Treatment

Treatment for Sheehan's syndrome is lifelong hormone replacement therapy for the hormones you're missing. Your doctor might recommend one or more of the following medications:

• Corticosteroids. Hydrocortisone (Cortef) or prednisone (Rayos), replace the adrenal hormones that aren't being produced because of an adrenocorticotropic hormone (ACTH) deficiency.

  You'll need to adjust your medication if you become seriously ill or experience major physical stress. During these times, your body would ordinarily produce extra cortisol — a stress hormone. The same kind of dosage fine-tuning may be necessary when you have the flu, diarrhea or vomiting, or have surgery or dental procedures.

  Dosage adjustments might also be necessary during pregnancy or with marked weight gain or weight loss. Taking the appropriate amount can help avoid the side effects associated with high doses of corticosteroids.

• Levothyroxine (Levoxyl, Synthroid, others). This medication boosts deficient thyroid hormone levels caused by low or deficient thyroid-stimulating hormone (TSH) production.

  If you change brands, let your doctor know to ensure you're still receiving the right dosage. Also, don't skip doses or stop taking the drug because you're feeling better. If you do, signs and symptoms will gradually return.

• Estrogen. This includes estrogen alone if you've had your uterus removed (hysterectomy) or a combination of estrogen and progesterone if you still have your uterus.

  Estrogen use has been linked to an increased risk of blood clots and stroke in women who still make their own estrogen. The risk should be less in women who are replacing missing estrogen.

  Preparations containing luteinizing hormone (LH) and follicle-stimulating hormone (FSH), also called gonadotropins, might make future pregnancies possible. These can be delivered by injection to stimulate ovulation.

  After age 50, around the time of natural menopause, discuss the risks and benefits of continuing to take estrogen or estrogen and progesterone with your doctor.

• Growth hormone. Growth hormone may improve the body's muscle-to-fat ratio, maintain bone mass and lower cholesterol levels. Growth hormone is expensive, and side effects may include joint stiffness and fluid retention.

Your endocrinologist is likely to test your blood regularly to make sure that you're getting adequate — but not excessive — amounts of hormones.