Symptoms Of Cushing's Disease

Cushing’s disease symptoms Last updated Aug. 4, 2023, by Marisa Wexler, MS Fact-checked by Joana Carvalho, PhD Common symptoms Complications Symptoms by gender Symptoms in children FAQs

The symptoms of Cushing’s disease are caused by excess levels of cortisol, called the “stress hormone,” and can include weight gain, skin changes, muscle weakness, and extreme fatigue.

Normally, cortisol helps to regulate a wide array of bodily functions, such as controlling how the body uses energy, regulating salt and sugar levels, blood pressure, inflammation, breathing, and even helping form memories. However, chronically high cortisol levels, a condition also known as hypercortisolism, can lead to a wide variety of physical, hormonal, and psychological symptoms.

Cushing’s disease is caused by a tumor in the brain’s pituitary gland; it is a type of Cushing’s syndrome, a broader umbrella term referring to any disorder driven by high cortisol levels. It is the most common form of endogenous Cushing’s syndrome, in which high cortisol levels are driven by internal factors, usually a tumor, in the body. Treatment generally involves surgery to remove the disease-driving tumor and/or medications to help normalize cortisol levels.

Cushing’s disease can cause fatal health complications, especially if left untreated for a long time, and research has shown that even with treatment, patients are at a higher mortality risk, potentially affecting their life expectancy. A timely diagnosis and prompt treatment are important to ensure a good prognosis.

Common symptoms of Cushing’s disease

Cushing’s disease can lead to a wide array of signs and symptoms, including:

• weight gain and a buildup of fat in certain parts of the body
• skin changes, like acne, unusual stretch marks, easy bruising, and slow wound healing
• muscle weakness and thinning of the arms and legs
• extreme fatigue and emotional issues, such as irritability, depression, and anxiety
• hair loss on the head and appearance of thicker body hair elsewhere
• reduced sex drive and fertility issues
• other health issues, ranging from high blood pressure and diabetes to osteoporosis.

The way these symptoms manifest varies from person to person. Not everyone with Cushing’s disease will experience all of its possible signs and symptoms.

Changes in body fat content and distribution, as well as skin changes and excessive hair growth on certain body parts, are among its most common symptoms.

Body fat changes

Cortisol changes the way the body uses energy and stores fat. In Cushing’s disease, high cortisol levels commonly lead to symptoms such as:

• excess weight gain, or obesity
• buildup of fat around the abdomen, sometimes referred to as “central obesity”
• unusual fat buildup in the face (“moon face”), in the back of the neck, and between the shoulder blades (“buffalo hump”)
• thinner-than-normal arms and legs.

Skin changes

High cortisol levels and subsequent hormonal changes in people with Cushing’s disease can trigger skin alterations, such as:

• acne
• skin darkening
• easy bruising, especially on the arms and legs
• wide pink or purple stretch marks, most commonly on the abdomen, thighs, buttocks, arms, and/or chest
• unusually fragile and thin skin
• slow wound healing.

Body hair changes

High cortisol levels and other hormonal changes in Cushing’s disease also may lead to changes in body hair, including:

• balding
• excess growth of thick, dark body hair, also known as hirsutism, on the face, neck, chest, stomach, and/or thighs.

Mental health and emotional problems

Cortisol is commonly referred to as the “stress hormone,” because its levels are higher when a person is under stress. The high cortisol levels present in Cushing’s disease can also cause problems with emotions and mental health, including:

• anxiety
• depression
• irritability
• difficulty concentrating
• memory problems.

Other symptoms and complications of Cushing’s disease

Cushing’s disease can lead to other health problems, especially when it remains untreated for a long time. Although less common, these problems include:

• muscle weakness
• persistent feeling of tiredness or fatigue
• headache
• sleeplessness
• swelling
• high blood pressure (hypertension)
• bone loss (osteoporosis), which increases the risk of bone fractures
• recurrent infections
• blood clots in the legs and/or lungs
• heart attack or stroke
• abnormally high levels of fatty molecules in the bloodstream (dyslipidemia)
• problems regulating blood sugar levels, which may lead to insulin resistance and type 2 diabetes.

Specific Cushing’s disease symptoms in men and women

In both men and women, Cushing’s disease can cause problems with fertility, reduce sex drive (libido), and cause issues with sexual arousal.

Specific Cushing’s disease symptoms in men

Men with Cushing’s disease often have a low sperm count, which may reduce or compromise fertility. They may also experience erectile dysfunction and show decreased interest in sex.

Some studies have suggested that men with Cushing’s disease seem to be more prone to osteoporosis than women, and that both groups exhibit different clinical patterns.

Specific Cushing’s disease symptoms in women

The high levels of cortisol that characterize Cushing’s disease may disrupt the function of a woman’s ovaries, causing menstrual periods to become irregular or to stop altogether. As a result, women with Cushing’s disease usually have more difficulty getting pregnant. Those who do become pregnant typically are at an increased risk of experiencing a miscarriage or early pregnancy loss. They are also more likely to experience pregnancy complications, including gestational diabetes and preeclampsia.

Women with Cushing’s may also experience issues with sexual arousal and satisfaction, which may include reduced vaginal lubrication and difficulty achieving an orgasm.

While excess body hair, or hirsutism, can affect people of both sexes, it is usually more noticeable in women.

Specific Cushing’s disease symptoms in children

Children with Cushing’s disease can experience most of the same symptoms found in adults, including skin changes, weight gain, and emotional problems. The disease can interfere with a child’s normal growth, resulting in stunted growth.

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