The cardinal characteristics for diagnosis are
loss of sexual function, asthenia, and low basal metabolic rate. Patients
usually have lack of lactation and amenorrhea postpartum. There is a
characteristic facies, described as waxy white and sallow, as a result of a
lack of melatonin. There is a loss of pubic and axillary hair, the skin is
dry, the eyebrows thin. The thyroid may be impalpable. Untreated patients
may have a low pulse rate with an often low and labile blood pressure.
Atypical patient may have maintained menstruation and with subsequent
pregnancies, may have much improved symptoms because of the adrenocortical
hormones secreted by the placenta. Treatment is by hormone replacement
including hydrocortisone and thyroxine, and ovulation may be induced with
follicle-stimulating hormone and luteinizing hormone therapy.