Panhypopituitarism Presents As Amenorrhea Secondary to Post Traumatic Stress Disorder in a 33-Year-Old Patient: A Case Report

Hormonal derangements should be suspected whenever a patient experiences amenorrhea with no abnormal physical exam findings. Clinical suspicion is increased if she also reports psychological trauma that could affect her nervous system and, by association, her hormones since the pituitary gland is present in the brain. Additional exams that aid in the diagnosis of amenorrhea include a variety of blood panels and imaging scans. Panhypopituitarism is a disorder in which there is a deficiency of all pituitary hormones that include but are not limited to the thyroid-stimulating hormone (FSH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Diagnosis is usually made by baseline blood sampling of these hormones. Secondary to panhypopituitarism, amenorrhea can be disguised as other neurogenic problems. In this case study, we present a 33-year-old female patient who presented to the clinic with amenorrhea and a traumatic past social history. Upon further workup of the patient, it was determined that the patient had panhypopituitarism that had to be managed with medications indefinitely. This case study is of the utmost interest because it highlights how panhypopituitarism, being such a rare condition, can easily be mistaken as amenorrhea secondary to psychological issues and how integral it is for a physician to keep an open mind when evaluating such patients.