Medical Care & Treatment Plan
What Medical Care Can You Expect?
Pituitary Ireland believes that everyone living with a pituitary condition should have access to timely diagnosis, specialist care, appropriate treatment, and ongoing support.
Pituitary conditions are rare, and many healthcare professionals may have limited experience of diagnosing or managing them. However, all patients deserve to have their symptoms taken seriously and to receive appropriate investigations, treatment, and follow-up care.
We support equitable access to healthcare for all people affected by pituitary conditions, regardless of age, gender, ethnicity, religion, disability, or geographical location within the Republic of Ireland.
Specialist Assessment and Care
If a pituitary condition is suspected, patients should be referred to an endocrinologist – a doctor specializing in hormone disorders – for further assessment and management.
Where appropriate, patients should have access to specialist pituitary services with expertise in diagnosing and treating pituitary disorders. Care is often provided through a multidisciplinary team (MDT) that may include:
Endocrinologists
Pituitary neurosurgeons
Specialist endocrine nurses
Radiologists
Ophthalmologists (eye specialists)
Oncology and radiotherapy specialists where required
Other healthcare professionals involved in patient care
Investigations and Monitoring
Patients should have access to appropriate investigations, which may include:
Hormone blood tests
MRI or CT imaging of the pituitary gland
Vision and visual field assessments
Bone density (DEXA) scans where clinically indicated
Specialist endocrine testing when required
These investigations help healthcare teams establish an accurate diagnosis and develop an individualized treatment plan.
Surgery and Specialist Treatment
Where surgery is required, patients should be treated by surgeons experienced in pituitary surgery and supported by specialist multidisciplinary teams. Following treatment, patients should receive ongoing monitoring and follow-up care to assess hormone function, recovery, and long-term health.
Pituitary Surgery
Some people living with pituitary conditions may require surgery to remove or reduce the size of a pituitary tumor (adenoma). For many patients, surgery can play an important role in relieving symptoms, restoring hormone balance, protecting vision, and improving overall health.
Types of Pituitary Surgery
Most pituitary operations are performed through the nose using a procedure called transsphenoidal surgery. This approach allows surgeons to access the pituitary gland without making visible incisions on the head.
Modern pituitary surgery is often performed using specialised endoscopic equipment, which provides surgeons with enhanced visibility and precision. In some cases, neurosurgeons and ENT (Ear, Nose and Throat) surgeons work together during the procedure.
A less common operation, known as a craniotomy, involves accessing the tumour through the skull. This is generally reserved for complex cases where the tumour cannot be safely reached through the nose.
What Does Surgery Aim to Achieve?
The goal of pituitary surgery is to safely remove as much of the tumor as possible while protecting surrounding nerves, blood vessels, and brain structures.
Surgery may:
Relieve pressure on nearby structures, including the optic nerves
Improve or restore hormone balance
Reduce tumor size
Improve symptoms caused by hormone overproduction or tumor growth
Prevent further complications
Many pituitary tumors can be successfully treated with surgery. However, in some cases, a small amount of tumor tissue may remain and require ongoing monitoring or additional treatment.
Are Pituitary Tumos Cancerous?
It is important to remember that the vast majority of pituitary tumors are benign (non-cancerous). Although they are not cancer, they can still affect hormone production and surrounding structures and may require treatment.
Recovery After Surgery
Recovery varies from person to person. Even though there may be no visible scar, pituitary surgery is still major surgery and it can take time for the body to heal.
Following surgery, you may experience:
Tiredness and fatigue
Nasal congestion or discomfort
Temporary changes in hormone levels
The need for ongoing hormone replacement therapy
Your healthcare team will advise you on recovery, activity levels, medications, and follow-up appointments.
Follow-Up Care
Regular follow-up is an important part of pituitary care.
After surgery, patients are typically reviewed by their endocrinologist and surgical team. Follow-up may include:
Hormone blood tests
MRI scans of the pituitary gland
Vision assessments where appropriate
Review of hormone replacement therapy
Monitoring for tumor recurrence
The timing and frequency of follow-up appointments will vary depending on your individual condition and treatment plan.
Long-Term Monitoring
People diagnosed with a pituitary tumor should remain under specialist endocrine care. Regular monitoring helps ensure hormone levels remain well managed and allows healthcare professionals to detect any changes that may require further treatment.
Although pituitary tumors are usually benign and often grow very slowly, they can occasionally return or increase in size over time. Ongoing specialist follow-up is therefore an important part of long-term care.
Support and Information
At Pituitary Ireland, we provide information, support, and signposting to trusted resources for people undergoing investigation, treatment, or recovery from pituitary surgery. If you have questions about your condition or treatment, always speak with your endocrinologist, neurosurgeon, or specialist healthcare team.
Radiotherapy for Pituitary Tumors
Radiotherapy is sometimes used as part of the treatment for pituitary tumours (pituitary adenomas). Its primary purpose is to stop tumour growth, reduce the risk of regrowth, and help control hormone production when surgery or medication alone has not been fully effective.
Most pituitary tumours are benign (non-cancerous), but they can still grow and affect hormone levels, vision, and surrounding structures. Radiotherapy may be recommended if a tumour cannot be completely removed during surgery, if it regrows after treatment, or if hormone levels remain elevated despite surgery and medication.
How Does Radiotherapy Work?
Radiotherapy uses carefully targeted high-energy X-rays to damage tumour cells and prevent them from growing and dividing. Treatment is delivered using specialised machines called linear accelerators (Linacs), which direct radiation precisely at the tumour while minimising exposure to surrounding healthy tissue.
Unlike surgery, the effects of radiotherapy occur gradually. Tumour growth may be controlled immediately, but any shrinkage often happens slowly over months or even years.
Radiotherapy is an external treatment and does not make you radioactive, meaning it is safe to be around family, friends, and children during and after treatment.
When Might Radiotherapy Be Recommended?
Your multidisciplinary pituitary team may consider radiotherapy if:
Part of the tumour remains after surgery.
The tumour is located in an area that cannot be safely removed surgically.
Hormone levels remain elevated despite surgery and medication.
The tumour regrows following previous treatment.
Additional treatment is needed to reduce the risk of future tumour growth.
Treatment Planning
Before radiotherapy is recommended, your healthcare team will review:
MRI or CT scan results
Hormone blood tests
Visual assessments
Previous treatments and surgery
Decisions are usually made by a specialist multidisciplinary team that may include endocrinologists, neurosurgeons, radiation oncologists, radiologists, and specialist nurses.
Follow-Up Care
Following radiotherapy, ongoing monitoring is important. Patients typically have regular:
MRI scans
Hormone blood tests
Vision assessments
Endocrinology reviews
This helps ensure the tumor remains stable and allows healthcare professionals to identify any changes that may require further treatment.
Support and Information
At Pituitary Ireland, we understand that decisions about radiotherapy can feel overwhelming. We provide information, support, and signposting to trusted resources to help patients and families better understand their treatment options and ongoing care.
Hormone Replacement Medication Interactions
People with pituitary disease often need treatment with several different pituitary hormones, which can frequently interact with one another. This section reviews how growth hormone (GH), thyroxine, corticosteroids, and male and female sex hormone replacement can affect each other.
Depending on your Pituitary Gland condition, diagnosis, treatment paths may vary, many patients start a treatment plan of medications and hormone replacement therapy. Hormone Replacement Therapy for Pituitary Conditions
The pituitary gland is often referred to as the body's "master gland" because it controls the production of many important hormones that regulate growth, metabolism, reproduction, stress response, and water balance. When a pituitary condition affects the gland's ability to produce these hormones, hormone replacement therapy may be required.
Hormone replacement therapy aims to restore hormone levels to as close to normal as possible, helping to improve symptoms, protect long-term health, and enhance quality of life. Treatment is tailored to each individual and depends on which hormones are affected. Some people may require one hormone replacement medication, while others may need several different treatments.
Regular monitoring by an endocrinologist is important to ensure medications remain effective and doses are adjusted when necessary.
Common Hormone Replacement Therapies
Adrenal Hormone Replacement
Used when the body does not produce enough cortisol.
Common medications include:
Hydrocortisone
Prednisolone
Cortisone acetate
Dexamethasone (occasionally)
Thyroid Hormone Replacement
Used to treat secondary hypothyroidism caused by pituitary disease.
Common medication:
Levothyroxine
Growth Hormone Replacement
Used for adults and children with Growth Hormone Deficiency (GHD).
Common medication:
Recombinant Human Growth Hormone (Somatropin)
Examples include:
Genotropin®
Norditropin®
Omnitrope®
Nutropin®
Sex Hormone Replacement
Women
Used when oestrogen levels are low due to pituitary hormone deficiency.
Common treatments include:
Oestrogen replacement therapy
Combined Hormone Replacement Therapy (HRT)
Progesterone (where appropriate)
Men
Used when testosterone production is reduced.
Common treatments include:
Testosterone gel
Testosterone injections
Testosterone patches
Antidiuretic Hormone (ADH) Replacement
Used in Arginine Vasopressin Deficiency (AVP-D), formerly known as Diabetes Insipidus.
Common medication:
Desmopressin (DDAVP)
Available as:
Tablets
Nasal spray
Oral melt preparations
Other Medical Treatments for Pituitary Conditions
Some pituitary conditions require medications that reduce hormone production or shrink pituitary tumours.
Examples include:
Prolactinoma
Cabergoline
Bromocriptine
Quinagolide
Acromegaly
Octreotide
Lanreotide
Pasireotide
Pegvisomant
Cushing's Disease
Osilodrostat
Metyrapone
Ketoconazole
Pasireotide
Monitoring and Long-Term Care
Most people living with pituitary conditions require ongoing follow-up with an endocrinologist. Regular blood tests, scans, and clinical assessments help ensure treatments remain effective and hormone levels are appropriately managed.
At Pituitary Ireland, we provide information, support, and signposting to trusted resources to help patients better understand their condition and treatment options. Treatment decisions should always be made in consultation with your endocrinologist or healthcare team.