A health condition in which a milky discharge from nipples occurs and is not related to milk production or breastfeeding is called galactorrhea. Generally, this is not a disease but it may indicate other health problems. In most cases, it happens in women, even in those who do not have children or have gone through menopause. However, galactorrhea may occur in men and babies too.
Adverse reactions to certain medications, pituitary gland diseases, and excessive breast stimulation usually contribute to galactorrhea. However, the primary cause of this health problem is increased levels of Prolactin hormone, which stimulates milk production in women during pregnancy.
Sometimes, the exact cause of galactorrhea cannot remain unknown. In most cases, this problem goes away on its own but sometimes it requires treatment.
Symptoms
- Nipple discharge (usually involving multiple milk ducts)
- Persistent milky discharge from nipples
- Irregular or lack of menstrual periods
- Vision problems
- Headaches
- Discharge can sometimes occur from both breasts
- Spontaneously leakage
Contact your healthcare professional if you experience spontaneous milky nipple discharge either from one or both breasts and you are not pregnant.
Moreover, excessive nipple manipulation during sexual activity may trigger a nipple discharge from multiple ducts but it goes away on its own usually and does not require medical attention. However, if you experience non-milky nipple discharge (including bloody, yellow, or clear spontaneous discharge) that does not go away, immediately contact your healthcare provider. It may be a symptom of an underlying breast cancer.
Causes
The primary cause of galactorrhea is increased Prolactin levels in the body. This is a hormone that triggers milk production after a baby is born. Moreover, the pituitary gland produces and releases Prolactin hormone and increased levels may indicate a pituitary gland condition. Check below other galactorrhea causes:
- Some medicines (including sedatives, antidepressants, antipsychotics, hypertension medicines, and others)
- Birth control pills
- Herbal supplements (such as anise, fenugreek seeds, or fennel)
- Opioid use
- A benign pituitary tumor (called prolactinoma) or other diseases of the pituitary gland
- Hypothyroidism (underactive thyroid gland)
- Chronic kidney disease
- Excessive breast stimulation associated with prolonged clothing friction, sexual intercourse, or others
- Spinal cord surgery, tumors, or injury
- Stressful situations
- Nerve damage
Idiopathic Galactorrhea
When healthcare providers cannot identify the exact cause of unusual nipple discharge they call this condition idiopathic galactorrhea. Sometimes, breast tissue may be sensitive to the Prolactin hormone in the blood. People with increased sensitivity to Prolactin may develop galactorrhea even with normal Prolactin levels.
Galactorrhea in Males and Newborns
This health problem in men is usually associated with reduced Testosterone levels (male hypogonadism). Along with galactorrhea they often experience gynecomastia (enlargement or tenderness of the breasts). Moreover, sexual dysfunction and reduced sex drive also may happen.
Sometimes, newborns may experience galactorrhea due to high maternal Estrogen levels in the baby’s blood. As a result, enlargement of the breast tissue may occur. In most cases, milky nipple discharge goes away on its own. If discharge continues, you should visit a doctor.
Risk Factors
Anyone can get galactorrhea because anything that may cause an increase in the Prolactin hormone leads to milky nipple discharge. Check below some risk factors:
- Health conditions that negatively affect the pituitary gland (including benign (noncancerous) pituitary tumors
- Certain diseases (such as chronic kidney disease, spinal cord or chest wall injuries, hypothyroidism, and others)
- Stress
- Medications (including recreational drugs and herbal supplements)
- Rubbing or touching the breasts for long periods
Diagnosis
Healthcare providers may perform multiple tests to determine the exact cause of galactorrhea. Finding the underlying cause can help to get rid of galactorrhea. Check below some tests:
- Physical examination – During this procedure, doctors will check for breast lumps, abnormal areas of thickened tissue of the breast, abnormalities in the region around the nipples, and others.
- Blood Tests – These tests help doctors measure your Prolactin levels. If the levels of this hormone are high, you may need to measure thyroid-stimulating hormone (TSH) levels too.
- Pregnancy test – This test is usually done to rule out pregnancy because it is a cause of galactorrhea.
- Mammography and ultrasound – These tests help doctors get detailed images of the breasts, which help to find abnormal tissue or breast lumps.
- MRI (magnetic resonance imaging) of the brain – During this test, physicians will check for abnormalities of the pituitary gland. MRI of the brain is often done when blood tests show high Prolactin levels.
Treatment
Physicians usually focus on treating the underlying cause, which helps get rid of galactorrhea. However, in some cases, doctors are unable to find the exact cause of this health problem. Therefore, they may prescribe some medications that block the Prolactin effects or reduce its level in the body. Check below some underlying causes and possible treatments:
- Medications – If medicines you are using cause galactorrhea, your doctor may recommend interrupting using it or changing the medication. Do not change any medicine without a doctor’s approval because it may lead to unpleasant outcomes.
- Hypothyroidism – Doctors may recommend using Levothyroxine to supply insufficient hormone production by the thyroid gland.
- Prolactinoma (a pituitary tumor) – In such cases, patients usually get a prescription of medications that help to shrink the tumor or surgery that removes it. For more details, discuss it with your healthcare professional.
- The cause is not known – Physicians recommend certain medicines that reduce Prolactin levels, which stop milky nipple discharge. These include Cabergoline, Bromocriptine, and others. However, previous medicines may give you some adverse reactions including headaches, nausea, vomiting, dizziness, and others.
Frequently Asked Questions
What is the most common cause of galactorrhea?
Mostly, people experience this health problem due to a benign tumor of the pituitary gland. This tumor causes an increased Prolactin production.
What happens if galactorrhea is left untreated?
Although galactorrhea is not a serious condition, not treating it people may experience serious complications. These include infertility, osteoporosis (bone loss), amenorrhea, and others. Consult with your doctor if you suspect you have galactorrhea.
What are the most common medicines that cause galactorrhea?
These include:
- Antipsychotics
- Antidepressants
- Estrogen-containing medications
- Prokinetics
- Antihypertensives
- Opioid drugs
If you have additional questions, ask your healthcare professional.
