Galactorrhea

1 What is Galactorrhea?

Galactorrhea is a condition associated with the discharge of a milky substance which is unrelated to the normal milk formed during breastfeeding.

This is not a disease but it is an indication of an underlying problem. This is a common condition among women and especially those that had never had children or after menopause.

It also can occur in men and infants. It forms with excessive breast stimulation, medication side effects or disorders of the pituitary glands. This is formed as a result of increased prolactin and other hormones that increase milk production.

Sometimes, the cause may not be known and may just resolve on its own.

2 Symptoms

Some of the signs and symptoms associated with galactorrhea include the intermittent production of the milky substance. It also may involve nipple discharge involving multiple milk ducts.

Spontaneous leaking can also be experienced. It may occur in either one or both of the breasts. It is also associated with absent or irregular menstrual periods. It leads to a headache or vision problems.

It is recommended that one any of the symptoms appears, one needs to see a medical doctor for medical attention as soon as possible.

In the case when a non-milky substance is produced, such as blood, yellow or clear spontaneous discharges, one needs to see a doctor immediately. This may be an indication of breast cancer.

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3 Causes

There are several causes of galactorrhea that are known. They can be stimulated by the pituitary glands and hypothalamus. This often leads to the production of excessive prolactin which is the main enzyme that is responsible for milk production after delivery. Prolactin is produced by the pituitary gland which serves to regulate other key enzymes.

Some other possible causes of this condition may also include a use of medication such as sedatives, antidepressants, antipsychotics and high blood pressure. They can also be induced by use of cocaine, marijuana or opioids. Some of the herbal supplements such as fenugreek, funnel or anise can be produced.

It is indicated that use of birth control pills may also be the cause of galactorrhea. Cancer of the pituitary affecting the section that produces prolactin (prolactina) is also involved in some cases. Hypothyroidism, kidney disease / failure.

Excessive stimulation of the breast as a result of sexual activity may also be involved in inducing galactorrhea, manipulation of the nipples with breast self-exams and prolonged clothing friction, spinal cord injury or tumors are also believed to cause this condition.

When the cause of galactorrhea is not found, this condition is referred to as idiopathic galactorrhea. This may be an indication that the breasts are just sensitive to the milk producing the hormone in the blood. At times, increased sensitivity for prolactin even at normal levels can promote galactorrhea.

When the milky substance is produced in men, it is associated with testosterone deficiency (hypogonadism). It is also associated with the enlargement of the breasts and tenderness also referred to as gynecomastia. This is the main cause of erectile dysfunction which is associated with low sexual desire.  

In newborn babies, this is associated with high maternal estrogen levels when they are able to cross the placenta into the blood of the baby before birth. This induces the enlargement of the baby’s breast tissues. This may lead to the production of the milky discharge.

4 Making a Diagnosis

A diagnosis of Galactorrhea will be made by your OB/GYN.

It is necessary to find the underlying cause of galactorrhea which can be a very complicated task but has so many possibilities:

  • It can be achieved with a physical exam by checking for the expression of the fluids within your nipple.
  • Signs of breast lumps can also be checked or thickened breast tissues.
  • Analysis of the fluids can also be done to examine the presence of fat droplets in the fluids.
  • A blood test may also be used to check for the presence of prolactin or thyroid stimulating hormone (TSH).
  • A pregnancy test may also cause the discharge of the nipples.
  • Similarly, a mammography or ultrasound and even both can be used to get the pictures of the breast tissues.
  • In more serious case, an MRI scan can be used to check for the presence of tumors or pituitary glands abnormalities which may be associated with increased levels of prolactin.

5 Treatment

Treatment is administered to manage the underlying cause of the galactorrhea. It may be difficult for the doctor to determine the exact cause of galactorrhea; hence, he will recommend a direct treatment of the condition especially under excessive nipple discharge.

Drugs blocking the effect of prolactin can be administered so as to lower the amount of prolactin in the body. This may reduce or eliminate galactorrhea. Drugs may be stopped when the underlying cause involves the use of medications.

Thyroid replacement therapy may be used for conditions associated with hypothyroidism, surgery or drugs to shrink the pituitary glands for conditions associated with prolactinoma or tumor of the pituitary.

6 Prevention

The doctors will examine you and recommend a few things that will be important in the prevention of galactorrhea.

It is advised that you should see a family doctor or gynaecologist when these symptoms present. You can also be referred to as breast health specialist.

When preparing for these appointments, take note of the possible symptoms you have experienced in the duration since you first identified the signs and symptoms. Also, review personal information needed during the visit, prepare a list of the medications such as the vitamins or supplements in use, and finally down the possible questions that can be asked during the visit.

Some of the questions that can be asked during the interview may include:

  • what is the likely cause of my symptoms?
  • What are the possible causes of the condition?
  • What tests are needed to confirm this condition?
  • What is the best treatment recommended for this condition?
  • Is there any generic equivalent that can be prescribed?
  • Are there any existing home remedies?

Moreover, some of the questions ones will also expect from the doctor include:

  • what is the colour of the breast discharge?
  • Does it occur only in one or both breasts?
  • Are there any other breasts signs such as a lump or thickened tissues?
  • Do you experience any breast pains?
  • How frequent do you perform breast checkup?
  • Are there any changes on your breasts?
  • Are you pregnant?
  • Do you experience regular menstrual cycle?
  • Do you have any problems getting pregnant?
  • Are you taking any drugs?
  • Are you having any headache or vision loss? 

The doctors will examine you and recommend a few things that will be important in the prevention of the conditions. In the meantime, the doctor may advise you to avoid breast stimulation as a way of lowering the breast discharge and it will also be recommended that you use breast pads.

7 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with galactorrhea.

It is known that milky discharge in the absence of the disease and conditions may eventually disappear on their own.

This is especially the case when one avoids breast simulations or medications which are known to cause nipple discharge.

Avoid stimulation of your nipples during sexual activity, reduce the rate of frequent breast exams which cause the manipulation of the nipples and above all, wear clothing that would lower the friction between the fabric and nipples.

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