Galactorrhea - Specialists and information on milk flow outside of breastfeeding

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

Galactorrhea describes a discharge of secretions or milk from the nipple without the woman being pregnant or breastfeeding a child. Experts refer to milky discharge from the mammary gland outside of breastfeeding as galactorrhea. Galactorrhea can have various causes and can occur in both women and men. Below you will find information on the diagnosis and treatment of galactorrhea as well as specialists for the treatment of galactorrhea.

ICD codes for this diseases: N64.3

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Article overview

What is galactorrhea and what causes it?

In most cases, galactorrhea is associated with increased production of the hormone prolactin. This hormone is responsible for ensuring that the mammary glands produce milk during breastfeeding.

Normally, prolactin levels in the blood are only elevated during pregnancy and breastfeeding. If prolactin levels are high outside of this period, there is an underlying illness.

The trigger for abnormal breast milk discharge is often a prolactinoma. This special pituitary tumor is able to produce prolactin. It is one of the most common tumors of the pituitary gland.

In most cases, these tumors are benign. Only very rarely does pituitary cancer occur . Doctors differentiate between microprolactinomas and macroprolactinomas depending on their size .

Medication can also trigger galactorrhea.

These include above all

  • Birth control pills
  • psychotropic drugs
  • Neuroleptics
  • opiates
  • some blood pressure medications
  • some drugs for gastrointestinal treatment
  • Circulatory drugs

It is important to note that such medications can trigger the disease, but only do so occasionally.

In addition, in rare cases, other diseases also lead to an increase in prolactin levels and galactorrhea.

These include, among others:

Excessive stress, whether physical or psychological, can also trigger abnormal discharge from the nipples.

GalaktorrhoeIn galactorrhea, the breasts produce milk even though the baby is not breastfeeding @ Siniehina /AdobeStock

The interplay of hormones - metabolic disorders due to and with galactorrhea

The human body is a marvel. This is demonstrated not least by the interplay of hormones. They react to external stimuli and internal information.

If a situation is frightening, the body releases adrenaline and we humans develop amazing powers as a result. The rise and fall of hormones influences a woman's monthly cycle. The messenger substances influence the metabolism in various tasks.

The hormone prolactin also plays its part in the interplay of hormones. Among other things, it carries the information that a pregnancy is present.

Many affected women therefore experience less frequent monthly bleeding or a complete cessation of menstruation.

Ovulation may also fail to occur . Libido, the desire for sexual intercourse, often decreases and in some cases infertility can occur. In men, erectile dysfunction occasionally occurs when prolactin levels in the blood are high.

However, if secretions only come out on one side, this indicates changes in the milk ducts. The milk ducts transport breast milk to the nipple during breastfeeding. If cysts or polyps or cancer of the milk ducts form here , this leads to discharge from the breast.

Diagnosis - How doctors determine the cause of galactorrhea

If you discover a discharge from your nipples, you should urgently consult a doctor. Only a doctor can make the correct diagnosis and initiate the appropriate treatment. Your GP will refer you to a specialist if necessary.

The doctor will primarily examine your blood to determine whether you have an elevated prolactin level. He will often also check the levels of oestrogen and progestin in women and testosterone in men.

Your doctor will ask you what medication you are taking. This will enable him to determine whether galactorrhea is a side effect of a medication.

If the prolactin level in the blood is too high, he will use a computer tomography or magnetic resonance imaging to check whether a prolactinoma is present.

If the secretions are only on one side, a mammogram or an X-ray examination of the milk ducts with contrast medium is usually carried out . A mammary duct endoscopy or a cell examination may also be considered.

Mammographie bei GalaktorrhoeA mammogram is useful if galactorrhea is suspected @ Gorodenkoff /AdobeStock

Doctors classify galactorrhea into four different grades:

  • In grade 1, only a few drops of secretion are present
  • In grade 2, at least one milliliter of fluid can be squeezed out
  • In grade 3, there are intermittent, unpredictable discharges
  • In grade 4, there is a constant flow of milk

Treatment for galactorrhea

Galactorrhea is particularly easy to treat if it occurs as a side effect of tablets. In this case, your doctor simply needs to change the medication and work out a new medication plan with you.

An elevated prolactin level in the blood can be easily reduced with medication. The medication that lowers the prolactin level often also shrinks an existing tumor.

Surgery is not necessary. Only if patients do not respond to the medication and surgical measures is it necessary to irradiate the tumor.

You should always discuss the risks and benefits of the treatment options with a specialist. For example, a woman who does not wish to have children has no problems if ovulation and monthly bleeding do not occur.

Doctors also do not necessarily have to remove a tumor if it is a microprolactinoma. If you decide against an operation, an annual computer tomography or magnetic resonance imaging scan is recommended.

References

https://www.msdmanuals.com/de-de/heim/hormon-und-stoffwechselerkrankungen/erkrankungen-der-hirnanhangdr%C3%BCse-hypophyse/galaktorrh%C3%B6
https://www.gynecology-guide.com/gynaekologie/galaktorrhoe/
https://www.endokrinologie.net/prolaktinom.php
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