Hypothalamic hypopituitarism presenting as galactorrhea-amenorrhea

A young woman with secondary amenorrhea was also found to have a deficiency of growth hormone. Functional deficiency of adrenocorticotropic and thyroid stimulating hormones, and probably prolactin-inhibiting hormone, developed subsequently. No evidence of a mass lesion in the hypothalamic pituitary axis was found. She failed to respond to any pharmacologic agent believed to act functionally at a suprapituitary level, but responded to all stimuli believed to act directly on the pituitary. This progressive failure of the endocrine hypothalamus may be an extension of the idiopathic hypopituitarism syndrome found in children.