Galactorrhea is said to afflict 5–32% of women, but this number changes depending on how the condition is defined and diagnosed. It may be benign most of the time, but it could also be a sign of hormone imbalances or pituitary tumours. Galactorrhea can also happen in males, babies, and teenagers of both sexes.

Women of childbearing age are the most likely to have the illness. Research in India found that drugs caused 80% of galactorrhea cases. This illustrates the importance of verifying medications when making a diagnosis. To effectively treat and manage galactorrhea, it is essential to understand its epidemiology and causes.

If you want to be a doctor, you need to know a lot about galactorrhea. This will help you learn more and get ready for the NEET PG test. Read on to learn about the causes, symptoms, diagnosis, and treatment of galactorrhea.

What is Galactorrhea?

Galactorrhea is the sudden release of breast milk that has nothing to do with giving birth or breastfeeding. It can affect both men and women, and it is commonly associated with high levels of prolactin, a hormone produced by the pituitary gland. Galactorrhea occurs when milk is produced without nursing, typically a year after breastfeeding has stopped.

What Causes Galactorrhea?

Elevated levels of prolactin, a hormone made by the pituitary gland, are the most common cause of galactorrhea.
Here are the main causes of galactorrhea:

• Prolactinoma: A benign tumour of the pituitary gland that makes too much prolactin, which causes galactorrhea.
  
• Medications: Some medicines can raise prolactin levels or change dopamine levels, which control prolactin. These are:
  
  • Antipsychotic drugs like risperidone
    
  • Antidepressants, like selective serotonin reuptake inhibitors (SSRIs)
    
  • Medications for high blood pressure, such as verapamil
    
  • Opiates
    
  • Hormonal birth control
    
• Hypothyroidism: An underactive thyroid can cause levels of thyrotropin-releasing hormone (TRH) to rise, which may cause the body to make more prolactin.
  
• Chronic Kidney Disease: If the kidneys don’t function properly, they may not be able to eliminate prolactin as quickly, which can cause levels to rise.
  
• Nipple or Breast Stimulation: Prolactin levels can go up when you stimulate your nipples or breasts a lot or intensely, including when you have sex, wear tight clothes, or check yourself out.
  
• Stress: Long-term stress can alter hormone levels, such as increasing prolactin production.
  

What are the Signs of Galactorrhea?

The main signs of galactorrhea are as follows:

• Milky discharge from the nipple that may be persistent or come and go
  
• Discharge from one or both of your breasts
  
• Discharge that happens on its own or when the breasts are touched
  
• More than one milk duct is involved
  
• Menstrual periods that are irregular or don’t happen at all
  
• Headaches or issues with eyesight, especially if there is a pituitary tumor
  

If the patient is not pregnant or breastfeeding and one or both breasts keep leaking milk, they need to see a doctor.

How is Galactorrhea Diagnosed?

To diagnose galactorrhea, the following tests are done:

• Physical Exam: A doctor or nurse checks your breasts for lumps or other abnormal tissue. You can gently touch on the nipple to see if there is any discharge.
  
• Pregnancy Test: A pregnancy test is done to make sure that pregnancy is not the reason for the discharge from the nipple.
  

Tests for blood:

• Prolactin Levels: High levels of prolactin may be a sign of hyperprolactinemia, a major cause of galactorrhea.
  
• Thyroid-Stimulating Hormone (TSH): Checked to see if someone has hypothyroidism, which can cause galactorrhea.
  

Studies of images:

• If a breast lump or other problem is found during the physical exam, mammography and ultrasound are used.
  
• MRI (Magnetic Resonance Imaging) of the brain is done to find pituitary tumours or other problems if blood tests show high levels of prolactin.
  

Additional tests:

• Medication Review: Checking to see if any of your current medications, such as antipsychotics and antidepressants, could be causing galactorrhea.
  
• Visual Field Assessment: If a pituitary tumour is suspected, visual field tests may be done to see if the optic chiasm is being compressed.
  
• Additional Hormonal Tests: Depending on the situation, other pituitary hormones may be tested to gain a better understanding of the pituitary’s overall function.
  

What is the Best Way to Treat Galactorrhea?

The main goal of galactorrhea treatment is to treat the underlying causes, which are as follows:

• Changing the Dose of Medication
  If drugs cause galactorrhea, the doctor may tell you to stop taking them, change the dose, or switch to a different medicine. Before making any changes, always talk to a doctor.
  
• Thyroid Hormone Treatment
  If you have galactorrhea because of hypothyroidism, you can get therapy by taking thyroid hormone replacement, like levothyroxine, to bring your hormone levels back to normal.
  
• Dopamine Agonists
  Bromocriptine and cabergoline are two drugs that can reduce prolactin levels. They are commonly taken when the cause is uncertain or when there is a pituitary tumor.
  
• Surgery
  If medicine doesn’t work on pituitary tumors (prolactinomas), surgery may be needed to remove them.
  
• Changes to Your Lifestyle
  Avoiding tight clothes, reducing nipple stimulation, and managing stress can all assist with symptoms.
  

FAQs About Galactorrhea

1. Is it usual to have galactorrhea?

People don’t think galactorrhea is natural, but it doesn’t mean you have an illness. It means a milky discharge from the nipple that isn’t related to nursing and could be a sign of a health problem. It frequently happens to women, even ones who haven’t had kids or are postmenopausal, but it can also happen to men and babies.

2. Is there a way to treat galactorrhea?

Yes, the treatment for galactorrhea is aimed at getting rid of the cause. If no specific cause can be found, doctors may give you drugs like bromocriptine or cabergoline to lower prolactin levels and stop or slow the discharge.

3. Is galactorrhea a threat?

Galactorrhea alone isn’t hazardous, but it might be an indication of other problems, like hormone imbalances or tumours in the pituitary gland. It is essential to consult a doctor to determine the cause and appropriate treatment.

4. Can galactorrhea hurt kids?

Yes, babies can get galactorrhea. In babies, it’s usually caused by hormones from the mother and goes away on its own. However, a healthcare provider should investigate any symptoms that persist or are concerning.

5. Can I go about my daily life with galactorrhea?

Many people with galactorrhea live normal lives, especially when the cause is found and treated. Treatment can help alleviate symptoms, and in some cases, the problem may resolve on its own if no underlying cause can be identified.

Conclusion

It is crucial for individuals aspiring to be doctors and preparing for the NEET PG exam to gain extensive knowledge about galactorrhea. DocTutorials helps you prepare for the NEET PG exam by providing guidance, informative video courses, and rapid review programs.

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