Disease: Galactorrhea

    Overview

    Galactorrhea (guh-lack-toe-REE-uh) is a milky nipple discharge unrelated to the normal milk production of breast-feeding. 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. Often, galactorrhea results from increased levels of prolactin, the hormone that stimulates milk production.

    Sometimes, the cause of galactorrhea can't be determined. The condition may resolve on its own.

    Source: http://www.mayoclinic.com

    Symptoms

    Signs and symptoms associated with galactorrhea include:

    • Persistent or intermittent milky nipple discharge
    • Nipple discharge involving multiple milk ducts
    • Spontaneously leaked or manually expressed nipple discharge
    • One or both breasts affected
    • Absent or irregular menstrual periods
    • Headaches or vision problems

    When to see a doctor

    If you have a persistent, spontaneous milky nipple discharge from one or both of your breasts and you're not pregnant or breast-feeding, make an appointment to see your doctor.

    If breast stimulation — such as excessive nipple manipulation during sexual activity — triggers nipple discharge from multiple ducts, you have little cause for worry. The discharge probably doesn't signal anything abnormal, including breast cancer, but you should still see a doctor for evaluation.

    Nonmilky nipple discharge — particularly bloody, yellow or clear spontaneous discharge that comes from one duct or is associated with a lump you can feel — requires prompt medical attention, as it may be a sign of an underlying breast cancer.

    Source: http://www.mayoclinic.com

    Causes

    Galactorrhea often results from too much prolactin — the hormone responsible for milk production (lactation) when you have a baby. Prolactin is produced by your pituitary gland, a marble-sized 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
    • Cocaine, marijuana or opioid use
    • Herbal supplements, such as fennel, anise or fenugreek seed
    • Birth control pills
    • 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

    Idiopathic galactorrhea

    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.

    Galactorrhea in men

    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.

    Galactorrhea in newborns

    Galactorrhea sometimes occurs in newborns. 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.

    Source: http://www.mayoclinic.com

    Diagnosis

    Finding the underlying cause of galactorrhea can be a complex task because there are so many possibilities.

    Testing may involve:

    • A physical exam, during which your doctor may try to express some of the fluid from your nipple by gently examining the area around your nipple. Your doctor may also check for breast lumps or other suspicious areas of thickened breast tissue.
    • Analysis of fluid discharged from the nipple, to see if fat droplets are present in the fluid, which can help confirm the diagnosis of galactorrhea.
    • A blood test, to check the level of prolactin in your system. If your prolactin level is elevated, your doctor will most likely check your thyroid-stimulating hormone (TSH) level, too.
    • A pregnancy test, to exclude pregnancy as a possible cause of nipple discharge.
    • Mammography, ultrasound or both, to obtain images of your breast tissue, if your doctor finds a breast lump or observes other suspicious breast or nipple changes during your physical exam.
    • Magnetic resonance imaging (MRI) of the brain to check for a tumor or other abnormality of your pituitary gland, if your blood test reveals an elevated prolactin level.

    If your doctor suspects a medicine you're taking might be the cause of galactorrhea, he or she might instruct you to stop taking the medicine for a short time to assess this possible cause.

    Source: http://www.mayoclinic.com

    Lifestyle and home remedies

    Often, milky discharge associated with idiopathic galactorrhea goes away on its own, particularly if you can avoid breast stimulation or medications that are known to cause nipple discharge.

    To minimize breast stimulation:

    • Don't stimulate your nipples during sexual activity
    • Avoid performing frequent breast self-exams, manipulating your nipples
    • Wear clothing that minimizes friction between the fabric and your nipples

    Source: http://www.mayoclinic.com

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