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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Galactorrhea
After you read this, you will know what galactorrhea is, how
it is diagnosed, and how it is treated. Galactorrhea may be
a symptom of a condition that needs further medical
treatment, so it is important that you see your health care
provider to determine the cause of this problem.
What is galactorrhea?
Galactorrhea is a whitish or greenish discharge from the
breast nipples. Usually the discharge is from both breasts
rather than just one. A discharge like this is called
galactorrhea when women who are not pregnant or
breast-feeding have it.
How does it occur?
Galactorrhea occurs when your body produces too much
prolactin. Prolactin is a hormone produced by the pituitary
gland in the brain. Normally, prolactin stimulates the
production of milk when a woman has a baby.
Galactorrhea is often a symptom of another condition. It
may be caused by:
- too much estrogen in your body from birth control pills
- an underactive thyroid gland
- certain drugs, such as some high blood pressure
medications, tranquilizers, and antidepressants
- disorders or tumors of the pituitary gland
- some brain diseases, such as meningitis
- a cyst under the darkened area around the nipple
(called a galactocele)
- shingles (herpes zoster) caused by the chickenpox virus
in the chest wall
- other medical conditions such as kidney failure,
cirrhosis of the liver, and Cushing's disease of the
adrenal gland.
Any woman who has had a baby, whether or not she breast-fed
her baby, may later have galactorrhea.
In about half the cases, a cause cannot be found.
How is it diagnosed?
Your health care provider examines your breasts and gets a
sample of the discharge for lab tests. He or she will also
ask questions about your medical history, such as whether
you have stopped having menstrual periods, are having
trouble getting pregnant, or having headaches or vision
problems. Your health care provider will also ask about
what medications you are taking.
Your health care provider may order the following tests:
- mammogram (x-ray of the breasts) and/or ultrasound scan
of your breasts
- blood test for thyroid, liver, or kidney problems
- blood test to check your prolactin level
- CT scan (computerized x-rays) of your brain to look at
your pituitary gland.
How is it treated?
If your galactorrhea is due to a disorder such as thyroid
problems or meningitis, your health care provider will treat
the disorder. If a galactocele is causing the galactorrhea,
the cyst will be removed.
If the discharge is caused by drugs, it will clear up when
you stop taking the drugs. However, stopping drugs is not
always necessary (for example, you may continue taking birth
control pills).
If your galactorrhea is caused by a pituitary gland
tumor, you may need surgery, radiation, or drug treatments.
Often these tumors grow slowly, and some eventually stop
growing. Some can be treated successfully with
bromocriptine, a drug that stops the production of prolactin
by your pituitary gland.
If your diagnostic tests do not detect a cause of the
galactorrhea, you may not need any treatment. Or your
health care provider may prescribe bromocriptine, which can
successfully treat galactorrhea when the cause is unknown.
If you have stopped having periods, bromocriptine may cause
your periods to start again and may increase your chances of
becoming pregnant.
How long will the effects last?
Once the source of your galactorrhea is diagnosed and
treated, you should no longer have the discharge. However,
if you have a pituitary tumor, you may need long-term
treatment with bromocriptine or radiation because the tumor
could come back.
How can I take care of myself?
- If you are taking bromocriptine, be sure you take it
according to your health care provider's instructions.
- If your galactorrhea is mild and a cause cannot be found,
breast binders can help stop the discharge by preventing
stimulation of the nipples.
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