Sex Steroid Hormone Replacement

As the master gland, the pituitary gland controls sex hormones among others. Hormone replacement considerations for women and men with pituitary disorders or conditions are described below.

Hormone Replacement for Women with Pituitary Disorders

Women who have pituitary disorders that affect the production of sex steroids should consider hormone replacement as described below:

  • Women who have not yet gone through menopause should consider estrogen replacement with or without progesterone
  • Women who have gone through menopause should consider estrogen/progesterone replacement on the same basis as women without hypotuitarism

If the lack of sex steroid has been long standing, estrogen replacement should be gradual to avoid side-effects such as nausea and painful breasts. Some of the side effects of hormone replacement for women include:

  • Breast swelling
  • Heavy menstrual bleeding
  • Breakthrough bleeds (bleeding between periods)
  • Blood clots

Without hormone replacement, a woman with a pituitary disorder may have:

  • Osteoporosis
  • Possible early heart disease
  • Decrease in breast and uterine size
  • Intertility
  • A loss of interest in sex (libido)

Hormone Replacement for Men with Pituitary Disorders

Men with a pituitary disorder that causes hypogonadism should have testosterone replacement therapy. This can be given as a shot into the muscles every two to three weeks or as a skin patch or gel.

Testosterone replacement therapy can cause acne, breast enlargement (gynecomastia), lowered HDL cholesterol (the desirable cholesterol) and a higher red blood cell count.

There is a risk of prostate enlargement with testosterone replacement. Older men should have a PSA monitoring test every three to six months and then annually if there are no signs of prostate abnormalities.

Testosterone leves should be monitored at the four to six week point, the six month point and then annually unless test results suggest that more frequently monitoring is necessary.