Very rarely, a surgeon cannot remove all of the cancerous cells causing Cushing’s syndrome. And sometimes a person needs to continue taking glucocorticoid medication to treat an underlying condition, even though the medication is causing Cushing’s syndrome. In both these cases, Cushing’s syndrome symptoms might become worse, and additional symptoms can appear over time, including:
Health care providers can prescribe medication or other therapy to reduce these symptoms.
Individuals with Cushing’s disease have Cushing’s syndrome symptoms. However, because their symptoms are caused specifically by a pituitary gland tumor (adenoma) that produces adrenocorticotropic hormone (ACTH), the condition is called Cushing’s disease. About 70% of tumor-driven Cushing’s syndrome cases are caused by Cushing’s disease.2
Some benign or malignant tumors cause Cushing’s syndrome. In rare cases, these tumors can spread to other parts of the body if they are not detected and treated in time.3
It is unknown whether Cushing’s syndrome makes it more likely for cancer to develop. Scientists are working to understand more about how stress (which makes the body produce cortisol) or taking medicines containing cortisol may disrupt the body’s immune system.4
Cushing’s syndrome can affect fertility in both men and women.
The high levels of cortisol in Cushing’s syndrome disrupt a woman’s ovaries. Her menstrual periods may stop completely or become irregular. As a result, women with Cushing’s syndrome almost always have difficulty becoming pregnant.5,6,7 For those who do become pregnant, the risk of miscarriage is high.5,6,7
In rare cases, usually when a woman’s Cushing’s syndrome is caused by a benign adrenal tumor, pregnancy can occur, but it brings high risk for the mother and fetus.5,6,7
After a woman is treated for Cushing’s syndrome, her ovaries often recover from the effects of too much cortisol. Her regular menstrual cycles will return, and she can become pregnant.8
In some women, regular periods do not return after they are treated for Cushing’s syndrome. This occurs if surgery removes the part of the pituitary gland involved in reproduction.4 An infertility specialist can prescribe hormone therapy to bring back regular periods, ovulation, and fertility.8
A man diagnosed with Cushing’s syndrome may have a decline in sperm production and could have reduced fertility.9 He also might experience a lowered sex drive as well as impotence (pronounced IM-puh-tuhns). In addition, some medications used to treat Cushing’s syndrome can reduce fertility.10 However, fertility usually recovers after Cushing’s syndrome is cured and treatment has stopped.9
Cushing’s syndrome can cause serious and potentially life-threatening effects for the mother and the fetus during pregnancy.11,12 For example, Cushing’s syndrome raises a woman’s risk of developing pregnancy-related high blood pressure (called preeclampsia, pronounced pree-i-KLAMP-see-uh, or eclampsia) and/or pregnancy diabetes, which also is called gestational (pronounced je-STEY-shuhn-ul) diabetes). Infection and slow healing of any wounds are more likely, as is heart failure. When the syndrome is caused by a tumor, it will be surgically removed as early as possible to reduce any threat.13
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