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Galactorrhea

Inappropriate breast milk secretion, or galactorrhea, may occur 3 to 6 months after the discontinuation of breast-feeding (usually after a first delivery). It's also known as hyperprolactinemia. This disorder may follow an abortion or may develop in a female who hasn't

Causes

Galactorrhea has many causes. Here are some of them:

  • Medicines such as hormones, antidepressants, blood pressure medicines and others
  • Herbs such as nettle, fennel, blessed thistle, anise and fenugreek seed
  • Street drugs such as marijuana and opiates
  • Tumors (usually benign), especially tumors of the pituitary gland, which is in the brain
  • Pregnancy
  • Clothing that irritates the breasts
  • Doing very frequent breast self-exams
  • Stimulation of the breast during sexual activity

Signs and Symptoms

Usually, a woman with galactorrhea reports that her breast milk continues to flow after the 21-day period that is normal after weaning. The flow may be spontaneous and unrelated to normal lactation, or it may result from manual expression. Typically, she reports that both breasts are affected. She may also report amenorrhea.

Diagnostic tests

Galactorrhea is determined by palpating the breast from the periphery toward the nipple in an attempt to express any secretion. The diagnosis is confirmed by microscopic observation of multiple fat droplets in the fluid. (A computed tomography scan and, possibly, a mammogram may be ordered to rule out tumors.)

Treatment

The underlying cause is considered in determining the course of treatment, which ranges from simple avoidance of precipitating exogenous factors, such as drugs, to treatment of tumors with surgery, radiation, or chemotherapy.

The choice of therapy for idiopathic galactorrhea depends on whether the patient plans to have more children. If she does, treatment usually consists of bromocriptine; if she doesn't, oral estrogens (such as ethinyl estradiol) and progestins (such as progesterone) are used to effectively treat this disorder. After treatment with bromocriptine, milk secretion usually stops in 1 to 2 months and menstruation recurs after 6 to 24 weeks. Idiopathic galactorrhea may recur after discontinuation of drug therapy.

Prevention
  • Avoid wearing clothing that irritates the breast
  • Avoid frequent breast self-exam; usually once a month is enough
  • Avoid excessive sexual stimulation of the breasts
  • Do not use illicit drugs


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