The pituitary is a fleshy gland found inside the skull and is connected to a part of the brain called the hypothalamus. It is considered a "master gland" because it produces hormones that control the levels of other hormones secreted by other endocrine (hormone-producing) glands.
The anterior or front portion of the pituitary produces the following hormones: growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, luteinizing hormone, follicle stimulating hormone and prolactin. The posterior or back portion of the pituitary produces vasopressin and oxytocin hormones. These hormones have various functions in the body, including the regulation of growth and metabolism, sexual and reproductive function, and many more.
Pituitary Gland Tumors
Most abnormal new growths that develop in the pituitary are non-cancerous (benign) and they are usually called pituitary adenomas. These tumors usually grow in the anterior pituitary and therefore affect the production of hormones in this portion. Although these tumors are not cancerous, they can affect your health significantly if they produce excessive amounts of hormones or if the tumor grows to a size that will affect the surrounding brain tissues.
The most common type of pituitary gland tumor is called prolactinoma, which causes menstrual irregularities in women, infertility, abnormal milk production, decreased libido and erectile dysfunction in men. This type of tumor can be managed with medications, and surgery may be not be needed if the tumor size decreases.
Other types of tumors may need to be surgically removed if they are putting too much pressure on the brain tissues and if symptoms cannot be controlled with medications alone.
Post-operative Treatment of Pituitary Adenomas
After surgery, some patients continue to produce an excess amount of hormones, especially if the tumor was not removed entirely. In this case, medications may be given to reduce the hormone levels.
In some patients, removal of the tumor results in hormone deficiency (hypopituitarism). In these cases, hormone replacement is necessary. The type of hormones that may need to be replaced may vary, because some patients develop a deficiency of only one hormone, but others may lose the capacity to produce two or more, or all hormones.
All of these hormones can be replaced by synthetic hormones except prolactin. However, unlike the other types of hormones, which are necessary for life, the lack of prolactin does not cause serious life-threatening effects.
Doctors need to measure your hormone levels and prescribe the necessary medications you need. Depending on the type of hormones being replaced, medications may be administered using:
pills - Hydrocortisone, thyroid hormones, sex hormones and desmopressin
injections - growth hormone, testosterone, fertility drugs
skin patches - sex hormones (estrogen and testosterone)
skin gel - testosterone
nasal spray - desmopressin
mouth pellets - testosterone
Serious complications may occur if they are not taken properly. Monitoring of hormone levels during therapy is also important because dose adjustments may be required. Each patient has different dose requirements and reactions to medications.
Some patients may experience a return of normal pituitary gland function and hormone replacements may be stopped after proper assessment. However, in most patients, hormone replacement therapy may be a life long process.
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