Galactorrhea – Symptoms and Causes
Overview
Galactorrhea refers to milky discharge from the nipples that occurs outside the context of breastfeeding. This condition primarily affects individuals assigned female at birth, although it can also occur in males and infants.
The discharge happens regardless of childbearing history or menopausal status.
Several factors may trigger galactorrhea:
- Elevated prolactin levels (the hormone responsible for milk production)
- Excessive breast stimulation
- Medication side effects
- Pituitary gland disorders
In some cases, healthcare providers cannot identify a specific cause for the condition. Galactorrhea is not a disease itself but rather a symptom that might point to an underlying health issue.
The good news is that galactorrhea sometimes resolves without treatment. However, persistent discharge warrants medical evaluation to rule out serious conditions and determine appropriate management strategies.
Signs and Symptoms
People with galactorrhea may notice:
- Milky fluid coming from the nipples
- Discharge from multiple milk ducts
- Fluid that leaks without stimulation or when the breast is touched
- Discharge affecting one or both breasts
- Menstrual cycle changes or absence of periods
- Headaches or vision problems
When Medical Attention Is Needed
See a doctor if you notice ongoing milky discharge from your breasts when you’re not pregnant or breastfeeding. If nipple stimulation causes discharge from multiple ducts, this is usually not concerning and often resolves without treatment.
Seek immediate medical care for any non-milky discharge. Bloody discharge, clear fluid from a single duct, or discharge accompanied by a lump requires prompt attention as these may indicate breast cancer.
Regular breast self-exams help you notice unusual changes. During your appointment, the doctor will ask about your symptoms, medical history, and medications to determine the underlying cause and appropriate treatment plan.
Causes
The pituitary gland releases breast milk when not breastfeeding due to high levels of prolactin, a hormone. Several factors can trigger this condition, including:
- Medications: Some antidepressants, antipsychotics, sedatives, and blood pressure drugs.
- Substances: Opioids and certain herbal supplements (fennel, anise, fenugreek).
- Hormonal Factors: Birth control pills.
- Medical Conditions: Pituitary tumors (prolactinomas), hypothyroidism, chronic kidney disease.
- Physical Stimulation: Excessive breast handling, sexual activity, frequent self-examinations.
- Injuries: Nerve damage from chest surgery, burns, chest trauma.
- Neurological issues: Spinal cord injuries, surgeries, or tumors.
- Psychological factors: Stress.
Unexplained Milk Production
In many cases, doctors cannot identify a specific cause for milk discharge from the breasts. This is known as unexplained or idiopathic galactorrhea.
People with this condition may have breast tissue that responds more strongly to normal levels of prolactin. Their bodies produce a typical amount of the hormone, but their breast tissue is unusually sensitive to it, leading to milk production.
Milk Production in Men
When men experience breast milk discharge, it often relates to low testosterone levels (male hypogonadism). This hormone imbalance typically causes other symptoms like:
- Enlarged or tender breast tissue (gynecomastia)
- Difficulty achieving or maintaining erections
- Decreased sexual desire
Risk Factors
Several factors can raise the chance of developing galactorrhea. These include:
- Medications, street drugs, and some herbal supplements
- Pituitary gland issues, including non-cancerous tumors
- Medical conditions like chronic kidney disease, spinal cord injuries, chest wall trauma, and hypothyroidism
Frequent breast stimulation can also lead to this condition. High stress levels may also trigger the body to produce excess prolactin, the hormone responsible for galactorrhea.
