What Is Galactorrhea?
Symptoms, Causes, Treatment

You know you’re not pregnant, so why are you leaking a milky discharge from your nipples? You have galactorrhea — a nipple discharge that is entirely unrelated to normal breast milk production.[2]

The condition is more common in women regardless of whether you’ve had children or if you’ve reached menopause, but can also affect men, children, and infants.

Galactorrhea symptoms

Galactorrhea can affect one or both of your breasts and causes:

  • Persistent or intermittent nipple discharge
  • Nipple discharge from multiple ducts
  • Spontaneous or expressed nipple discharge

Galactorrhea often co-occurs with low estrogen, which can cause:

  • Absent or irregular, infrequent periods
  • Vaginal dryness
  • Painful sex
  • Libido loss
  • Hirsutism 
  • Infertility

In some cases, you might also experience headaches, blurry vision, or vision loss. 

Galactorrhea causes

Galactorrhea is due to having elevated prolactin levels. Prolactin is the hormone that triggers milk production when you have a baby. Your pituitary gland, a small bean-shaped gland at the base of your brain, produces prolactin, as well as several other hormones. 

Prolactinoma — a prolactin-secreting tumor in or on the pituitary gland — is the most common cause of elevated prolactin levels and galactorrhea.[4] You can also develop galactorrhea if you have a tumor above your pituitary gland what compresses the stalk of the gland. When the stalk of your pituitary gland is compressed, it doesn’t get dopamine, which decreases prolactin production. Prolactinomas are also known to compress the optic nerve, which causes vision problems, including blindness.

Other potential causes of galactorrhea include:

  • Medications including sedatives, antidepressants, antipsychotics, and hypertension drugs
  • Opioid use
  • Herbal supplements including fennel, anise, and fenugreek
  • Birth control pills
  • Hypothyroidism
  • Kidney disease
  • Excessive breast stimulation
  • Nerve damage to the chest wall
  • Spinal cord surgery, injury, or tumors
  • Stress

Men who have galactorrhea often have low testosterone. The milky discharge usually occurs with gynecomastia (enlarged and sensitive breast tissue). Men also often experience erectile dysfunction or libido loss alongside galactorrhea. 

Idiopathic galactorrhea doesn’t have an identifiable cause. Your breast tissue might just be more sensitive to prolactin. 

Related hormonal issues

Your pituitary gland is like the quarterback of your endocrine system.[5] It produces many of the hormones that stimulate and regulate other endocrine glands, including your thyroid, ovaries, and testes. If you have a tumor on or in your pituitary gland, in addition to triggering galactorrhea, it can also interfere with other parts of your endocrine system.

For example, if a tumor causes hypopituitarism, you can also develop hypothyroidism, adrenal insufficiency, and growth hormone deficiency. 

It can also interfere with the function of your ovaries or testes, leading to decreased estrogen and testosterone. Suboptimal sex hormone levels cause a wide range of disruptive symptoms, including osteoporosis, low libido, weight gain, fatigue, and mood disturbances. 

When to talk to a doctor about galactorrhea

Galactorrhea is a sign that something is wrong, and you should make an appointment if you have abnormal, persistent, and spontaneous milky nipple discharge. Additionally, if your nipple discharge is yellow or bloody, or if you can feel a lump in your breast, make an appointment with a doctor immediately for a breast cancer screening. 

If your nipple discharge follows excessive nipple stimulation, such as during sexual activity, your symptoms should subside on their own, and you don’t need to worry. If the discharge persists, you know what to do, call the doctor!

Diagnosing the cause

Successful treatment depends on identifying the condition causing your galactorrhea. When you meet with your doctor, they use an exam and various tests to diagnose the cause of your symptoms. 

Your doctor performs a full physical, including a breast exam. They need to see how your nipples respond to being squeezed (expressed) and to feel for signs of breast cancer. 

Your doctor orders a pregnancy test if there is any chance that you could be pregnant. They also order blood work to evaluate your prolactin and thyroid-stimulating hormone levels. Your doctor might also take a sample of your nipple discharge for testing. 

In some cases, you might need diagnostic imaging studies like MRIs or CT scans to check for prolactinomas or other tumors near your pituitary gland. Your doctor might also order a mammogram or ultrasound to examine the inside of your breasts. 

Galactorrhea treatment

Doctors treat galactorrhea by addressing the condition that causes it. For example, if your symptoms are due to a medication, your doctor can change your prescription. You should only change medicines or stop taking prescribed medication under the supervision of your doctor. Your doctor might also prescribe medication to correct an underactive thyroid or regulate your prolactin levels. 

However, if your milky nipple discharge is due to a pituitary tumor, your doctor can prescribe medicine to shrink the tumor or schedule surgery to remove it. 

If you have galactorrhea, contact your doctor to find out what’s causing your milky nipple discharge. If you have other signs of a hormonal problem, the team of physicians at HRT Wellness can help. Unlike many physicians who dismiss symptoms of hormonal disorders as signs of aging or poor lifestyle choices, our team takes your concerns seriously. Contact us today to start your journey toward optimized hormone health. 

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Galactorrhea is due to having elevated prolactin levels. Prolactin is the hormone that triggers milk production when you have a baby. Your pituitary gland, a small bean-shaped gland at the base of your brain, produces prolactin, as well as several other hormones. 

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