What is Empty Sella Syndrome?
Empty sella syndrome (ESS) is a condition that affects the area at the base of the brain where the pituitary gland sits. The pituitary gland helps control many important body functions, including growth, metabolism, and reproduction.
There are two main types of ESS. Primary ESS develops without a clear cause and may be linked to increased pressure around the brain. It is seen more often in women with obesity or high blood pressure.
Secondary ESS happens when the pituitary gland is affected by another condition or treatment, such as:
- Pituitary tumors
- Head injuries
- Radiation therapy
- Pituitary surgery
- Inflammation of the pituitary gland
With ESS, imaging tests may show that the pituitary gland looks flattened or smaller than usual. In many cases, the condition does not cause serious health problems and may be found during testing for another reason.
Symptoms
Some people with empty sella syndrome do not notice any symptoms. Others may develop symptoms related to changes in pituitary hormone levels.
Possible symptoms can include:
- Frequent headaches
- Low sex drive
- Erectile dysfunction
- Irregular menstrual periods
- Fertility problems
- Fatigue
- Early puberty in children
How is it diagnosed?
Providers diagnose empty sella syndrome using a combination of your symptoms, medical history, and imaging tests. An MRI is commonly used because it gives detailed pictures of the pituitary gland and surrounding structures. A CT scan may also be used in some cases.
Blood tests can help check whether the pituitary gland is producing normal hormone levels. These results help guide treatment decisions.
How is it treated?
Treatment depends on whether the condition is causing symptoms or hormone changes. Many people with ESS do not need treatment and only require routine monitoring.
If hormone levels are low, hormone replacement therapy may help restore balance and improve symptoms. Your provider may also treat related conditions that affect the pituitary gland.
Most people with empty sella syndrome are able to manage the condition successfully and continue normal daily activities.
