"My son's secret destroyed him"

About: North Yorkshire and York PCT

(as a relative),

Last August our 31-year-old son committed suicide. We discovered from letters that he'd been impotent. His girlfriend confirmed that he'd never managed full sex with her in the four years they were together. We wondered if this could have been something to do with a bad head injury he'd had aged 7. My sister found a large body of research that shows that 25% of moderate/severe head injury survivors have damage to their pituitary gland, which is likely to cause a deficiency of sex hormones and also of ACTH the hormone that governs people's reaction to stress. The pituitary gland may continue to work after the injury, but then malfunction, sometimes many years later.

Pituitary damage is terribly under-diagnosed. Our son's GP in Skipton Yorkshire didn't know of the risk. If he had, he would have referred our son to an endocrinologist when he consulted him the year before he died, complaining of headaches and saying that I, his mum, was worried in case he was developing a tumour on the site of his original head injury (which in fact he may have been - a pituitary tumour). He might also have been alerted by our son's previous episodes of depression. [However even in 2008 the research was very poorly disseminated, for example NICE did not refer to pituitary risk in their head injury guidelines (and still don't), and NHSDirect had no information on it.]

In fact going back further still, when he was depressed in 2003, our GP in Coulsdon whom he visited might have put two and two together and sent him to an endocrinologist then, instead of a psychiatrist and counsellor. However we do not blame them as most of the research came out after 2003.

I think there may be many people like our son, who have no idea their depression or sexual problems are caused by head injury, or that they could be treated with hormone replacement. Our son never asked his GP about his erectile dysfunction, probably believing that it was psychological. And we, from the outside, couldn't tell that he had any problems. We, and he, were absolutely trapped by our ignorance. There was no way he could get help.

If we'd only known, if we'd been warned, we would have made sure he was checked out by an endocrinologist, and then he could have had treatment. His girlfriend wouldn't have left him - she must have loved him a lot to stay with him so long - and he might be alive today, happy, maybe even a father.

I hope his, and our, experience can save other families from going through the same thing.

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