GALACTORRHEA

Galactorrhea is a milky nipple discharge unrelated to the normal milk production of breast-feeding.
This nipple discharge may leak from the breast on its own or when the breast is touched.
Galactorrhea itself isn’t a disease, but it could be a sign of an underlying problem.
It usually occurs in women, even those who have never had children or after menopause.
But galactorrhea can happen in men and even in infants.
Excessive breast stimulation, medication side effects or disorders of the pituitary gland all may contribute to galactorrhea.
Sometimes, the cause of galactorrhea can’t be determined. The condition may resolve on its own.

Sometimes doctors can’t find a cause for galactorrhea, this is called idiopathic galactorrhea, and it may just mean that your breast tissue is particularly sensitive to the milk-producing hormone prolactin in your blood.
If you have increased sensitivity to prolactin, even normal prolactin levels can lead to galactorrhea.

In males, galactorrhea may be associated with testosterone deficiency (male hypogonadism) and usually occurs with breast enlargement or tenderness (gynecomastia).
Erectile dysfunction and a lack of sexual desire also are associated with testosterone deficiency.

High maternal estrogen levels cross the placenta into the baby’s blood.
This can cause enlargement of the baby’s breast tissue, which may be associated with a milky nipple discharge.
This milky discharge is temporary and resolves on its own.
If the discharge is persistent, the newborn should be evaluated by a doctor.

Signs and symptoms associated with galactorrhea include:

Galactorrhea often results from having too much prolactin — the hormone responsible for milk production when you have a baby.
Prolactin is produced by your pituitary gland, a small bean-shaped gland at the base of your brain that secretes and regulates several hormones.
Possible causes of galactorrhea include:
Medications, such as certain sedatives, antidepressants, antipsychotics, and high blood pressure drugs
Opioid use
Herbal supplements, such as fennel, anise, or fenugreek seed
Birth control pills
A noncancerous pituitary tumor (prolactinoma) or other disorder of the pituitary gland
Underactive thyroid (hypothyroidism)
Chronic kidney disease
Excessive breast stimulation, which may be associated with sexual activity, frequent breast self-exams with nipple manipulation or prolonged clothing friction
Nerve damage to the chest wall from chest surgery, burns or other chest injuries
Spinal cord surgery, injury, or tumors
Stress

Doctors usually diagnose galactorrhea with a physical exam and medical history.
If needed, two tests can confirm diagnosis:
Blood tests tell doctors if the levels of prolactin (milk-producing hormone) in the body are abnormally high.
Imaging tests called CT and MRI scans enable doctors to look for a tumor in or near the pituitary gland.
Treatment for galactorrhea varies depending on the cause of the condition. In some people, it goes away on its own without any treatment.
To manage the condition, your doctor may recommend:
Avoiding the action or conditions that cause the condition
Stopping or changing medications that cause the condition
Taking medication to manage the production of prolactin
In cases where a pituitary tumor causes galactorrhea, the tumor is usually benign (not cancerous). If the tumor does not cause any other complications, your doctor may determine that treatment is unnecessary.
If your doctor recommends treatment for a pituitary tumor, it usually involves medication to shrink the tumor or stop the production of prolactin.
In rare cases, doctors use surgery or radiation therapy to remove or shrink a pituitary tumor.

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