Empty Sella SyndromeSymptoms, Doctors, Treatments, Advances & More
Learn About Empty Sella Syndrome
Empty sella syndrome is a condition in which the pituitary gland shrinks or becomes flattened.
Pituitary - empty sella syndrome; Partial empty sella
The pituitary is a small gland located just underneath the brain. It is attached to the bottom of the brain by the pituitary stalk. The pituitary sits protected inside a saddle-like bony compartment in the base of the skull. This compartment is called the sella turcica, but often just called the sella.
When the pituitary gland shrinks or becomes flattened, it cannot be seen on an MRI scan. This makes the area of the pituitary gland look like an empty sella. But the sella is not actually empty. It is often filled with cerebrospinal fluid (CSF). CSF is fluid that surrounds the brain and spinal cord. With empty sella syndrome, CSF has leaked into the sella turcica, putting pressure on the pituitary. This causes the gland to shrink or flatten.
Primary empty sella syndrome occurs when one of the layers (arachnoid) covering the outside of the brain bulges down into the sella and presses on the pituitary.
Secondary empty sella syndrome occurs when the sella is empty because the pituitary gland has been damaged by:
- A tumor
- Radiation therapy
- Surgery
- Trauma
Empty sella syndrome may be seen in a condition called pseudotumor cerebri, which mainly affects young, obese women and causes the CSF to be under higher pressure.
The pituitary gland makes several hormones that regulate other glands and hormones in the body, including:
- Adrenal glands
- Liver hormone related to growth (insulin-like growth factor-1)
- Ovaries
- Testicles
- Thyroid
A problem with the pituitary gland can lead to problems with any of the above glands and abnormal hormone levels of these glands.
Often, there are no symptoms or loss of pituitary function.
If there are symptoms, they may include any of the following:
- Erection problems
- Headaches
- Irregular or absent menstruation
- Decreased or no desire for sex (low libido)
- Fatigue, low energy
- Nipple discharge
For primary empty sella syndrome:
- No treatment is needed if pituitary function is normal.
- Medicines may be prescribed to treat any abnormal hormone levels.
For secondary empty sella syndrome, treatment involves replacing the hormones that are missing.
In some cases, surgery is needed to repair the sella to prevent CSF from leaking into the nose and sinuses.
Sabrina Chiloiro practices in Rome, Italy. Ms. Chiloiro is rated as an Elite expert by MediFind in the treatment of Empty Sella Syndrome. Her top areas of expertise are Acromegaloid Facial Appearance Syndrome, Hypertrichosis-Acromegaloid Facial Appearance Syndrome, Acromegaly, Hormone Replacement Therapy (HRT), and Orchiectomy.
Reading Hospital Endocrinology & Diabetes Center Wyomissing
. Dr. Gabriely is rated as an Experienced provider by MediFind in the treatment of Empty Sella Syndrome. His top areas of expertise are Low Blood Sugar, Hyperparathyroidism, Thyroid Cancer, and Anaplastic Thyroid Cancer.
Texas Health Neurosurgery And Spine Specialists
Dr. Joseph Quillin believes that the practice of neurosurgery is a tremendous privilege. His focus is on durable symptom relief, patient quality of life, maximum safe tumor resection, and the prevention of further neurological damage for his patients. His advanced training in brain, spine, and skull base/cerebrovascular disorders has enabled him to care for some of the most complex patients in neurosurgery. Dr. Quillin specializes in neurosurgical oncology and skull base surgery, using techniques such as radiotherapy and minimally invasive endoscopic surgery to promote tumor treatment and removal. He has served the DFW area since 2021.Dr. Quillin earned his medical degree at Louisiana State University Health Sciences Center in Shreveport. He completed his neurological surgery residency and fellowship training in neurological oncology at Emory University in Atlanta, Georgia. He also completed additional fellowship training in skull base/cerebrovascular surgery at Rutgers University in New Brunswick, N.J. Away from the office, Dr. Quillin has served as an ad hoc reviewer for publications including NEUROSURGERY, World Neurosurgery, and the Journal of Neuro-Oncology. He is a member of the American Association of Neurological Surgeons and Congress of Neurological Surgeons. Dr. Quillin is rated as an Experienced provider by MediFind in the treatment of Empty Sella Syndrome. His top areas of expertise are Meningioma, Pituitary Tumor, Brain Herniation, Endoscopic Transnasal Transsphenoidal Surgery, and Awake Craniotomy.
Primary empty sella syndrome does not cause health problems, and it does not affect life expectancy.
Complications of primary empty sella syndrome include a slightly higher than normal level of prolactin. This is a hormone made by the pituitary gland. Prolactin stimulates breast development and milk production in women.
Complications of secondary empty sella syndrome are related to the cause of pituitary gland disease or to the effects of too little pituitary hormone (hypopituitarism).
Contact your provider if you develop symptoms of abnormal pituitary function, such as menstrual cycle problems or impotence.
Published Date: April 24, 2025
Published By: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Bashari WA, Gillett D, MacFarlane J, Scoffings D, Gurnell M. Pituitary imaging. In: Melmed S, ed. The Pituitary. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 23.
Johannsson G, Ragnarsson O. Hypopituitarism including growth hormone deficiency. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 5.
Kaiser U, Ho KKY. Pituitary physiology and diagnostic evaluation. In: Melmed S, Auchus RJ, Goldfine AB, Rosen CJ, Kopp PA, eds. Williams Textbook of Endocrinology. 15th ed. Philadelphia, PA: Elsevier; 2025:chap 6.
Weiss RE. Anterior pituitary. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 205.