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(Inappropriate Lactation)

Definition

Galactorrhea is a milk-like discharge from one or both breasts. It is not from breastfeeding. The breast may leak fluid with or without being touched.

The Breast
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Causes

Sometimes the cause is not known. Some causes are:

  • Pregnancy
  • Stimulation of the breast from things like breast exams and clothing that rubs against them
  • Certain medicines, such as antidepressants, blood pressure medicines, sedatives, and medicines that contain hormones
  • Certain herbs, such as Nettle, Fennel, Blessed thistle, Anise, and Fenugreek seed
  • Drugs, such as marijuana and opioids
  • Some health problems, such as underactive or overactive thyroid, chronic kidney failure, tumors, or liver disease
  • Injury to the chest or spinal cord

Risk Factors

This problem is more common in women. It can happen in men and infants, but it is not as common. Other things that may raise the risk are:

  • Prior pregnancy
  • Stress
  • Wearing clothing that irritates the nipple
  • Frequent breast self-exam or frequent breast stimulation

Symptoms

The main symptom is a milky discharge from one or both breasts that is not due to breastfeeding. Other problems may be:

  • Enlarged breasts
  • Abnormal or absent menstruation
  • Headaches
  • Vision problems
  • Loss of sex drive
  • An increase in hair growth on the chin or chest
  • Erectile problems in men

Diagnosis

You will be asked about your symptoms and health history. A physical exam will be done. Tests may include:

Blood tests will be done to check hormone levels.

Images will be taken to look for signs of a tumor. This can be done with:

Treatment

Some people will not need treatment. The problem will go away in time. Others will be treated based on the cause. This may mean changing medicines or have surgery to remove a tumor.

Prevention

This problem may be prevented by avoiding:

  • Clothing that irritates the breasts
  • Stimulating the breasts and nipples
  • Conducting breast exams more than once a month

RESOURCES

American Congress of Obstetricians and Gynecologists  http://www.acog.org 

Family Doctor—American Academy of Family Physicians  http://familydoctor.org 

CANADIAN RESOURCES

The College of Family Physicians of Canada  http://www.cfpc.ca 

Health Canada  https://www.canada.ca 

References

Galactorrhea. Family Doctor—American Academy of Family Physicians website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/galactorrhea.html. Updated May 8, 2020. Accessed July 23, 2020.

Hyperprolactinemia. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/hyperprolactinemia  . Updated November 8, 2017. Accessed July 23, 2020.

Vilar L, Fleseriu M, et al. Challenges and pitfalls in the diagnosis of hyperprolactinemia. Arq Bras Endocrinol Metabol. 2014 Feb;58(1):9-22.

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