- Seek medical care if milk-like breast discharge happens outside pregnancy or breastfeeding.
- Bloody discharge, vision changes, or headaches should be checked by a doctor.
- Men with breast discharge, breast enlargement, or erectile dysfunction should seek medical evaluation.
Galactorrhea is the unexpected release of milk or milk-like discharge from the breasts. It can occur with or without breast stimulation and is not always related to pregnancy or breastfeeding.
Milk production is regulated by several hormones, including prolactin, estrogen, and thyrotropin-releasing hormone (TRH). Changes in these hormones can trigger galactorrhea.
This condition can affect both women and men, and in rare cases, newborns. Possible causes include pituitary disorders (such as tumors), certain medications, and endocrine conditions like hypothyroidism or polycystic ovary syndrome (PCOS).
Main symptoms
The main symptoms of galactorrhea are:
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Milk discharge from the breasts, which may be clear, milky, or bloody, and may occur in one or both breasts
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Irregular periods or missed periods
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Erectile dysfunction and gynecomastia
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Osteoporosis
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Vision changes, such as blurred vision or seeing bright spots
Hormonal changes can also cause infertility in both men and women.
Confirming a diagnosis
To diagnose galactorrhea, the doctor will review the person’s medical history and perform a physical exam to check for milk discharge from the breasts.
According to the American Academy of Family Physicians, people with galactorrhea should have prolactin levels checked, and those with high prolactin should be assessed for pregnancy, thyroid function, and kidney function.
In some cases, the discharged fluid may be analyzed, especially if it has unusual characteristics. Imaging tests may also be ordered, such as a mammogram or breast ultrasound to check breast tissue, as well as a CT scan or MRI to check for a tumor in or around the pituitary gland.
Main causes
The main causes of galactorrhea are:
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Pituitary adenoma: a benign tumor of the pituitary gland, which is a gland in the brain responsible for producing several hormones, including prolactin
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Breast stimulation through sexual activity, clothing, or frequent breast self-exams
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Diseases that cause hormonal changes, such as hypothyroidism, chronic kidney disease, and Addison’s disease
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Injuries to the chest wall, such as burns or surgery
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Spinal cord injury or trauma
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Long-term use of certain medications, such as antipsychotics, opioids, antidepressants, antihypertensives, and birth control pills
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Use of natural supplements, such as fenugreek and anise
Sleep and stress are other conditions that can increase prolactin production. However, they rarely cause changes significant enough to trigger galactorrhea.
Galactorrhea in men
lthough it is more common in women, men can also develop galactorrhea, most often due to thyroid disorders.
It can also result from very low testosterone levels and may occur together with gynecomastia, which is enlargement of the breast tissue.
Galactorrhea in babies
Although rare, galactorrhea can also occur in newborns, and it is considered normal when it happens up to 3 days after birth. This mainly occurs because the baby is still under the influence of maternal hormones, which are passed from mother to baby during pregnancy and breastfeeding.
As a result of increased maternal hormone levels in the baby’s blood, breast swelling and, in some cases, swelling in the genital area may be noticed, along with milk discharge. However, as the baby’s body eliminates these hormones, the swelling usually goes down without the need for specific treatment.
Treatment options
Treatment for galactorrhea is guided by an endocrinologist or gynecologist and may include:
- Taking dopamine agonists, such as cabergoline or bromocriptine, to lower prolactin levels in people with symptomatic prolactin-secreting pituitary tumors, according to the Endocrine Society
- Stopping or replacing the medication causing galactorrhea as a side effect, according to medical guidance
- Taking medication to treat underlying conditions, such as hypothyroidism
- Avoiding actions or activities that overstimulate the breasts, as well as wearing looser clothing to reduce friction
When galactorrhea is caused by a tumor, the doctor may recommend medication, surgery, or radiation therapy, depending on the case.