Heather in conversation with her Obstetrician Dr Chad Thomas: When Awareness Becomes Lifesaving

A Conversation on Sheehan’s Syndrome

With Heather Thiessen and Dr Chad Thomas

Introduction: When Awareness Becomes Lifesaving

Heather:
Hi everyone, and thank you so much for joining this important conversation today. I’m Heather Thiessen, and my journey into pituitary health began unexpectedly after the birth of my son.

Following multiple hospital visits and countless tests, we learned that the symptoms I was experiencing were caused by a rare condition called Sheehan’s Syndrome—damage to the pituitary gland that can occur after childbirth.

Because it’s so rare, diagnosis often takes years. What my medical team identified in about nine days can take other women up to nine years to uncover. I’m deeply grateful for the care I received and honoured to sit down with my obstetrician, Dr. Chad Thomas, to talk about recognizing early signs and ensuring women get the care they need sooner.

Our goal today is to raise awareness for both patients and providers—because when something feels off, it deserves to be investigated with urgency. Awareness doesn’t just change outcomes; it can save lives.

A Rare Case and a Shared First

Heather:
Dr. Thomas, thank you so much for being here. We’ve been through quite a journey together, and looking back, I realize how critical awareness is—for mothers and for the medical community. Is it fair to say we experienced a big first together?

Dr. Thomas:
Absolutely. Sheehan’s Syndrome is incredibly rare. In my 15 years as an OBGYN, you’re the only patient I’ve seen with it. In the U.S., it occurs in roughly one in 100,000 births. Globally, it’s more common due to different healthcare circumstances, but still unusual. So yes—you’re one of those cases I’ll always remember.

Understanding Sheehan’s Syndrome

Heather:
Before we go too far, can you help set the stage a bit? What’s actually happening physiologically when Sheehan’s develops?

Dr. Thomas:
Most often, Sheehan’s Syndrome occurs after a massive postpartum haemorrhage—when a mother loses a large portion of her blood volume and her blood pressure drops dramatically. The pituitary gland, which sits at the base of the brain, enlarges during pregnancy to support hormone production. When blood flow suddenly decreases, the gland can suffer damage or even infarction (tissue death) from the lack of oxygen.

Because the pituitary controls so many hormones—thyroid, adrenal, reproductive, and more—its failure can affect almost every system in the body.

Early Signs: What to Watch For

Heather:
My symptoms came on fast because my case was severe, but for women who might have a more gradual onset, what early signs should they look for?

Dr. Thomas:
That’s a great question. Sheehan’s can vary widely. The two signs I most often associate with it are:

Difficulty with milk production. If a mother’s milk doesn’t come in, that can be a red flag. Of course, there are many other reasons for low milk supply, so we have to be careful not to jump to conclusions.

Lack of menstrual return. If menstruation doesn’t resume several months after delivery and after stopping breastfeeding, that’s another clue worth investigating.

Because these symptoms can take time to become apparent, many women don’t realize something is wrong until they’re months or even a year postpartum.

Heather’s Story: From Home Birth to Hospital Crisis

Heather:
Everything looked healthy leading into my birth, so I chose a home birth. The delivery itself was beautiful—our son was healthy and everything seemed perfect.

But when it came time to deliver the placenta, everything changed. I developed a rare complication called an inverted uterus, which led to severe haemorrhaging. I remember the pain and the chaos, but everything happened so fast. I was rushed to the ER by ambulance.

The next day, I had a splitting headache—worse than anything I’d ever experienced. My care team tried everything, and I underwent several rounds of blood transfusions. Eventually, an MRI was done to help piece together what was happening.

Dr. Thomas:
By the time we saw you, you’d lost roughly half your blood volume. That’s an enormous loss. Initially, we were focused on stabilizing you and making sure your vital signs and lab results improved. It seemed like things were headed in the right direction—until your symptoms started to shift.

When you mentioned your milk wasn’t coming in, it triggered a memory for me from medical school—Sheehan’s Syndrome. It’s one of those “zebra” diagnoses we read about but rarely see. That prompted us to order the MRI and additional hormone testing, including prolactin and cortisol levels.

Connecting the Dots

Heather:
So it was really the combination of the haemorrhage and my milk not coming in that prompted the Sheehan’s diagnosis?

Dr. Thomas:
Exactly. Your prolactin levels were low and didn’t rise after breastfeeding attempts, which told us your pituitary wasn’t responding normally. We also found abnormalities in your cortisol levels—another sign that multiple parts of your pituitary were affected. That’s when we brought endocrinology on board and confirmed the diagnosis.

How Sheehan’s Can Vary

Heather:
For others who might be wondering, can Sheehan’s affect just part of the pituitary, or does it always involve the whole gland?

Dr. Thomas:
You can have Sheehan’s even if only part of the pituitary is affected. Usually, the posterior pituitary is more vulnerable, which can lead to issues like failure to lactate. But with more severe events, the anterior pituitary can also be damaged—impacting menstruation, blood pressure regulation, growth hormones, and more. The extent of the damage determines how widespread the hormone deficiencies are.

Testing and Diagnosis

Heather:
If someone suspects Sheehan’s—either a patient advocating for herself or a doctor evaluating a postpartum patient—what tests are most useful?

Dr. Thomas:
A good starting point is a prolactin level test, ideally measured after breastfeeding or pumping. Normally, prolactin spikes in response to feeding. If that level stays low or undetectable, that’s a red flag.

From there, depending on the symptoms, we might check cortisol and thyroid hormone levels, since those can also be impacted by pituitary injury. It’s always a balance—we don’t want to over-test, but we also don’t want to miss something serious.

Lessons Learned

Heather:
It’s incredible how many factors were at play—and how much depends on awareness and timing. I’m endlessly grateful that our paths crossed when they did and that you connected the dots so quickly.

Dr. Thomas:
Thank you, Heather. My takeaway from your case is a reminder to stay curious. Most of the time, we’re treating the “horses,” the common conditions. But occasionally, we encounter a “zebra”—the rare diagnosis that changes everything. When things don’t quite add up, that’s our cue to look deeper.

Closing Reflections

Heather:
I love that. My hope in sharing this story is that it helps shorten the path to diagnosis for other women. Recovery after childbirth looks different for everyone, and listening to your intuition, asking questions, and advocating for follow-up care can make all the difference.

Dr. Thomas, thank you for your compassion, for your curiosity, and for helping to bring more visibility to maternal pituitary health. The more we talk about these rare conditions, the more women we can reach—and the more lives we can change.

Dr. Thomas:
You’re welcome. I’m glad to be a part of it.