response can lead to hypopituitarism.
- Sheehan’s syndrome: Severe blood loss during childbirth can damage the pituitary gland, particularly the anterior part.
- Hypothalamic disorders: Tumours or diseases in the hypothalamus, the part of the brain above the pituitary, can interfere with the regulation of the pituitary gland.
Symptoms
Hypopituitarism symptoms differ depending on the hormone that is lacking.
| Types of treatment** | |
|---|---|
Growth hormone deficiency |
|
Luteinising hormone and follicle-stimulating hormone deficiency |
|
Thyroid-stimulating hormone deficiency |
|
Adrenocorticotropic hormone deficiency |
|
Anti-diuretic hormone deficiency |
|
Diagnosing Pituitary Gland Disorders
Diagnosing pituitary gland disorders involves taking a thorough medical history to identify symptoms, risk factors, and potential genetic links. Subsequently, a combination of hormone testing, imaging, and specialised assessments can provide crucial insights into the gland’s function and detect any abnormalities.
Blood tests help assess pituitary function by measuring key hormones such as TSH, ACTH, GH, prolactin, LH, FSH, and cortisol. Abnormal hormone levels can indicate imbalances and help pinpoint specific pituitary disorders, such as excess or insufficient hormone production.
These tests involve administering substances to stimulate or suppress hormone production and assess how the pituitary gland responds. They help determine the gland’s ability to regulate hormone release properly, aiding in the diagnosis of disorders like hypopituitarism or Cushing’s disease.
MRI scans are the primary imaging technique used to detect tumours, cysts, or structural abnormalities in the pituitary gland. These scans provide detailed images that help assess the size, shape, and location of any growths, enabling precise treatment planning.
Visual field testing evaluates whether a pituitary tumour is pressing on the optic nerves. This test helps detect vision changes that may result from nerve compression, which is a common symptom of larger adenomas affecting the pituitary region.
Pituitary Gland Disorder Treatments
Treatment for pituitary disorders aims to regulate hormone levels, shrink tumours, and alleviate symptoms. Approaches include medications, surgery, radiation therapy, and, when necessary, hormone replacement therapy.
The treatment approach depends on the type of pituitary adenoma, as some respond well to medications that shrink the tumour and regulate hormone levels. For prolactinomas, dopamine agonists such as cabergoline or bromocriptine are the first-line treatment. These medications effectively reduce prolactin levels, shrink tumour size, and alleviate symptoms.
Surgical removal of the tumour is recommended when medication is ineffective or not well tolerated. It is particularly considered for large tumours that do not fully respond to drug therapy or for individuals with hormone-secreting adenomas that require immediate intervention. Surgery may also be necessary when the tumour compresses surrounding structures, such as the optic nerves, causing vision problems.
The most common surgical approach for pituitary adenomas, prolactinomas and acromegaly caused by tumours is transsphenoidal surgery. It is a minimally invasive procedure performed through the nose and sphenoid sinus to remove the tumour.
Following surgery, once the bulk of the tumour is excised, radiation therapy is typically recommended. High doses of X-rays are directed at the tumour site to shrink the tumour and lower hormone levels.
The pituitary gland may not function properly after surgery or radiation, leading to deficiencies in essential hormones. HRT may be recommended to restore normal hormone levels and prevent complications related to hormone imbalances.
The need for HRT depends on the extent of pituitary damage and the hormones affected. Regular follow-ups are necessary to monitor hormone levels and adjust treatment as needed.
Our Endocrinologist
Dr Linsey Gani
Consultant Endocrinologist
MBBS (Aust), B Med Sci, FRACP (Endocrine), FAMS (S’pore), MPH (Harvard), Clinical Assistant Professor (Duke-NUS Medical School)
Languages: English, Mandarin, Bahasa Indonesia
Dr Gani is an experienced endocrinologist with a strong focus on diagnosing and treating pituitary gland disorders. Her expertise spans conditions related to hormonal imbalances, including those affecting growth and metabolism. Dr Gani completed her residency in Melbourne, Australia. She is a fellow of the Royal Australian College of physician and the Academy of Medicine, Singapore.
Why Choose Us?
Dr Gani takes the time to consider each patient’s unique condition and needs to provide personalised care for those with pituitary gland disorders.
At LG Endocrinology, we diagnose and treat a wide range of pituitary gland disorders through a comprehensive, evidence-based approach.
Our clinic creates a welcoming and comfortable atmosphere to ensure a positive and relaxed experience for every visit.
FAQs About Pituitary Gland Disorders
Who gets pituitary gland disorders?
Pituitary gland disorders can affect individuals of any age and gender, though they are more commonly diagnosed in older adults. While most people with pituitary disorders do not have a family history, some rare pituitary tumours may run in families.
What are the symptoms of pituitary gland disorders?
Pituitary gland disorders can lead to a variety of symptoms, including:
- Hormonal imbalances
- Unexplained weight gain or weight loss
- Fatigue or weakness
- Vision problems
- Changes in mood or behaviour
- Irregular menstruation in women
- Infertility
- Growth abnormalities (e.g., excessive growth or stunted growth in children)
What is the difference between adrenal gland disorders and pituitary disorders?
Adrenal gland disorders affect the adrenal glands, which are located above the kidneys. They produce hormones like cortisol, aldosterone, and adrenaline. In contrast, pituitary disorders affect the pituitary gland, which regulates a range of hormones that control other glands, including the adrenal glands.
Adrenal disorders can lead to conditions such as Addison’s disease or Cushing’s syndrome, while pituitary disorders may cause hormone imbalances, such as growth hormone deficiency or pituitary tumours, which impact multiple endocrine functions. Since the pituitary gland controls adrenal function, certain pituitary disorders can cause secondary adrenal issues, such as adrenal insufficiency due to inadequate ACTH production.
Book an Appointment
Fill out the form below to schedule your appointment.
Dr. Linsey Gani Endocrinology
10 Sinaran Drive, #10-08, Novena Medical Center, Singapore 307506
+65 6397 7101
+65 9128 7480
Monday - Friday
08:30 - 12:30
14:00 - 17:30
09:00-12:00
Closed
Monday - Friday
08:30 - 12:30
14:00 - 17:30
09:00 - 12:00
Closed