The condition known as galactorrhea happens when one or both breasts make milk or a milky discharge. Galactorrhea is not related to the production of milk in breastfeeding. In cases of galactorrhea the breasts may leak only when touched, or on their own. This issue may occur in women or in men, but is less common in men. Though rare it can occur in newborns. Be aware that galactorrhea itself is not a disease, although it could be a sign of an underlying problem.
Usually it is found in women, even those who have never had children or after menopause. Medication side effects, excessive breast stimulation, or disorders of the pituitary gland all may contribute to galactorrhea. In many cases galactorrhea results from increased levels of prolactin, the hormone that stimulates milk production. However there are times when the cause of galactorrhea cannot be determined and the condition may resolve on its own.
Galactorrhea signs and symptoms include erectile dysfunction in men, decreased sex drive, acne, headaches or vision problems, and an increase in hair growth on the chin or chest. Persistent or intermittent milky nipple discharge may occur and one or both breasts may affected. Nipple discharge involving multiple milk ducts can happen as well as spontaneously leaked or manually expressed nipple discharge. Absent or irregular menstrual periods have also been noted.
Diagnosing the underlying cause of galactorrhea can be a challenging and complex task because there are so many possibilities including excessive breast stimulation, which may be associated with sexual activity, frequent breast self-exams with nipple manipulation or prolonged clothing friction, and birth control pills. Other possible causes of galactorrhea include medications, such as certain sedatives, antidepressants, antipsychotics and high blood pressure drugs and cocaine, marijuana or opioid use. Also indicated as causes are a noncancerous pituitary tumor, underactive thyroid, chronic kidney disease and use of herbal supplements, such as fennel, anise or fenugreek seed.
Your doctor may test you by physical exam, during which they may try to express some of the fluid from your nipple by gently examining the area around your nipple while also checking for breast lumps or other suspicious areas of thickened breast tissue. You could be subject to analysis of fluid discharged from the nipple, to see if fat droplets are present in the fluid, which can help confirm the diagnosis of galactorrhea. An MRI (Magnetic Resonance Imaging) may be called for to check the brain for a tumor or other abnormality of your pituitary gland, if your blood test reveals an elevated prolactin level.
The treatment of galactorrhea depends on the cause. If tumors are benign they can be treated with medicine or surgery. Also medication can be useful if your body is producing too much of a hormone, such as prolactin. Medicines as well help treat problems such as hypothyroidism. If it is discovered that certain medications cause galactorrhea your doctor may prescribe a different medicine. Doctors sometimes cannot determine an exact cause of galactorrhea and in such a case they might recommend treatment anyway if you have bothersome or persistent nipple discharge. In such an event you might be given a medication to block the effects of prolactin or to lower the amount of prolactin in your body as reducing the prolactin level in your body may eliminate galactorrhea.