What is Galactorrhea?
This is a problem where there is a milky nipple discharge from the breast which is not related to the normal production of milk for breast feeding. It is not a disease but it is a sign of an underlying problem. It does occur mostly in women, but galactorrhea can occur in men as well and even in infants.
Some conditions that contribute to galactorrhea include excessive stimulation of the breast, disorders of the pituitary gland or the side effects of medication. It often results from levels of prolactin which are increased. Prolactin is the hormone that stimulates the production of milk.
In some cases, the reason for galactorrhea cannot be found and the condition goes away on its own.
Galactorrhea Symptoms
Symptoms and signs which are linked to galactorrhea consist of:
- Intermittent or persistent discharge from the nipple that is milky and has no blood traces
- Both or only one breast affected
- Irregular or absent menstrual periods
- Manually expressed or spontaneously leaked nipple discharge
- Vision or headache problems
If an individual has a nipple discharge which is persistent and milky, from both or only one breast and the individual is not breast-feeding or pregnant, then it is time to see a primary care physician.
If any stimulation of the breast activates a discharge from the nipple from several ducts, then there is slight reason to be concerned. This discharge possibly does not signal cancer of the breast but it should be seen by a physician for a complete examination.
Discharge which is non-milky, especially if any discharge is yellow, clear or bloody and is taking place from only one duct does require a critical medical assessment, as it can be a symptom of an underlying cancer of the breast.
Galactorrhea Causes
Often galactorrhea results because of prolactin in amounts too high – which is the hormone accountable for the production of milk after a woman delivers a baby. Normally prolactin is produced and regulated by the pituitary gland which is a gland that is marble-sized at the base of the brain which manages several hormones.
Probable reasons for galactorrhea consist of:
- Certain drugs, such as some tranquilizers, medicines for blood pressure which is high as well as anti-depressants
- Birth control pills
- Herbal supplement for instance anise, fenugreek seed or fennel
- An underactive thyroid – hypothyroidism
- A non-cancerous pituitary tumor – prolactinoma – or additional problems with the pituitary gland
- Kidney disease which is chronic
- Breast stimulus which is excessive, and can be linked to sexual action, breast self-exams that are frequent, prolonged clothing friction or a skin rash on the chest
- Spinal cord surgery, tumors or injury
- Damage to nerves in the wall of the chest from chest surgery, chest injuries or burns.
Idiopathic Galactorrhea
Often physicians cannot find any reason for galactorrhea. It is then referred to as “idiopathic galactorrhea” that the tissue of the breast is very sensitive to prolactin hormone for milk-producing and is in the blood. If this is the case, even prolactin levels which are normal may cause galactorrhea.
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Galactorrhea in Men
In some males, this condition may be related to the deficiency of testosterone (male hypogonadism) and normally is accompanied with tenderness of the breast or enlargement (gynecomastia). Loss of sexual drive as well as erectile dysfunction can be associated with a deficiency of testosterone.
Galactorrhea in newborns
This often happens in new born babies. High estrogen levels which are maternal flow cross the placenta into the blood of the baby’s. This may cause tissue enlargement in the breast of the baby’s and can be linked with a nipple discharge which is milky.
Galactorrhea Diagnosis
Trying to find any underlying reason for galactorrhea may be a task which is very complex since there many possibilities.
Tests can involve the following:
- A physical exam by a physician where he/she might attempt to prompt some of the fluid from the nipple by squeezing it gently or pressing around the area of the nipple in order to decide if the discharge can be replicated. The physician will also check for any lumps in the breast or other areas suspicious of breast tissue which is thickened
- Fluid analysis of any nipple discharge. The physician can do a test which is very simple on the discharge in order to determine whether there is any blood existing in the fluid.
- Blood test checking for the quantity of prolactin in the system. If the level of prolactin is elevated, the physician may also test your TSH level – thyroid-stimulating hormone.
- Pregnancy test in order to confirm or exclude pregnancy as being a probable cause of this nipple discharge.
- Ultrasound, mammography, or both in order to produce images of the tissues of the breast. If the physician finds a lump in the breast or other abnormality during the physical exam as well as to appraise the region which is in back of the nipple
- Magnetic resonance imaging – MRI – to see if there is any tumor or other anomaly of the pituitary gland, especially if the blood test reveal any elevated levels of prolactin
If the physician believes that medication use is causing galactorrhea, the individual will be told to halt that medicine for a small period of time in order to assess if this is possibly the cause.
Galactorrhea Treatment
If needed, any treatment will focus on solving the underlying reason for galactorrhea.
Often physicians will not be able to decide on an exact reason for galactorrhea, nevertheless it will need to be managed anyhow. This could be the situation if the patient is experiencing really embarrassing or bothersome discharge from the nipple. In these situations, the patient may be given drugs to stop the properties of prolactin or lower the amount. Reducing the levels of prolactin can stop galactorrhea.
Galactorrhea Medication
- Medication usage – halt taking some medication or change dose or change to another one.
- Hypothyroidism – Take medication for underactive thyroid gland
- Pituitary tumor – Medication to contract the tumor or surgery to take out
- Cause is unknown – Medicine to lessen the prolactin level, such as Parlodel or Dostinex
Galactorrhea Surgery
If this condition of galactorrhea perseveres and nothing is working to relieve the symptoms, surgery can be another option. The physician can mention this and refer you to a surgeon in order to deliberate the probability of have a bilateral duct excision – this removes the milk ducts from each breast.
