Sheehan's syndrome's most common initial symptoms are difficulties with or total absence of lactation (agalactorrhea). Another common sign is infrequent menstrual cycles (oligomenorrhea) or absent menstrual cycles (amenorrhea) following delivery. In addition to menstrual irregularities other signs of sex hormone deficiency are hot flashes, decreased libido, and breast involution. Symptoms and signs of thyroid disorder are tiredness, intolerance to cold, constipation, weight gain, hair loss, slowed thinking, as well as a slowed heart rate and low blood pressure. Adrenal gland malfunction can present acutely or chronically. In a more chronic case, it is similar to Addison's disease with symptoms including fatigue, weight loss, hypoglycemia (low blood sugar levels), low hemoglobin levels (anemia) and hyponatremia (low sodium levels) that develop over several months or years. Acute adrenal insufficiency is referred to as an adrenal crisis, which can be life-threatening, and occurs very shortly after the inciting event i.e. significant blood loss post-partum in the context of Sheehan's syndrome. Adrenal crisis signs and symptoms include hypoglycemia, hypotension, weakness, fatigue, and seizures from severe hyponatremia. Growth hormone deficiency is one of the most common hormone deficiencies of hypopituitarism seen in Sheehan’s syndrome. Low levels of growth hormone may present with low energy, body aches, or subtle wrinkling of the skin around the eyes or mouth. The symptoms of anti-diuretic hormone deficiency are increased thirst, excessive urination, headache, and fatigue. Hematological changes might be seen as well such as anemia or low platelets (thrombocytopenia). Hyponatremia is seen in many cases of Sheehan's syndrome because it can result from multiple etiologies. Drops in thyroid hormones and glucocorticoid/adrenal hormones can indirectly lead to hyponatremia through water retention, while blood loss can trigger hyponatremia through ADH secretion. The development of Syndrome of Inappropriate Anti-Diuretic Hormone in patients with Sheehan's syndrome has been documented in the literature, although the mechanism is not well understood. Causes As stated, Sheehan's syndrome is caused by damage to the pituitary, thereby causing a decrease in one or more of the hormones it normally secretes. Sheehan's syndrome typically occurs because of excessive blood loss after delivery (post-partum hemorrhage), although there are several risk factors that may contribute to its development. This syndrome does not appear to be exclusively linked to childbirth, as Sheehan's syndrome has been reported in pregnant patients that experienced massive hemorrhage from non-obstetrical causes. The pituitary gland grows and has a higher metabolic demand during pregnancy because the pituitary needs