treatment

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Treatment is dependent on cause:

  • sex hormones:
    • cyclical oestrogen with low-dose progesterone if uterus intact in women; if premenopausal, consider an oral oestrogen contraceptive since ovulation and conception may occur in hypopituitarism
    • testosterone in men - depot or subcutaneous
  • thyroxine - 100-200 mcg daily in a single dose
  • hydrocortisone - 10-20 mg in the morning, 10 mg in late afternoon - mineralocorticoids not needed
  • growth hormone replacement therapy in adults
  • intranasal desmopressin if diabetes insipidus - 10 mcg once or twice daily

Note that if there is combined adrenal and thyroid failure, an adrenal crisis may be precipitated by starting thyroxine replacement before corticosteroids.

Last reviewed 01/2018

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