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Galactorrhea

(Inappropriate Lactation)

Definition

Galactorrhea is a discharge of milk-like substance from the breast that is not associated with breastfeeding after pregnancy. This condition mainly occurs in women. It does occur in men, but much less commonly. The milky white discharge can come from one or both breasts, and the breast may leak fluid with or without stimulation.
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Causes

Galactorrhea has many causes, though sometimes the cause is unknown. Tumors of the pituitary gland, called pituitary adenomas or prolactinomas, can cause galactorrhea. The pituitary is a small gland attached to the brain. Pituitary tumors are usually not cancerous. They can cause galactorrhea when they produce excess prolactin, a hormone that stimulates milk production.
Other causes of galactorrhea include:

Risk Factors

Galactorrhea is more common in women. Other factors that may increase your chance of galactorrhea include:

Symptoms

The primary symptom is a milky discharge from the nipple that is not associated with breast-feeding. The discharge can come from one or both breasts. Other symptoms that can occur along with the discharge include:

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:
If the discharge is not milky or contains blood, then this is not galactorrhea. Other tests must be done to check for breast cancer or other disorders.

Treatment

Treatment depends on the cause. In some mild cases, no medical treatment is necessary, and the condition will go away on its own. In these cases, breast binders that prevent stimulation of the nipples may be effective. If medications are identified as the potential cause, safe alternatives should be sought.
If an underlying cause for galactorrhea, such as a pituitary tumor, is found, this condition may be treated.
Tumors of the pituitary gland that cause galactorrhea are usually benign. Small tumors may be treated with a medication, such as a dopamine agonist. Larger tumors that do not respond to medication may be treated with the following:
Despite treatment, pituitary gland tumors often recur.

Prevention

To reduce your risk of galactorrhea, take these steps:

RESOURCES

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

National Library of Medicine http://www.nlm.nih.gov

CANADIAN RESOURCES

Canadian Family Physician http://www.cfpc.ca

Health Canada http://www.hc-sc.gc.ca

References

Eftekhari N, Mohammaalizadeh S. Pregnancy rate following bromocriptine treatment in infertile women with galactorrhea. Gynecol Endocrinol . 2009;25(2):122-124.

Galactorrhea. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/galactorrhea.html . Updated August 2010. Accessed June 11, 2013.

Hyperprolactinemia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated March 5, 2012. Accessed June 11, 2013.

Leung AKC, Pacaud D. Diagnosis and management of galactorrhea. Am Fam Physician . 2004; 70:543-550,553-554.

Rodden A. Common breast concerns. Primary Care . 2009;36(1):103-113.

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