Galactorrhea is a condition that occurs due to too much prolactin (the hormone responsible for milk production/lactation). Prolactin is produced by the pituitary gland, a gland the size of a marble at the base of the brain and is responsible for secreting and regulating a number of hormones.
This condition causes the breasts to discharge when touched or with stimulation. This can occur in women and in men, but it is less common in men. A woman who has galactorrhea can produce milk even though she is not breastfeeding.
Causes of Galactorrhea
- Take certain medications, such as antidepressants, antipsychotics, and high blood pressure medications.
- The use of cocaine, marijuana, and opioids.
- Take birth control pills.
- Non-cancerous pituitary tumor (prolactinoma) or other pituitary gland disorders.
- Underactive thyroid (hypothyroidism).
- Chronic kidney disorder.
- Excessive breast stimulation, which is associated with certain sexual activities, or friction with clothing for too long.
- Nerve damage in the chest wall due to chest surgery, burning, or other chest trauma.
- Surgery on the spinal cord, the damage or tumors in the spinal cord.
- Persistent or intermittent ASI discharge.
- Breast milk leakage occurs spontaneously or manually (it can be one or both breasts).
- Irregular menstrual cycles
- There is a headache
- Vision loss
When should you see a doctor?
If breast milk from the nipple is continuously and spontaneously out of one or both breasts — and you are not pregnant or breastfeeding, then you need to see a doctor.
If the expenditure of breast milk occurs while in sexual activity, then this is something that does not need to worry. The release of liquid milk is not dangerous. But you need to visit a doctor for evaluation.
However, if the fluid that comes out is non-breast milk, such as blood, or yellowish fluid coming from a duct or lump in the breast, then it could be because of a sign of breast cancer.
- Idiopathic galactorrhea
Sometimes doctors cannot find the cause of galactorrhea. This is called idiopathic galactorrhea. This condition indicates that your breast tissue is sensitive to the hormone prolactin. When breast tissue increases its sensitivity to prolactin, this is what triggers galactorrhea.
- Galactorrhea in men
In men, galactorrhea can be associated with testosterone deficiency (male hypogonadism) and usually they experience breast enlargement (gynecomastia). Erectile dysfunction and lack of sexual desire can also be associated with testosterone deficiency conditions.
- Galactorrhea in infants
Galactorrhea sometimes occurs in newborns. High estrogen levels in the mother will cross the placental blood vessels into the baby’s bloodstream. This can cause enlargement of the baby’s breast glands, and is also associated with the expenditure of milk in infants.
Finding the cause of galactorrhea can be a complicated task because there are so many possibilities. Some testing usually involves:
- Physical examination. The doctor will try to reveal several possible types of fluid coming out of the nipple by examining the area around the nipple. In addition, the doctor may also check for breast lumps or other areas that lead to thickened breast tissue.
- Analysis of fluid coming out of the nipple. This is done to see if the fat droplets can help confirm the diagnosis of galactorrhea.
- Blood test. This test is done to check the level of prolactin in the body. If your prolactin level is high, your doctor will most likely check your thyroid-stimulating hormone (TSH) levels as well.
- Pregnancy test. This test is done to exclude pregnancy as a possible cause of nipple discharge.
- Mammography or ultrasound. This test is done to get images of breast tissue. This is done when the doctor discovers a breast lump or observes any suspicious changes in the breasts or nipples during a physical examination.
- Magnetic resonance imaging (MRI) of the brain to examine tumors or other abnormalities of the pituitary gland. This is usually done if a blood test shows a high level of prolactin.
Meanwhile, if your doctor suspects that the medicine you are taking is a possible cause of galactorrhea, he may ask you to stop taking the medicine for some time.
Galactorrhea treatment will be adjusted to the underlying cause. Sometimes doctors cannot determine the exact cause of galactorrhea. Usually, the doctor will recommend to undergo therapy. For example, maybe you will get treatment to block the effects of prolactin or reduce levels of prolactin in the body. Reducing prolactin levels in the body will reduce the condition of galactorrhea.
Treatment that suits the underlying cause such as:
- If the cause is drug use, the doctor will suggest stopping the drug or changing the dose of certain drugs.
- Hypothyroidism as a cause, the doctor will prescribe levothyroxine drugs to get enough thyroid levels in the body (thyroid hormone replacement therapy)
- If the cause is a pituitary tumor (prolactinoma), then the use of drugs to treat the tumor, or surgical removal of the tumor can be a solution.
- The cause is unknown, the doctor will give drugs to reduce levels of prolactin, such as bromocriptine or kabergoline, and minimize or stop the release of milk from the nipple. Side effects of these drugs are often nausea, headaches, and dizziness.