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Empty Sella Syndrome

What is empty sella syndrome?

Empty sella syndrome (ESS) may occur if you have an enlarged sella turcica. This is a bony structure where the pituitary gland sits at the base of the brain. During an imaging test of the area, the pituitary gland may first look like it is missing. In primary ESS, the pituitary gland is usually flattened. This type is more common in women who are obese and have high blood pressure. It has also been linked to a buildup of fluid in the brain. In secondary ESS, the pituitary gland may be small because of injury, radiation therapy, or surgery.

What causes empty sella syndrome?

Doctors do not know what causes primary ESS. Secondary ESS may be caused by injury, radiation therapy, or surgery. ESS is not a life-threatening illness.

What are the symptoms of empty sella syndrome?

You may not have any symptoms. If symptoms occur, they may include:

  • Impotence in men
  • Less desire for sex
  • Irregular menstrual periods in women

Symptoms vary from person to person. They also depend on your age and what caused the syndrome. Symptoms may look like other health problems. Always see your health care provider for a diagnosis.

How is empty sella syndrome diagnosed?

Your health care provider will ask about your past health and do a physical exam. You may also need these tests:

  • CT scan. This test uses X-rays and a computer to make images of your body. It helps find any problems.
  • MRI. This test creates 2-D views of an internal organ or structures, especially the brain or spinal cord.

How is empty sella syndrome treated?

Your health care provider will figure out the best treatment for you based on:

  • How old you are
  • Your overall health and past health
  • How sick you are
  • How well you can handle specific medicines, procedures, or therapies
  • How long the condition is expected to last
  • Your opinion or preference

You may not need treatment if you do not have any symptoms, and if your pituitary gland is not enlarged. Your health care provider will treat any hormone problems with hormone replacement.

When should I call my health care provider?

Call your health care provider if your symptoms get worse or you have new ones.

Key points

  • ESS may happen if you have an enlarged sella turcica. This is a bony structure where the pituitary gland sits at the base of the brain. The syndrome is not life-threatening.
  • The syndrome may not cause any symptoms. If symptoms occur, they may include impotence, less desire for sex, and irregular menstrual periods.  
  • You may not need treatment if you do not have symptoms, and if your pituitary gland is not enlarged.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
Online Medical Reviewer: Berry, Judith, PhD, APRN
Online Medical Reviewer: Foster, Sara, RN, MPH
Date Last Reviewed: 1/16/2014
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