Galactorrhoea (abnormal breast milk discharge): Causes & Treatment

Definition: What is galactorrhoea?

The Leakage from milk or a milk-like liquid made from the mammary glands outside the breastfeeding period is referred to as Galactorrhoea (also known as galactorrhoea). This Milk flow It can occur on one or both sides and is often a cause for concern. Galactorrhoea refers to However, it is a symptom, not a disease in its own right. Whilst there are harmless causes, it can also be a pathological discharge of breast milk be the underlying Hormonal imbalances or indicates other medical conditions. An assessment by Medical professionals is therefore always advisable.

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Causes: Why does pathological lactation occur?

The Milk production is mainly caused by the Production of the hormone prolactin is regulated by the pituitary gland. The the most common cause of galactorrhoea is therefore an elevated level of prolactin in the blood (hyperprolactinaemia). The Causes of galactorrhoea can take many forms:

Physiological causes (non-pathological)

• Ongoing Milk flow after a Breastfeeding break or complete weaning (which can take anywhere from months to years).
• Mechanical stimulation of the nipples.
• Severe stress.

Pathological causes (disease-related)

• Prolactinoma: A benign tumour of the pituitary gland (known as a prolactinoma) which produces prolactin uncontrollably. This is a common underlying cause for a significant Increase in prolactin levels.
• Medicines: Many medicines can Causes of galactorrhoea, e.g. certain Antipsychotics, antidepressants, blood pressure medication or Oestrogen-containing preparations.
• Hypothyroidism: It affects hormone regulation.
• Kidney or liver disease.
• Disorders of the hypothalamus.
• Injuries or operations in the chest area.
• Less common: other hormone-producing tumours.
• Idiopathic hyperprolactinaemia: Elevated prolactin levels with no identifiable cause.

Symptoms and complaints associated with galactorrhoea

The main symptom is Leakage by milky discharge from on one side or both sideson the nipples. This can to varying degrees be. Accompanying Symptoms and complaints depend on the underlying cause from:

• In women (particularly pre-menopausal women): Menstrual disorders (more irregular Menstrual cycle), Missed period (Amenorrhoea), reduced libido, infertility.
• For men: Loss of libido, erectile dysfunction, gynaecomastia (enlargement of the Breast tissue).
• In the case of a prolactinoma: Headaches and visual disturbances may be a sign of a Indications of a prolactinoma.
• Symptoms of an underactive thyroid (fatigue, weight gain, etc.).

Diagnosis: Identifying the cause of galactorrhoea

1. Medical history Tracking of medication, menstrual cycles, pregnancies, breastfeeding periods, stress and symptoms.
2. Physical examination Investigation of the both breasts, palpation, assessment of the secretions oozing out.
3. Laboratory tests Pregnancy test. Prolactin levels (often several times, as it depends on stress levels). Thyroid test results (TSH). Kidney and liver function tests.
4. Imaging Head MRI scan (if you suspect Prolactinoma). In this context, it is also possible to Contrast medium are used. Mammography/breast ultrasound: To rule out other possibilities Diseases of the mammary gland, although galactorrhoea is rarely a symptom of early Stage of breast cancer is (unlike, for example, bloody discharge from a Milk passage, which suggests a Ductal papilloma (might suggest).

Treatment of galactorrhoea

The Treatment depends on the identified Causes of galactorrhoea:

• No treatment: This is often not necessary in cases where the causes are harmless and do not cause any distress.
• Change of medication: If medicines cause the Galactorrhoea resulting from trigger elevated prolactin levels.
• Dopamine agonists: The treatment of choice for Prolactinoma and often also in cases of idiopathic hyperprolactinaemia to reduce the Prolactin levels.
• Thyroid hormones: In cases of hypothyroidism.
• Surgery or radiotherapy: Rare in prolactinomas that do not respond to medication.
• Treatment of other underlying conditions.

When is it necessary to see a doctor?

Everyone Milk production outside pregnancy and breastfeeding should be investigated by a doctor, particularly if it is a new symptom, persists or is accompanied by other symptoms. This is the only way to distinguish between a harmless condition and one that requires treatment, pathological A distinction must be made between the causes.

Galactorrhoea in men, children and infants

If galactorrhoea occurs at Men and children In such cases, a thorough examination is particularly important, as hormonal disorders or tumours are often the cause (Prolactinoma) behind it. In the case of Infants A slight flow of milk („witch’s milk“) is normal and harmless during the first few weeks.

Coverage of the costs of diagnosis and treatment

The diagnostic procedures for investigating the Causes of galactorrhoea as well as the Treatment Treatment for the underlying condition (e.g. medication for prolactinoma) is medically indicated and is therefore usually covered by the Health insurance funds taken over.