Other Cushing Syndrome FAQs

Basic information for topics such as “What is it?” is available in the About Cushing Syndrome section. Answers to other frequently asked questions (FAQs) specific to Cushing syndrome are in this section.

Untreated Cushing syndrome can cause serious and potentially life-threatening problems for the mother and the fetus during pregnancy.1 If a woman with untreated Cushing syndrome is able to get pregnant, the risk of miscarriage is high.1,2,3 For the mother, untreated Cushing syndrome raises the risk of developing pregnancy-related high blood pressure (called preeclampsia or eclampsia) and pregnancy-related diabetes (called gestational diabetes). She also has a higher risk of heart failure, and any wounds are more likely to get infected and to heal slowly. When a tumor causes the syndrome, it will be surgically removed as early as possible to reduce any threat.4

Cushing disease is the term used to describe Cushing syndrome symptoms that result from a pituitary adenoma (a type of tumor). The adenoma in the pituitary gland produces adrenocorticotropic hormone (ACTH). The adrenal gland detects the ACTH and makes more cortisol, leading to Cushing symptoms.

Cushing disease accounts for the majority of the cases of Cushing syndrome caused by tumors.5

It is unknown whether Cushing syndrome makes it more likely for cancer to develop. Scientists are working to understand more about how excess exposure to cortisol or medicines containing cortisol may disrupt the body’s immune system.6

Cushing syndrome can affect fertility in both men and women.

Women

The high levels of cortisol in Cushing syndrome disrupt the function of a woman’s ovaries. Menstrual periods may stop completely or become irregular. As a result, women with untreated Cushing syndrome usually have difficulty becoming pregnant.1,2,3 Those who do become pregnant are at higher risk for miscarriage/early pregnancy loss.1,2,3

After a woman receives treatment for Cushing syndrome, her ovaries may recover from the effects of too much cortisol. Her menstrual cycles can become regular, and pregnancy is more likely.7

Some women continue to have irregular menstrual periods and problems with ovarian function even after treatment for Cushing syndrome. This is most likely when surgery removes the part of the pituitary gland involved in reproduction.6 Women should work with their healthcare providers and possibly a fertility specialist to get treatment that can bring back regular periods, ovulation, and fertility.7

Men

A man with Cushing syndrome may make fewer sperm and could have reduced fertility.8 He also might have less of a sex drive. He also could experience impotence. However, fertility usually recovers after Cushing syndrome is cured and treatment has stopped.8

Citations

  1. Abraham, M. R., & Smith, C. V. (n.d.). Adrenal disease and pregnancy: Cushing syndrome. Retrieved March 13, 2017, from http://emedicine.medscape.com/article/127772-overview#a6 
  2. Pickard, J., Jochen, A. L., Sadur, C. N., & Hofeldt, F. D. (1990). Cushing’s syndrome in pregnancy. Obstetrical & Gynecological Survey, 45(2), 87–93. Retrieved April 9, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/2405312
  3. 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), 3077–3083. Retrieved April 9, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/15705919
  4. Ezzat, S., Asa, S. L., Couldwell, W. T., Barr, C. E., Dodge, W. E., Vance M. L., & McCutcheon, I. E. (2004). The prevalence of pituitary adenomas: A systematic review. Cancer, 101(3), 613–619. Retrieved April 9, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/15274075
  5. Nieman, L. K., & Ilias, I. (2005). Evaluation and treatment of Cushing’s syndrome. Journal of American Medicine, 118(12), 1340–1346. Retrieved April 9, 2019, from https://www.ncbi.nlm.nih.gov/pubmed/16378774
  6. Biddie, S. C., Conway-Campbell, B. L, & Lightman, S. L. (2012). Dynamic regulation of glucocorticoid signalling in health and disease. Rheumatology, 51(3), 403–412. Retrieved May 19, 2012, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3281495
  7. Klibansky, A. (n.d.). Pregnancy after cure of Cushing’s disease. Retrieved March 13, 2017, from https://csrf.net/doctors-articles/reproductive-issues/pregnancy-after-cure-of-cushings-disease/ 
  8. Jequier, A. M. (2011). Male infertility: A clinical guide, 2nd ed. Cambridge, United Kingdom: Cambridge University Press. Retrieved March 13, 2017, 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 
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