Galactorrhea

After you read this, you will know what galactorrhea is, how it is diagnosed, and how it is treated. Galactorrhea may be a symptom of a condition that needs further medical treatment, so it is important that you see your healthcare provider to determine the cause of this problem.

What is galactorrhea?

Galactorrhea is a milklike discharge of fluid from the breast nipples. Usually the discharge is from both breasts rather than just one. A discharge like this is called galactorrhea unless you are pregnant or breast-feeding.

How does it occur?

Galactorrhea usually occurs when your body produces too much prolactin. Prolactin is a hormone produced by the pituitary gland in the brain. Normally, prolactin helps a woman make milk when she has a baby.

Galactorrhea may be caused by:

• birth control pills and other medicines
• an underactive thyroid gland
• problems with the pituitary gland or hypothalamus in the brain
• some brain diseases, such as meningitis
• a cyst under the darkened area around the nipple (called a galactocele)
• shingles caused by the chickenpox virus in the chest wall
• surgery on the chest
• other medical problems such as kidney failure, liver disease, sarcoidosis (a chronic lung disease), and Cushing's disease of the adrenal gland.

Any woman who has had a baby, whether or not she breast-fed her baby, may later have galactorrhea.

In about half the cases, a cause cannot be found.

How is it diagnosed?

Your healthcare provider will examine your breasts. Your provider will also ask about your medical history, such as whether you have stopped having menstrual periods, are having trouble getting pregnant, or having headaches or vision problems. Your provider will also ask about what medicines you are taking. A sample of the discharge may be tested in the lab.

Your provider may order the following tests:

• blood tests
• mammogram (X-ray of the breasts)
• ultrasound scan of your breasts
• CT scan (computerized X-rays) of your brain to look at your pituitary gland and hypothalamus.

How is it treated?

If your galactorrhea is due to a disorder such as thyroid problems or meningitis, your healthcare provider will treat the disorder. If a galactocele is causing the galactorrhea, the cyst will be removed.

If the discharge is caused by drugs, it will clear up when you stop taking the drugs. However, stopping drugs is not always necessary (for example, you may continue taking birth control pills).

If the galactorrhea is caused by a pituitary gland or hypothalamus tumor, you may need surgery, radiation, or drug treatments. Often these tumors grow slowly, and some eventually stop growing. Some can be treated with bromocriptine, a drug that stops the production of prolactin by your pituitary gland.

If tests do not find a cause of the discharge, you may not need any treatment. Or your provider may prescribe bromocriptine, which can successfully treat galactorrhea when the cause is unknown. If you have stopped having periods, this medicine may cause your periods to start again and may increase your chances of becoming pregnant.

How long will the effects last?

Once the cause of the discharge is diagnosed and treated, you should no longer have the discharge. However, if you have a pituitary tumor, you may need long-term treatment with bromocriptine or radiation because the tumor could come back.

How can I take care of myself?

• Follow your healthcare provider's recommendations for follow-up tests.
• If you are taking bromocriptine, be sure you take it according to your provider's instructions.
• If the galactorrhea is mild and a cause cannot be found, breast binders can help stop the discharge by preventing stimulation of the nipples.