Just as a symphony, which is music to the ears, is the result of a well orchestrated team of musicians, so also is the action of hormones in the human body! Hormones are substances produced by various glands such as the thyroid gland, the ovaries, the testis, the adrenals etc. Once produced in the human body, hormones travel through the blood and act on various organs in the body.  All these glands are finally controlled by the maestro, the pituitary gland which is a tiny little spherical gland attached to the base of the brain. For example, even though the thyroid gland is situated in the neck, its secretion has effects on various bodily functions. Thyroid secretion maybe inadequate if the pituitary does not send a hormone, the thyroid stimulating hormone (TSH) signal to the thyroid gland to start its secretion (T3-T4). This deficiency, in a woman, makes her miss her periods, put on weight, get constipated, have dryness of the skin, prevents her from getting pregnant, and if she does get pregnant it may cause an abortion, and if the pregnancy continues and her thyroid deficiency does not get corrected it can cause delayed mental development in the baby! Just a small dose of thyroid hormone can correct the deficiency and prevent such problems. On the other hand if the thyroid hormone is being produced in abundance (hyperthyroidism) then it can cause weight loss, tremors of the hands, thumping of the heart or palpitations, excessive hunger and thirst and sometimes protrusion of the eyeballs, which can be quite upsetting. This is not the result of pituitary dysfunction, but a dysfunction of the thyroid gland which can be corrected with medication. 

Similarly the ovaries are situated in the female pelvis, but its hormone estrogen has effects on the breasts, vagina, urinary tract, bones heart, skin, hair, nails, muscles, joints etc. Being a gynecologist, I will focus on the hormones which affect reproduction which are controlled by the pituitary gland. When the pituitary functions normally, all goes well.

But if the pituitary gland becomes ill due to infection, or lack of oxygen or injury or a tumor growing within it, then all hell breaks loose! The pituitary produces various hormones which affect various hormonal glands. It produces the follicular stimulating hormone (FSH) and luteinizing hormone (LH) which stimulate the ovaries to produce estrogen. But if the pituitary does not produce FSH & LH, the ovaries refuse to function and go into a sleep mode and refuse to secrete the female hormones, mainly estrogen, which then leads to a phase of absent periods, depression, thinning and dry hair, lack of sexual desire and sleep, and difficulty to conceive leading to infertility.

The other hormone which the pituitary releases in a woman is prolactin. Prolactin is responsible for letting down milk from the breasts in a breast feeding mother. Prolactin is always raised in a pregnant woman, but if it is raised in a non-pregnant woman, it is known as “hyperprolactinemia” which causes milky discharge from the breasts and scanty and delayed/ absent periods. This leads to infertility and early pregnancy losses. Also, optic nerves are the nerves which start from the brain and reach the eyes. If the prolactin levels are high because of a tumor in the pituitary gland, then the tumor could press on these optic nerves, which are lying under the pituitary gland, and cause blindness!

One more important hormone is oxytocin which is released during labor in a pregnant woman. This hormone helps the uterus to contract which helps the baby to be delivered. If oxytocin  is not released in good time, the lady goes beyond her due date and if the labor still does not start for a week or two following the due date, it can harm the baby because, the placenta, which supplies nutrition to the baby out lives its life span. In such cases we offer oxytocin to initiate labor and prevent this harm.

The last important hormone is adreno cortico tropic hormone (ACTH) which acts on the adrenal glands (small glands situated on top of the kidneys). If this hormone is secreted excessively by the pituitary, then it leads to excessive steroid production from the adrenal gland which leads to obesity, pigmentation, acne and hair growth on the face and in areas where generally only men have hair.

Therefore, there are a range of hormones produced by the pituitary which may be produced normally, or in excess, or not at all! When produced normally, the pituitary works brilliantly and should be applauded as we applaud the conductor or maestro of a 100 member orchestra!

With over 3 decades of experience, we at Gynaecworld completely understand a woman’s world and are here to look after the medical hurdles that come your way. You are the center of all our efforts!!!

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