Sheehans syndrome can present with complete or partial pituitary insufficiency resulting from severe post partum hemorrhage. The pituitary gland, owing to its enlargement during pregnancy secondary to high estrogen levels and hypervascularity, remains vulnerable to arterial prressure changes and prone to emorrhage/infarction following hypovolemic shock encountered during post partum hemorrhage. The presentation ranges from sudden catastrophic event of hypovolemic shock followed by pituitary necrosis to gradual onset of partial to complete pituitary insufficiency over months to years. Here is the case of a patient presenting with central hypopituitarism 9 yrs after the acute episode of post partum hemorrhage.
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