Replacement therapy in hypothalamo-pituitary insufficiency after childhood: management in the adult.

Replacement therapy in cases of hypopituitarism in the adult has improved dramatically in the last decade. After initial detailed investigation of the extent of the hormone deficiency, the replacement therapy is tailored to the particular needs of the individual. Over-replacement with glucocorticoids must be avoided. Replacement of gonadal steroids is simpler than the induction of fertility. Gonadotrophin-releasing hormone has simplified fertility induction in cases of hypothalamic origin of the disease. Altered body composition and poor quality of life reversible with GH therapy have emphasised the importance of GH in the adult.