Pituitary Gland Dysfunction in Men

The pituitary gland, also known as the hypophysis, is a pea-sized gland located at the base of the brain. 

Known as the “master gland”, the pituitary produces hormones that regulate other parts of the endocrine system. 

Basically, the pituitary controls other glands including the thyroid and adrenal gland. 

Through the hormones it produces, the pituitary gland regulates metabolism, sexual maturation, growth, blood pressure, reproduction, and other functions. 

For that reason, pituitary gland dysfunction can induce a wide range of problems. In this post, we focus on pituitary gland dysfunction in men. 

What is pituitary gland dysfunction?

Pituitary gland dysfunction occurs when the master gland produces too much or too little of a specific hormone, or more of them. This endocrine gland produces a wide range of hormones that regulate different functions in the body. Hormones produced by the pituitary gland include:

  • Growth hormone – controls growth in childhood, maintains metabolism and body structure in adulthood
  • Adrenocorticotropic hormone (ACTH) – regulates the production of cortisol
  • Thyroid-stimulating hormone – regulates the number of hormones produced by the thyroid
  • Oxytocin – controls functions of the reproductive system
  • Prolactin – involved in the production of breast milk
  • Follicle-stimulating hormone – involved in reproduction, production of sperm
  • Luteinizing hormone – involved in reproduction together with follicle-stimulating hormone
  • Anti-diuretic hormone – helps kidneys manage the amount of water in the body

Everyone can develop a pituitary gland dysfunction, regardless of age. But, these problems are not common. Their impact on a person’s quality of life is significant, but most conditions are manageable. 

Diagnosing these conditions can be challenging, primarily because symptoms may not always be pronounced or apparent until the problem worsens. Treatment of pituitary disorders focuses on improving the quality of life in patients and reducing the severity of symptoms they experience. The pituitary gland is tricky primarily because problems with this gland can cause a chain of reactions throughout the body.

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Symptoms

The exact symptoms of pituitary gland dysfunction vary from one specific disorder to another. However, the most common symptoms include:

  • Anxiety and/or depression
  • Vision changes
  • Unexplained weight gain
  • Hair loss
  • Low energy 
  • Irregular menstrual periods (in women)
  • Unusual growth spurts or stunted growth 
  • Unexpected production of breast milk (in women)

Causes

The main cause of pituitary gland dysfunction is a noncancerous tumor or pituitary carcinoma. The tumor can make the body produce excessive or insufficient amounts of hormones. But, it’s not the only cause of the pituitary disorder. 

Other causes include:

  • Some medications
  • Certain cancer treatments such as radiation to the head or neck
  • Head injury
  • Bleeding in/near the pituitary gland (hemorrhage) 
  • Brain surgery
  • Stroke i.e. lack of blood flow to the brain or pituitary gland
  • Meningitis and other infections of the brain
  • Infiltrative diseases that affect multiple parts of the body e.g. sarcoidosis
  • Inflammation of the pituitary gland due to an abnormal response of the immune system, such as lymphocytic hypophysitis, a rare condition of the pituitary gland
  • Genetic mutation (in some cases)

Types of pituitary disorders

Pituitary disease can affect men and women of all ages. Pituitary dysfunction can include overproduction of hormones or insufficient secretion. They can be inherited or not. Inherited pituitary disorders include multiple endocrine neoplasia type I (MEN I) and familial isolated pituitary adenoma (FIPA). 

Conditions that are associated with excessive production of pituitary hormone include:

  • Prolactinoma – noncancerous pituitary gland tumor that makes this gland produce too much prolactin hormone. This condition decreases the levels of sex hormones i.e. testosterone in men and estrogen in women.
  • Acromegaly – a rare condition wherein the body produces an excessive amount of growth syndrome. As a result, bones and tissues grow faster. Eventually, a patient with this condition can have abnormally large hands and feet. Lack of this hormone can cause pituitary dwarfism. 
  • Cushing’s syndrome – occurs when the body produces too much cortisol over time. Also known as hypercortisolism, Cushing syndrome can lead to the formation of fatty bump between shoulders, rounded face, pink or purple marks on the skin, but may also result in type 2 diabetes, bone loss, high blood pressure.

Disorders that occur due to insufficient production of pituitary hormones include:

Diabetes insipidus

Diabetes insipidus is a rare condition wherein a person often feels extremely thirsty and produces large amounts of urine. In this condition, urine is insipid i.e. odorless or colorless. 

Adult growth hormone deficiency

This usually occurs due to damage to the hypothalamus or the pituitary gland. A person with this condition has an impaired ability to expend body energy and consume oxygen at rest and work.

Pituitary tumors

Abnormal growths in the pituitary gland. Most cancers are benign i.e. not cancerous. The most common pituitary tumor that leads to decreased production of hormones is nonfunctional adenoma (null cell adenoma). Patients usually experience no symptoms until the tumor increases in size. At that point, they may develop symptoms such as vision problems and headaches.

Hypopituitarism

This occurs when the pituitary gland is not active enough and thereby fails to produce a sufficient amount of pituitary hormones. Also known as pituitary insufficiency, hypopituitarism may result from disorders that affect the hypothalamus, the pituitary gland itself, or the surrounding structures including the pituitary stalk. Pituitary insufficiency can also include luteinizing hormone deficiency, follicle-stimulating hormone deficiency, thyroid-stimulating hormone deficiency, ACTH deficiency, and anti-diuretic hormone deficiency.

Complications

When left untreated, pituitary gland dysfunction can lead to a multitude of complications. Like with symptoms, the precise complications depend on the type of pituitary dysfunction or hormone that is insufficiently or overproduced. 

For instance, growth hormone deficiency is linked to high cholesterol, metabolic syndrome, and obesity. 

It’s important to mention deficiency of all anterior pituitary hormones is more common than deficiency of individual hormones. 

Low levels of luteinizing hormone and follicle-stimulating hormone can lead to the loss of facial, trunk, and scrotal hair in men. The affected persons may experience anemia and loss of muscle mass.

Deficiency in thyroid-stimulating hormone can pave the way to hypothyroidism. In this condition, the thyroid gland hormone fails to produce sufficient amounts of its own hormones. As a result, a person may experience various symptoms ranging from increased sensitivity to cold to unexplained weight gain. 

When it comes to the posterior pituitary hormones, insufficient production of anti-diuretic hormone can lead to diabetes insipidus, which can cause complications such as polyuria (producing large amounts of clear urine), dehydration, and hypernatremia (excessive sodium levels).

Can it affect your sex life or sexual health?

Generally speaking, everything can affect sex life or sexual health, and problems with the pituitary gland are not the exceptions. Problems with anterior pituitary hormones such as deficiency in follicle-stimulating hormone and luteinizing hormone can decrease libido and affect sexual function in men.

The truth is that the relationship between pituitary gland dysfunction and sexual health in me requires further research. Current evidence shows high prolactin levels (hyperprolactinemia) are the most recognized hyperfunction of the pituitary gland that contributes to male sexual dysfunction. The underlying mechanisms are still unclear, though. 

High prolactin can cause erectile dysfunction (ED) in 1% to 5% of cases. At the same time, low libido and ED are the most common onset symptoms of a pituitary gland tumor called a prolactinoma, which is often linked to low testosterone levels.

Additionally, growth hormone also has an impact on erectile function. You see, increased growth hormone levels in systemic blood cavities and cavernous tissues have been detected in flaccidity and tumescence penile stages in healthy men. These effects were not observed in men with organic erectile dysfunction, thus suggesting that problems with secretion of growth hormone can impair erectile function. 

Moreover, growth hormone has a positive effect on vascular endothelium homeostasis. As a result, it may increase the production of nitric oxide and protect the endothelium from oxidative stress.

When it comes to pituitary disorders, erectile dysfunction is particularly high in men with acromegaly. Up to 60% of men with this disorder also have ED. The relationship between the two problems isn’t fully understood, but it could be down to complications of acromegaly which include hypogonadism and metabolic problems such as diabetes, high blood pressure, and even sleep apnea.

Erectile dysfunction and low libido are also associated with Cushing’s disease. In fact, about 69% of men with high cortisol levels complain about low libido. 

The influence of these and other pituitary hormones such as oxytocin on male sexual health and function requires a lot more research. The more we know, the easier it could be to manage those problems.

When to see a doctor

Schedule an appointment to see a healthcare professional if you experience the abovementioned symptoms of pituitary gland dysfunction. Seek medical assistance immediately if the symptoms occur suddenly and also include severe headache, drop in blood pressure, confusion, and visual disturbances. 

These symptoms are linked to pituitary apoplexy (also known as pituitary infarction), sudden destruction of the tissue of the pituitary gland. Since pituitary apoplexy is a medical emergency, you need medical assistance urgently as soon as these symptoms develop. 

Treatment

If you experience the symptoms described above, you need to schedule an appointment to see the doctor. The doctor will recommend certain tests to diagnose the problem. 

These tests may include blood tests, brain imaging, and vision tests. Once the type of pituitary dysfunction is diagnosed, the doctor will recommend adequate treatment. 

In most cases, the treatment of pituitary dysfunction revolves around hormone replacement therapy i.e. taking medications to normalize hormone levels. 

The specific medications depend on the type of pituitary gland disorder and may include:

  • Fertility hormones – infertile men could receive gonadotropins injections to stimulate the production of sperm.
  • Sex hormones – men with low testosterone may get injections of this hormone, or it can be administered via gel or patch.
  • Corticosteroids – may include hydrocortisone or prednisone to replace the adrenal hormones that are insufficiently produced in the case of adrenal insufficiency. 
  • Levothyroxine – for the treatment of hypothyroidism caused by thyroid-stimulating hormone deficiency. 
  • Growth hormone – administered through injection.

To patients with disorders that include overproduction of hormones, the doctor may prescribe medications to decrease hormone production and thereby reduce symptoms.

Treatment of pituitary gland dysfunction also includes eye care, since problems with this gland can affect vision.

The main course of treatment of pituitary tumors or cancer is pituitary surgery or radiation therapy. 

Conclusion

Pituitary gland dysfunction can refer to excessive or insufficient production of hormones produced by this important gland. Disorders caused by pituitary dysfunction can induce a wide range of symptoms and have a major impact on male sexual function. For that reason, you shouldn’t ignore the symptoms of these disorders, see your doctor, and adhere to the treatment regimen they prescribe. 

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