Are there disorders or conditions associated with Cushing syndrome?
Very rarely, a surgeon cannot remove all of the cancerous cells causing Cushing syndrome. And sometimes a person needs to continue taking glucocorticoid medication to treat an underlying condition, even though the medication is causing Cushing syndrome. In both these cases, Cushing syndrome symptoms might become worse, and additional symptoms can appear over time, including:
- Persistent fatigue
- Muscle weakness
- Abdominal and facial weight gain
- Mood swings
- High blood pressure
- High blood sugar
Health care providers can prescribe medication or other therapy to reduce these symptoms.
What’s the difference between Cushing syndrome and Cushing disease?
Individuals with Cushing disease have Cushing 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 disease. The majority of tumor-driven Cushing syndrome cases are caused by Cushing disease.2
Can Cushing syndrome lead to cancer?
Some benign or malignant tumors cause Cushing 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 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
If one partner has Cushing syndrome, can the couple still get pregnant?
Cushing syndrome can affect fertility in both men and women.
The high levels of cortisol in Cushing syndrome disrupt a woman’s ovaries. Her menstrual periods may stop completely or become irregular. As a result, women with Cushing 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
After a woman is treated for Cushing 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 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 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 syndrome can reduce fertility.10 However, fertility usually recovers after Cushing syndrome is cured and treatment has stopped.9
Does Cushing syndrome affect pregnancy?
Cushing syndrome can cause serious and potentially life-threatening effects for the mother and the fetus during pregnancy.11,12 For example, Cushing 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
- Margulies, P. (n.d.). Adrenal diseases—Cushing’s syndrome: The facts you need to know. Retrieved May 21, 2012, from National Adrenal Diseases Foundation website http://www.nadf.us/adrenal-diseases/cushings-syndrome/
- Nieman, L. K., & Ilias, I. (2005). Evaluation and treatment of Cushing’s syndrome. Journal of American Medicine, 118(12), 1340-1346. PMID 16378774.
- American Cancer Society. (n.d.). Fact sheet on pituitary tumors. Retrieved May 19, 2012, from http://documents.cancer.org/acs/groups/cid/Documents/webcontent/003133-pdf.pdf (PDF - 171 KB).
- Biddie, S. C., Conway-Campbell, B. L, & Lightman, S. L. (2012). Dynamic regulation of glucocorticoid signalling in health and disease. Rheumatology, 51(3), 4034-4112. Retrieved May 19, 2012, from PMID: 3281495.
- Abraham, M. R., & Smith, C. V. (n.d.). Adrenal disease and pregnancy. Retrieved April 8, 2012, from http://emedicine.medscape.com/article/127772-overview - aw2aab6b6.
- Pickard, J., Jochen, A. L., Sadur, C. N., & Hofeldt, F. D. (1990). Cushing’s syndrome in pregnancy. Obstetrical & Gynecological Survey, 45(2), 87-93. PMID 2405312.
- Lindsay, J. R., Jonklaas, J., Oldfield, E. H., & Nieman, L. K. (2005). Cushing’s syndrome during pregnancy: Personal experience and review of the literature. Journal of Clinical Endocrinology and Metabolism, 90(5), 3077. PMID 15705919.
- Klibansky, A. (n.d.). Pregnancy after cure of Cushing’s disease. Retrieved April 27, 2012, from http://03342db.netsolhost.com/page/pregnancy_after_cure_of_cushings_disease.php.
- Jequier, A.M. Endocrine infertility. In Male infertility: A clinical guide (2nd ed.). Cambridge University Press, 2011: chap 20, pages 187-188. Retrieved May 19, 2012, from http://books.google.com/books?id=DQL0YC79uCMC&pg=PA188&lpg=PA188&dq=male+infertility+causes+and+treatment+Cushing&source=bl&ots=k1Ah5tVJC7&sig=WJR4N0wUawlh0Rant31QMPq6ufs&hl=en&sa=X&ei=hGe5T-LrHYSX6AHgrvmzCw&ved=0CGoQ6AEwAQ#v=onepage&q=male%20infertility%20causes%20and%20treatment%20Cushing&f=false.
- Stewart, P. M., & Krone, N. P. (2011). The adrenal cortex. In Kronenberg, H. M., Shlomo, M., Polonsky, K. S., Larsen P. R. (Eds.). Williams textbook of endocrinology (12th ed.). (chap. 15). Philadelphia, PA: Saunders Elsevier.
- Abraham, M. R., & Smith, C. V. Adrenal disease and pregnancy. Retrieved April 8, 2012, from http://emedicine.medscape.com/article/127772-overview - aw2aab6b6.
- Buescher, M. A. (1996). Cushing's syndrome in pregnancy. Endocrinologist, 6, 357-361.
- Ezzat, S., Asa, S. L., Couldwell, W. T., Barr, C. E., Dodge, W. E., Vance M. L., et al. (2004). The prevalence of pituitary adenomas: A systematic review. Cancer, 101(3), 613-619. PMID 15274075.