Treatment

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.