Galactorrhea

Galactorrhea is when there is a milky nipple discharge. It is different from normal milk in nursing mothers. It usually comes from both nipples. Galactorrhea is not a disease but may be a symptom of a problem. It may continue for years after weaning. Galactorrhea is caused by the hormone prolactin, which stimulates milk production. If the breast discharge looks like pus, is bloody or if there is a lump present in the affected breast, the discharge may be caused by other problems including:

  • A benign cyst.

  • Papilloma.

  • Breast cancer.

  • A breast infection.

  • A breast abscess.

It can also be seen in men who have a low or absent male hormone (testosterone) level. Galactorrhea can be present in a newborn if the mother had high female hormone (estrogen) levels that crossed into the baby through the placenta. The baby usually has enlarged breasts, but in time, it all goes away on its own.

CAUSES

  • Tumor of the pituitary gland in the brain.

  • Problems with the hypothalamus in the brain that stimulates the pituitary gland.

  • Low thyroid function (hypothyroid disease).

  • Chronic kidney failure.

  • Medications, antidepressants, tranquilizers and blood pressure medication.

  • Herbal medications (nettle, fennel, blessed thistle, anise and fenugreek seed).

  • Illegal drugs (marijuana and opiates).

  • Breast stimulation during sexual activity or too many and frequent self breast exams.

  • Birth control pills.

  • Surgery or trauma to the breast causing nerve damage.

  • Spinal cord injury.

SYMPTOMS

  • White, yellow or green discharge from one or both breasts.

  • No menstrual period (amenorrhea) or infrequent menstrual periods (hypomenorrhea).

  • Hot flashes, lack of sexual desire or vaginal dryness.

  • Infertility in women and men.

  • Headaches and vision problems.

  • Decrease in calcium in your bones (developing osteopenia or osteoporosis).

DIAGNOSIS

Your caregiver may be able to know your problem by taking a detailed history and physical exam of you. Tests that may be done, include:

  • Blood tests to check for the prolactin hormone, your female and thyroid hormones and a pregnancy test.

  • A detailed eye exam.

  • Mammogram.

  • X-rays, CT scan or MRI of breasts or your brain looking for a tumor.

TREATMENT

  • Stopping medications that may be causing the galactorrhea.

  • Treating low thyroid function with thyroid hormones.

  • Medical or surgical (if necessary) treatment of a pituitary gland tumor.

  • Medication to lower the prolactin hormone level when no cause can be found.

  • Surgery as a last resort to remove the breasts ducts if the discharge persists with treatment and is a problem.

  • Treatment may not be necessary if you are not bothered by the breast discharge.

HOME CARE INSTRUCTIONS

  • Before seeing your caregiver, make a list of all your symptoms, medications, when the breast discharge started and questions you may have.

  • Avoid breast stimulation during sexual activity.

  • Perform breast self exam once a month.

  • Avoid clothes that rub on your nipples.

  • Use breasts pads to absorb the discharge.

  • Wear a support bra.

SEEK MEDICAL CARE IF:

  • You have galactorrhea and you are trying to get pregnant.

  • You develop hot flashes, vaginal dryness or lack of sexual desire.

  • You stop having menstrual periods or they are irregular or far apart.

  • You have headaches.

  • You have vision problems.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your breast discharge is bloody or pus-like.

  • You have breast pain.

  • You feel a lump in your breast.

  • Your breast shows wrinkling or dimpling.

  • Your breast becomes red and swollen.