Galactorrhea is a type of milky nipple discharge in people who aren't breast-feeding. Find out more about the possible causes and treatments.
Galactorrhea (guh-lack-toe-REE-uh) is a milky nipple discharge unrelated to the normal milk production of breast-feeding. Galactorrhea itself isn't a disease, but it could be a sign of an underlying problem. It usually occurs in women, even those who have never had children or after menopause. But galactorrhea can happen in men and even in infants.
Excessive breast stimulation, medication side effects or disorders of the pituitary gland all may contribute to galactorrhea. Often, galactorrhea results from increased levels of prolactin, the hormone that stimulates milk production.
Sometimes, the cause of galactorrhea can't be determined. The condition may resolve on its own.
Signs and symptoms associated with galactorrhea include:
If you have a persistent, spontaneous milky nipple discharge from one or both of your breasts and you're not pregnant or breast-feeding, make an appointment to see your doctor.
If breast stimulation — such as excessive nipple manipulation during sexual activity — triggers nipple discharge from multiple ducts, you have little cause for worry. The discharge probably doesn't signal anything abnormal, and this discharge often resolves on its own. If you have persistent discharge that doesn't go away, make an appointment with your doctor to get it checked out.
Nonmilky nipple discharge — particularly bloody, yellow or clear spontaneous discharge that comes from one duct or is associated with a lump you can feel — requires prompt medical attention, as it may be a sign of an underlying breast cancer.
Galactorrhea often results from having too much prolactin — the hormone responsible for milk production when you have a baby. Prolactin is produced by your pituitary gland, a small bean-shaped gland at the base of your brain that secretes and regulates several hormones.
Possible causes of galactorrhea include:
Sometimes doctors can't find a cause for galactorrhea. This is called idiopathic galactorrhea, and it may just mean that your breast tissue is particularly sensitive to the milk-producing hormone prolactin in your blood. If you have increased sensitivity to prolactin, even normal prolactin levels can lead to galactorrhea.
In males, galactorrhea may be associated with testosterone deficiency (male hypogonadism) and usually occurs with breast enlargement or tenderness (gynecomastia). Erectile dysfunction and a lack of sexual desire also are associated with testosterone deficiency.
Galactorrhea sometimes occurs in newborns. High maternal estrogen levels cross the placenta into the baby's blood. This can cause enlargement of the baby's breast tissue, which may be associated with a milky nipple discharge. This milky discharge is temporary and resolves on its own. If the discharge is persistent, the newborn should be evaluated by a doctor.
The pituitary gland and the hypothalamus are located within the brain and control hormone production.
Finding the underlying cause of galactorrhea can be a complex task because there are so many possibilities.
Testing may involve:
If your doctor suspects that a medicine you're taking might be the cause of galactorrhea, he or she might instruct you to stop taking the medicine for a short time to assess this possible cause.
When needed, galactorrhea treatment focuses on resolving the underlying cause.
Sometimes doctors can't determine an exact cause of galactorrhea. Your doctor might recommend treatment anyway if you have bothersome or persistent nipple discharge. A medication that blocks the effects of prolactin or lowers your body's prolactin level could help eliminate galactorrhea.
|Underlying cause||Possible treatment|
|Medication use||Stop taking medication, change dose or switch to another medication. Make medication changes only if your doctor says it's OK to do so.|
|Underactive thyroid gland (hypothyroidism)||Take a medication, such as levothyroxine (Levothroid, Synthroid, others), to counter insufficient hormone production by your thyroid gland (thyroid replacement therapy).|
|Pituitary tumor (prolactinoma)||Use a medication to shrink the tumor or have surgery to remove it.|
|Unknown cause||Try a medication, such as bromocriptine (Cycloset, Parlodel) or cabergoline, to lower your prolactin level and minimize or stop milky nipple discharge. Side effects of these medications commonly include nausea, dizziness and headaches.|
Often, milky discharge associated with idiopathic galactorrhea goes away on its own, particularly if you can avoid breast stimulation or medications that are known to cause nipple discharge.
To lessen breast stimulation:
You're likely to start by seeing your family doctor or gynecologist. However, you may be referred to a breast health specialist instead.
To prepare for your appointment:
For galactorrhea, possible questions to ask your doctor include:
Your doctor may ask you questions, such as:
Until your appointment, follow these tips to deal with unwanted nipple discharge: