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Treatment of galactorrhea

Causes of galactorrhea

This is a condition in which milk is secreted from the mammary glands outside the lactation period. This condition is considered an obvious pathology when it develops in a non-pregnant woman or continues 5 months after the end of the lactation period. It is noteworthy that it can also develop in males, but it is extremely rare.

Causes of galactorrhea associated primarily with hormonal disorders, more precisely with hyperproduction of prolactin. However, they are not the only ones that exhaust the list of factors that determine milk production outside the lactation period:

• hyperprolactinemia - excessive concentration of the hormone prolactin in the blood; its increase is normal only during pregnancy and lactation;
• diseases of the central nervous system that prevent the entry of prolactin-inhibiting factors into the pituitary gland;
• malignant neoplasms in the structure of the pituitary gland - prolactinoma or somatotropinoma;
• diseases of the thyroid gland - mainly with disturbances in the production of thyroid hormones, such as hyperthyroidism or hypothyroidism;
• diseases of the adrenal glands - malignant neoplasms in them or impaired hormone production;
• ovarian diseases, which are also accompanied by hormonal imbalance, for example, polycystic ovary syndrome;
• hypothalamic dysfunction;
• liver or kidney failure;
• long-term use of certain types of medications and hormonal drugs, in particular psychotropic ones or to lower blood pressure;
• long-term and uncontrolled consumption of certain herbal remedies - nettle, fennel, knykus, anise, Greek fenugreek seeds;
• taking drugs, in particular marijuana or opiates;
• mental disorders requiring previous use of phenothisine, chlorpromazine or aminazine;
• pregnancy - milk discharge is acceptable on the eve of childbirth, however, it is necessary to notify the doctor observing the pregnancy about this.

Medical practice knows cases of idiopathic, that is, with an unknown origin, galactorrhea. Galactorrhea should be a reason for immediate consultation with a specialized specialist - a mammologist or endocrinologist. The obvious symptom of the disorder - discharge from the mammary gland (sometimes even mixed with blood) - is often complemented by other unpleasant symptoms of galactorrhea:

• women have menstrual irregularities or no menstruation at all;
• decreased libido or complete lack of interest in sex - in men up to impotence; women experience discomfort during sex due to vaginal dryness;
• In women, intensive hair growth on the chest or chin;
• feeling of heat in attacks, so-called hot flashes;
• acne;
• regular headaches and dizziness;
• visual dysfunction, in particular deterioration of peripheral vision.

A characteristic feature of galactorrhea, incl. Even in nursing mothers, milk flow from the breast is considered to be uneven. For nursing mothers, this may be a drip or between feedings. This does not cause severe anxiety or pain, but occasionally the mammary glands swell and it becomes necessary to squeeze out the secretion that has been produced from them.

How to treat galactorrhea?

Treatment of galactorrhea impossible without a thorough diagnosis to determine the cause of the deviation. Symptomatic treatment is used, but much less often than etiotropic treatment, that is, one that is aimed at eliminating the disorder that provoked galactorrhea. Symptomatic treatment is given preference only to the entire range of appropriate procedures, which are not sufficient to establish the causes of the disease. Then it is classified as idiopathic, and its therapy consists of maintaining normal levels of the hormone prolactin.

Treatment of galactorrhea includes a wide range of activities, specific of which are determined by therapeutic expediency. If galactorrhea is based on hormonal imbalance, then the health of the endocrine system is restored. If during the examination a malignant neoplasm was detected, for example, in the structure of the pituitary gland or adrenal glands, but surgical intervention and a course of chemotherapy drugs cannot be avoided. If galactorrhea is a consequence of uncontrolled medication use or a stress factor, it is necessary to stop the adverse effects on the body.

Taking drugs that normalize the level of prolactin in the blood is prescribed as part of the conservative treatment of galactorrhea. Such treatment can have both a long-term and short-term effect, which again is determined by the causes of dysfunction.

Drug of choice in treatment of galactorrhea, as in the treatment of hyperprolactinemia, it is customary to consider drugs produced on the basis of bromocriptine. Bromocriptine is prescribed both for the treatment of small prolactinomas and for restoring the menstrual cycle. Taking it among women can increase estrogen levels, reduce the risk of osteoporosis and, of course, stop pathological milk production.

Women with small prolactinomas can take estrogens or oral contraceptives containing estrogens because estrogens do not make small tumors grow faster. It is recommended to repeat a CT or MRI scan once a year for the next two years to ensure that the tumor is not growing in size. For persons with large tumors, surgery may be recommended after a thorough examination of the endocrine system. In the preoperative period, the same bromocriptine can be prescribed and if it reduces the level of prolactin in the blood and the symptoms disappear, then there is no need for surgery.

If you still cannot avoid it, then the use of prolactin-lowering drugs will reduce the tumor in size. Prolactinomas often recur, and therefore the use of radiation and chemotherapy cannot be ruled out.

What diseases can it be associated with?

Galactorrhea is often a concomitant disease, that is, developing against the background of a certain established dysfunction. The predominant number of clinical cases occurs from hormonal imbalances, namely:

• hyperprolactinemia,
• hyperthyroidism,
• hypothyroidism,
• hypoestrogenism.

Another common cause of galactorrhea is malignant neoplasms in the pituitary gland (prolactinoma or somatotropinoma), pituitary hyperplasia, and hypothalamic dysfunction.

Changes in hormonal levels that can provoke galactorrhea are largely determined by:

• diseases of the central nervous system,
• thyroid diseases,
• diseases of the ovaries, in particular PCOS,
• adrenal diseases,
• liver or kidney failure.

Treatment of galactorrhea at home

Treatment of galactorrhea very popular at home. Whatever the reason for its development, surgical intervention is prescribed either for large tumors or due to the low effectiveness of conservative methods. Among the causes of galactorrhea are those that do not require hospitalization, but only dispensary observation, therefore treatment is carried out at home.

What drugs are used to treat galactorrhea?

To directly affect milk production, it is enough to take drugs that suppress the secretion of prolactin. This:

• - taken orally , during meals, the dosage is set individually, but the initial single dose can be 1.25-2.5 mg 1-3 times a day; used in both mono- and combination therapy;
• - in the treatment of hyperprolactinemia, doses are selected individually, the initial dose can be from 500 mcg per week, which is usually taken in one dose, and sometimes in two divided doses;
• - taken orally , during meals, the dosage is set individually; a single daily dose can range from 1.25 to 40 mg per day.

A course of medications prescribed by a doctor may be sufficient to eliminate galactorrhea, normalize the menstrual cycle and restore prolactin balance. However, if the underlying cause of galactorrhea is a serious disease, for example, a malignant disease or a hormonal disorder, then the effect of the above drugs will be only temporary.

Treatment of galactorrhea with traditional methods

In the majority of cases, galactorrhea is a consequence of hormonal imbalance or malignant neoplasm. It is necessary to understand that neither one nor the other can be significantly treated with folk remedies alone. The consumption of folk remedies cannot significantly affect the mechanism of hormone production, much less destroy the tumor. However, the use of herbal decoctions can be an addition to the main traditional therapy, if the attending doctor has no objections to this.

Discuss the following prescriptions with your healthcare provider:

• combine motherwort, valerian, lemon balm, and St. John's wort in equal proportions; 1 tbsp. place the collection in a thermos and pour a glass of boiling water, leave for 1-1.5 hours, then strain; take ¼ cup 3-4 times a day before meals; the next day prepare a new decoction; the course of treatment lasts 21 days, after a week's break it can be repeated;
• combine passionflower, hops, hawthorn, and elderberry in equal proportions; 2 tbsp. pour a glass of boiling water over the collection, leave in a water bath for 15 minutes, remove from heat and strain after another half hour; take ¼ cup 3-4 times a day before meals; the next day prepare a new decoction; the course of treatment lasts 14-21 days, it can be repeated after a week's break.

Treatment of galactorrhea during pregnancy

Galactorrhea during pregnancy is not a critical condition. As a woman prepares for childbirth, hormonal changes occur in her body, with a corresponding increase in the production of the hormones oxytocin and prolactin. In this way, the body prepares for the production of milk during the lactation period, and its individual secretions are possible earlier.

Special measures for treatment of galactorrhea It is not recommended for pregnant women, but it is still worth notifying your doctor about your condition. In some cases, additional studies may be indicated, for example, blood tests for hormone levels, the overproduction of which is still possible. Diagnosis of hyperprolactinemia during pregnancy does not occur, since the content of prolactin in the blood of a pregnant woman is increased and constantly varies, however, such a diagnosis can be made earlier and is not an obstacle to conception. Hyperprolactinemia during pregnancy requires monitoring by medical personnel, and control tests and, especially, thorough treatment measures are carried out already in the postpartum period.

Which doctors should you contact if you have galactorrhea?

• Mammologist
• Neurosurgeon
• Endocrinologist

The release of milk outside the lactation period should be a reason to consult a doctor and further diagnosis. The diagnosis itself can be made based on the patient’s complaints after an objective examination, and a more detailed diagnosis is necessary to determine the causes of the disease. During the examination, the doctor determines the sensitivity of the breast during palpation and visually assesses the amount of secretion produced.

Treatment of galactorrhea is impossible without finding out its causes, and therefore the patient is prescribed:

• hormonal studies - a blood test that allows you to detect the concentration of prolactin, luteinizing and follicle-stimulating hormones; with galactorrhea, there is a decrease in estrogen and an increase in 17-ketosteroids; prolactin levels usually exceed 200 mcg/d;
• computer or magnetic resonance imaging - can detect prolactinomas or other neoplasms that determine hormonal dysfunction;
• mammography - allows you to assess the condition and structure of the mammary glands; a mamogram will show shadows of dilated ducts;
• consultation with an ophthalmologist and ophthalmoscopy - to identify tumors in the brain that can impinge on the optic nerve.

Additional methods for diagnosing galactorrhea are ultrasound of the liver, ovaries, kidneys and thyroid glands, which help determine the cause of the disorder.

Treatment of other diseases starting with the letter - g

Contrary to the opinion of many, galactorrhea is not a disease, but a kind of symptom or condition in which there is a discharge from the mammary glands of a liquid similar in composition to milk or colostrum.

The term “galactorrhea” is literally translated from Greek as “leakage of milk.” Most often, it is a sign of an incorrect balance of hormones in the body, but the participation of other development factors cannot be ruled out.

Galactorrhea syndrome develops as a consequence of increased levels of prolactin in the bloodstream. More often, this syndrome is diagnosed in the fair sex, but there are cases where children or men are affected.

Galactorrhea-amenorrhea syndrome

Combined galactorrhea-amenorrhea syndrome refers to pathological conditions in which, due to the secretion of breast milk, there are no periods and infertility is diagnosed. The cause of this syndrome is hyperprolactinemia, which, in turn, can be caused by tumor processes in the pituitary gland, disorders in the hypothalamus, primary hypothyroidism, psychotrauma, and prolonged treatment with certain medications.

We can talk about a similar syndrome if amenorrhea and milk production are present in a woman who has stopped breastfeeding her baby (we are talking about the so-called Chiari-Frommel syndrome).

ICD-10 code

N64.3 Galactorrhea not associated with childbearing

O92.6 Galactorrhea

Epidemiology

With galactorrhea, milk is released from the ducts of the mammary glands - and this condition is in no way related to the stage of lactation. The volume and severity of discharge can vary - from the detection of small spots on a bra or clothing, to a more intense discharge.

The pathological condition can be unilateral or bilateral, and it is diagnosed mainly in women of reproductive age. However, men are no exception - galactorrhea occurs in them, although much less frequently.

According to statistics, milk leakage in women outside the period of feeding the baby occurs in 20% of the fair sex, aged 25 to 40 years. In men, pathology is diagnosed in 0.07% of cases.

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Causes of galactorrhea

The root causes of the development of galactorrhea can be:

• malignant, benign tumor processes affecting the pituitary gland;
• chaotic use of medications, such as hormonal drugs, sedatives, antidepressants, narcotic analgesics, cardiovascular drugs;
• tumor processes affecting the hypothalamus or the structure of the limbic system;
• insufficient thyroid function;
• disorders of the adrenal glands;
• liver diseases (especially chronic forms of pathologies);
• mechanical damage, trauma, burns, operations that cause damage to the sensitive fibers of the sympathetic and parasympathetic nervous system;
• tumor processes affecting spinal structures;
• hyperstimulation of the nipple area (with frequent sexual intercourse, using tight underwear, allergies, etc.);
• after operations affecting the spinal cord;
• bronchogenic cancer process;
• Itsenko-Cushing's and Addison's diseases;
• taking medications or folk remedies based on fennel, anise, nettle leaf, fenugreek.

Risk factors

There are several known factors that do not themselves cause galactorrhea, but contribute to its appearance. These factors include:

• Stein-Leventhal syndrome (PCOS, accompanied by galactorrhea and amenorrhea);
• hydatidiform mole;
• uterine choriocarcinoma;
• inflammatory processes in the tissues of the mammary glands.

Galactorrhea is normal if observed within five months after the end of the lactation period. If there is discharge for six months or more, then pathology can be suspected.

Discharge in infants during the newborn period is also considered a relative norm: this condition is associated with the concomitant influence of hormones that were passed on to the baby from the mother. This phenomenon goes away on its own and does not require any treatment.

It is worth noting that in approximately every second patient it is not possible to establish the cause of galactorrhea, even after all diagnostic measures have been carried out. In such a situation, the diagnosis includes a term such as “idiopathic galactorrhea.”

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Pathogenesis

Pathological galactorrhea most often becomes a consequence of diseases that are associated with impaired functioning of the hypothalamus (inflammation, trauma) or the pituitary gland (malignant and benign tumors, “empty sella”).

Increased synthesis of prolactin provokes the development of puffiness, swelling and pain in the mammary glands. Vegetative symptoms may appear: migraine-like pain in the head, swelling of the limbs, discomfort in the abdominal area. A constant elevated level of prolactin becomes a chronic stimulating irritant for the mammary glands, which causes the development of galactorrhea as a symptom. The root cause may be a large number of pathologies and pathological conditions.

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Symptoms of galactorrhea

The basic symptom that determines the name of the pathology is the leakage of varying volumes of milk or colostrum from the milk duct. Discharge can be observed constantly, or only occasionally. Their color also varies - from translucent whitish to yellow-greenish.

The pathology may be accompanied by other signs that depend on the causative disease:

• migraine-type headaches;
• blurred vision;
• deterioration of the skin condition;
• tachycardia;
• a sharp change in body weight, in one direction or another;
• libido disturbance.

In girls, the monthly cycle may be disrupted and unpleasant sensations may appear in the vagina. Excessive hair growth in the area of ​​the limbs, face, and chest is also typical.

If galactorrhea develops in men, then the following first signs become typical:

• violation of potency;
• gynecomastia (swelling of the mammary glands);
• deterioration of health, fatigue, headache.

For newborn babies, any symptoms other than the discharge itself are not typical.

Galactorrhea in adolescents

A fluid that looks like milk can sometimes be released during puberty. This refers to ages from 12 to 16 years. As a rule, the provoking factor is a hormonal surge, since no disturbances in the formation of glandular tissues are usually found.

Other factors in the development of galactorrhea in adolescents may include:

• taking medications, medicinal plants;
• formation of tumors affecting the pituitary gland, hypothalamus;
• decreased performance of the thyroid gland;
• increased cortisol levels due to disorders of the adrenal glands;
• pathologies of the reproductive sphere, kidneys, liver;
• disorders in the spinal cord.

To accurately determine the cause, you should conduct a diagnosis and consult with individual specialists.

Galactorrhea in men

Adult men may also have problems with milk leaking from the mammary glands. This pathology is called male hypogonadism and is associated with a lack of testosterone in the body. In addition to galactorrhea, other symptoms are also observed:

• dulling of sexual desire;
• erectile dysfunction;
• enlargement and swelling of the mammary glands.

We also cannot exclude the possibility of the influence of other factors, such as taking medications, the presence of tumors, thyroid pathologies, spinal cord injuries, etc.

Galactorrhea and gynecomastia

The leakage of milk fluid from the mammary glands is not in all cases accompanied by their swelling. Gynecomastia is often either absent or present, but in a mild or moderate form. Enlarged glands are more often found in men: it is usually bilateral, and libido depression is observed.

In women, galactorrhea is manifested by a slight increase in the volume and density of the glands. In some cases, the patient feels some tension and mild pain. With unilateral damage, milk secretion can be prolonged, without certain breaks, or periodic. The latter usually does not depend on the phase of the monthly cycle, or occurs several days before menstrual bleeding.

Galactorrhea and pregnancy

At the stage of preparation for pregnancy, galactorrhea should be cured. Based on the fact that the flow of milk from the breasts is associated with an increase in the secretion of prolactin, such an imbalance can become an obstacle to conceiving a baby, and in the future can jeopardize the normal course of the pregnancy itself.

If galactorrhea was discovered already during pregnancy, then such a condition cannot be called critical. A woman’s body is actively preparing for the birth of a baby, including the hormonal system. As the date of birth approaches, the synthesis of hormones such as prolactin and oxytocin increases, so many women begin to secrete milk well in advance of the onset of labor.

However, the expectant mother must inform the doctor if she has milky discharge from her breasts. After all, the possibility of developing pathology during pregnancy cannot be completely excluded. Therefore, additional analyzes cannot be ruled out.

Forms

Taking into account the severity of galactorrhea, the following stages of pathology are distinguished:

1. Mild stage - a drip of characteristic liquid is observed only when the isola is compressed.
2. Middle stage - liquid flows out in a trickle when the area around the nipple is compressed.
3. Severe stage - fluid flows out of the milk ducts spontaneously.

If the discharge is observed from one gland, then they speak of a unilateral lesion, and if from two glands, then they speak of a bilateral lesion.

The types of pathology are also determined depending on the etiological factor:

• galactorrhea associated with lactation;
• galactorrhea not related to lactation;
• physiological galactorrhea (occurs during pregnancy).

Galactorrhea not associated with childbirth is not an independent disease. It develops as a result of any pathological processes within the body - for example, due to endocrine disorders, oncology, or against the background of frequent and excessive stimulation of the nipple area.

Another type of pathology, galactorrhea with normal prolactin, also occurs occasionally. In such a situation, they often point to an idiopathic – that is, an unidentified cause of galactorrhea. Provoking factors in this case may be dilated milk ducts, mastopathy, tumor processes in the mammary glands.

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Complications and consequences

Since galactorrhea is only a condition that has its own underlying causes, the likelihood of developing certain complications depends precisely on the initial pathology:

• With tumor processes affecting the pituitary gland, there is a great danger of loss of vision, hemorrhage in the brain tissue, and ischemic stroke.
• With tumor processes in the breast, there is a possibility of cancer cells spreading with the formation of secondary malignant foci.
• With hypothyroidism, hypothyroid coma and fluid accumulation in the pericardium or pleural cavity may occur.

If galactorrhea is caused by a hormonal imbalance, then for a woman this can result in infertility or a disruption in the processes of bearing a baby.

The listed complications develop mainly in advanced cases. Therefore, to prevent them, it is necessary to be examined in a timely manner and begin treatment of the underlying disease.

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Diagnosis of galactorrhea

As a rule, diagnosing galactorrhea syndrome is not difficult: it is much more difficult to determine the cause of this condition. Therefore, all complex diagnostic procedures are aimed at determining the root cause of the syndrome.

The first stage of diagnosis includes:

• interview and examination of the patient (the doctor finds out all the circumstances under which the pathology arose);
• examination and palpation of the mammary glands;
• for women - pregnancy test.
• Tests are the next diagnostic stage, which includes:
• general blood test;
• tests for hormone levels in the blood;
• blood chemistry.

Instrumental diagnosis depends on what disease is suspected. So, the doctor may prescribe:

• computer or magnetic resonance imaging of the skull;
• chest x-ray;
• mammography;
• ultrasonography, ultrasound of the mammary glands and reproductive organs;
• biopsy - if indicated.

Consultations with specialized specialists may be required: endocrinologist, gynecologist, mammologist, surgeon.

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Differential diagnosis

Differential diagnosis should be carried out with the following pathologies:

• primary hypothyroidism (hyperproduction of thyrotropin-releasing hormone);
• sclerocystic ovarian syndrome;
• congenital hyperplasia of the adrenal cortex;
• tumor processes;
• iatrogenic conditions (taking contraceptives, sedatives, antipsychotics, drugs Dopegit, Cerucal, Reserpine, Cimetidine, as well as frequent hyperglycemic episodes in patients with type I diabetes);
• chest injuries, mechanical irritations;
• fibrocystic mastopathy;
• various somatic pathologies.

Treatment of galactorrhea

The main therapy for galactorrhea is aimed at eliminating the root cause of this condition - for example, normalizing prolactin levels.

• Drugs are prescribed that slow down the secretory activity of the pituitary gland
• Surgical treatment or radiation treatment is prescribed if we are talking about tumor processes.
• If there are disorders of the thyroid gland, then endocrine pathology is treated.
• They adjust their diet and lifestyle, and reconsider the advisability of the patient taking medications that could cause galactorrhea.

Vitamins

Most processes in the mammary glands occur under the direct influence of hormones. Moreover, any change in hormonal balance causes a response from the breast. Vitamins are also involved in similar mechanisms. For example, vitamin A has an anti-estrogenic effect, reducing the risk of epithelial tissue proliferation.

Vitamin A in the form of pharmaceutical preparations can be taken, but with great caution. Excess retinol can accumulate, which increases the load on the liver. For this reason, it is safer to use beta-carotene provitamin A supplements.

For galactorrhea, 50 thousand IU of vitamin A per day is prescribed for several months.

Tocopherol is an antioxidant that has a complex effect on the body. In particular, this vitamin potentiates the production of progesterone, improves fat metabolism, normalizes the monthly cycle and reduces the signs of premenstrual syndrome.

For galactorrhea, tocopherol is taken in an amount of 50-100 mg daily for several months.

Ascorbic acid also functions as an antioxidant, and also simultaneously potentiates the action of other antioxidants, providing them with protection from destruction. In addition, ascorbic acid perfectly stimulates the immune system in the body. Dosages of vitamin C for galactorrhea are determined individually.

Physiotherapeutic treatment

For patients whose galactorrhea is associated with fibrous pathologies, cysts or tumor processes, it is not advisable to practice physiotherapeutic procedures, and this is especially true for warming procedures and compresses. This warning is associated with the stimulation of metabolic reactions in the disturbed area, which can cause the development of adverse consequences. There is no direct danger to the mammary glands during physiotherapy, but the procedures can cause deterioration of the condition and aggravation of pathological processes.

Let's face it, with galactorrhea, medical specialists very rarely write out a referral for physiotherapy. Ignoring this type of treatment is due, first of all, to the fact that physiotherapy often involves thermal and stimulating effects, which is extremely undesirable for galactorrhea. For the same reason, women are not recommended to visit the sauna or stay in the sun for a long time.

The use of ultrasound, electrophoresis, shock wave therapy, and mud therapy is allowed only in situations if this will really contribute to the successful elimination of the disease.

Traditional treatment

When it comes to folk treatment of galactorrhea, experts advise paying attention to plants containing phytohormones. Such herbs will help stabilize the hormonal system and generally restore the body.

• The periwinkle plant regulates prolactin levels, so it can stop galactorrhea. At the same time, periwinkle can cure both men and women. In the evening pour 2 tbsp. l. herbs 0.5 liters of boiling water, cover the container with a warm scarf and leave to brew until the morning. The entire resulting infusion should be drunk over the next day - approximately 150 ml three times a day between meals. In the evening, a new portion of the product is brewed - and this is how the treatment is carried out for 1-2 weeks.
• Sage is used to eliminate galactorrhea in a woman who has finished breastfeeding but continues to produce milk. There are many recipes for using sage. For example, you can simply swallow half a teaspoon of ground sage in the morning (before meals) with warm water or tea. You can prepare an infusion: 1 tbsp. l. The plants are brewed in 250 ml of boiling water and drunk at a time instead of tea. This drink should be consumed 2-6 times a day, depending on the severity of the pathology.
• Sorrel - or rather, the root of the plant - is crushed, poured with drinking water at room temperature (1:20) and infused overnight. In the morning, the drug is brought to a boil, after which it is removed from the heat, cooled and filtered. Drink 3 tbsp. l. medications three times a day after meals.
• Freshly picked jasmine flowers are fixed on the mammary glands and held for an hour. The procedure is repeated 2-3 times a day. Jasmine narrows the milk ducts and helps stop galactorrhea.
• Collect 100 g of nut leaves, 50 g of chickweed grass, geranium leaves and lemon balm. Pour 1 ½ tbsp into a thermos. l. collect 0.7 liters of boiling water, leave overnight. In the morning, the drug is divided into three parts, each of which is drunk after the next meal. The duration of treatment may vary, depending on the intensity of the symptoms.
• Collect 100 g of basil grass and parsley rhizomes, 50 g of mint, sage and periwinkle leaves. Brew 2 tsp. mixture in 0.7 liters of boiling water, leave for 10-15 minutes, filter. Take 1 glass between meals.
• Collect 100 g of sorrel rhizome, 50 g of mint, thyme, yarrow leaves, as well as 25 g of boron uterus. Before going to bed, pour 30 g of the mixture into 0.7 liters of water at room temperature. In the morning, the drug is brought to a boil over heat, cooled, and filtered. Drink throughout the day. The course of such therapy lasts 2-3 weeks.

Homeopathy

Homeopathic treatment can be used if galactorrhea is not caused by various tumor processes. If a tumor is excluded, then you can try the following homeopathic remedies:

• Allium sativum - helps eliminate galactorrhea after the end of breastfeeding.
• Calcarea carbonica 6, 12 – improves the condition of swollen mammary glands with the release of watery milk.
• Cyclamen europeum - eliminates galactorrhea in girls or women in the absence of pregnancy.
• Crocus sativus - alleviates the condition of the so-called “false pregnancy”.
• Mercurius solubilis - can cure galactorrhea in boys or girls during menstrual bleeding.
• Phytolacca decantra 3 – stops galactorrhea associated with the development of inflammatory processes in the mammary glands.

Dosages of drugs are determined individually, taking into account the constitutional characteristics of the patient. Side effects during treatment occur extremely rarely, due to small dilutions of the drugs.

Surgery

The help of a surgeon is resorted to only in exceptional cases. It is believed that even in the presence of tumor processes, it is not always advisable to perform surgery: most tumors, including pituitary adenoma, respond well to drug treatment. If a patient is diagnosed with a macroadenoma that responds poorly to medications, then a visit to a surgeon may be considered.

Prevention

To prevent galactorrhea, you need to systematically take tests and undergo preventive examinations. You should also, if possible, exclude factors that can provoke hormonal imbalance in the body:

• stress, excessive worries;
• Unhealthy Lifestyle;],

is a pathological secretion of milk from the mammary glands, which is not associated with the process of feeding the child. It occurs in men and women of different ages and is often associated with hyperprolactinemia. The causes of galactorrhea may be systemic diseases, pathology of the hypothalamic-pituitary system, or side effects of certain medications. During diagnosis, hormone levels are determined, an ultrasound of the pelvic organs, and an MRI of the brain are performed. Treatment depends on the cause of galactorrhea. Medicines that block the production of prolactin are used, and for tumors, surgery and radiation therapy.

ICD-10

N64.3 Galactorrhea not associated with childbirth

General information

Galactorrhea is more common in women than in men and is observed both during reproductive age and at the threshold of menopause. During the neonatal period, it is diagnosed with equal frequency in girls and boys, but in this case it is a manifestation of physiological adaptation and goes away without treatment. In 67% of cases with galactorrhea, the level of prolactin is increased, but there is no direct relationship between the appearance of milk and the degree of increase in the hormone. Most women with galactorrhea have irregular menstrual cycles, and 70% experience infertility.

Causes

Galactorrhea is a pathological symptom; it appears without connection with the process of lactation after childbirth, and can occur in nulliparous women. Hormone releases occur during sexual intercourse, during exercise, stress and sleep, but they do not lead to galactorrhea. The reasons for the pathological increase in hormone levels and the appearance of milk are:

• Hypothalamic lesions. Hyperprolactinemia and galactorrhea against its background develop with tumors of the hypothalamus. The cause may be traumatic brain injury, previous brain surgery, or encephalitis. In rare cases, galactorrhea is a consequence of radiation damage to the hypothalamus.
• Endocrine syndromes. Galactorrhea, which is accompanied by hyperprolactinemia, occurs in polycystic ovary syndrome. Milk secretion may begin in patients with hypothyroidism, Cushing's syndrome and acromegaly.
• Pathology of the adrenal glands or kidneys. Adrenal tumors, in which estrogen production increases, cause an increase in prolactin, which entails galactorrhea. In renal failure, the excretion of prolactin is impaired, it remains circulating in the blood and causes galactorrhea.
• Iatrogenic factors. Galactorrhea develops while taking drugs that affect the secretion and metabolism of dopamine, reduce its reserves in the central nervous system or stimulate the serotonergic system. Anticonvulsants, antidepressants, antipsychotics, amphetamines, opiates, including cocaine, heroin have such effects.
• Malignant tumors. Prolactin can be secreted not only in the brain. Its synthesis occurs in some malignant tumors. This is most often observed in bronchogenic carcinoma, hypernephroma.

Pathogenesis

In humans, prolactin secretion is controlled by a complex neuroendocrine mechanism, involving the central and peripheral nervous systems. Dopamine, somatostatin, gamma-aminobutyric acid, gastrin and some other peptides inhibit prolactin release. Stimulating factors include oxytocin, TSH, GnRH, melanocyte-stimulating hormone, serotonin, opiates, insulin, estrogens and androgens.

The main inhibitory factor is dopamine. As its influence decreases, the release of prolactin into the blood increases. Due to prolonged stimulation of lactotroph cells in the pituitary gland, they first hyperplasia, and then micro- and macroadenomas appear. Under its influence, the synthesis of gonadotropin-releasing hormone is disrupted, and the release of FSH and LH is reduced. In a woman with galactorrhea, the menstrual cycle changes according to the type of amenorrhea, and infertility develops.

The extragenital effect of prolactin leads to disruption of carbohydrate metabolism, promotes the conversion of glucose into fats and the development of obesity. Many people develop insulin resistance. The production of dihydroandrostenedione is stimulated, and in women hyperandrogenism is formed with its characteristic symptoms. Endocrine disorders lead to the development of osteopenia.

Classification

For galactorrhea to occur, it is necessary that an increase in hormone levels occurs with a simultaneous decrease in estrogen. The appearance of breast milk sometimes appears several years earlier than menstrual irregularities; in half of the patients these symptoms develop simultaneously. The degree of galactorrhea is determined depending on the amount of milk produced:

• 1st degree. A woman develops single drops of liquid resembling milk when she presses hard on the nipple.
• 2nd degree. With gentle pressure, large drops or streams of milk flow out.
• 3rd degree. Milk is released spontaneously without external influence.

Symptoms

The main symptom of galactorrhea is the appearance of milk from the mammary glands. The volume of discharge depends on the severity of the disease. The menstrual cycle is disrupted. Menstruation becomes rare, short-lived, and blood loss decreases. Amenorrhea gradually develops. Trying to get pregnant for a year and no longer brings results. Many women report symptoms of estrogen deficiency in the form of vaginal dryness and decreased libido.

Galactorrhea often causes headaches, and visual disturbances occur in the presence of pituitary macroadenoma. There are also cerebellar-vestibular, oculomotor, pyramidal, and chiasmatic disorders. They are the first signs of neurological pathologies. Many patients with galactorrhea develop a tendency toward depression, depressed mood, decreased memory, and increased fatigue.

Women develop obesity and cannot lose weight through dieting or physical activity. Insulin resistance can eventually develop into type 2 diabetes. Hyperandrogenism leads to hirsutism, increased greasiness of the skin and hair, and the appearance of acne. There is also an acceleration of bone tissue resorption, which is manifested by pain in the legs, and osteoporosis develops.

Complications

If left untreated, galactorrhea can cause permanent infertility. The danger is the effect of hyperprolactinemia on metabolic processes. Over time, obesity leads to an increased risk of developing cardiovascular diseases and brain accidents. Osteoporosis in advanced form is the main cause of pathological bone fractures, which are difficult to treat.

The influence of increased prolactin on the risk of hyperplastic processes in the reproductive organs is also noted. Research shows that chronic galactorrhea increases the likelihood of breast cancer. But there is evidence that proves the opposite, that prolactin blocks genes that are responsible for cancer aggression.

Diagnostics

Examination for galactorrhea is aimed at excluding organic changes in the structure of the brain. A gynecologist takes part in the diagnosis. Consultation with an endocrinologist is required, and for differential diagnosis with hypothalamic tumors, a specialized examination and examination is carried out by a neurosurgeon. The following diagnostic methods are used:

• Gynecological examination. Women are required to be examined by a gynecologist to rule out pregnancy. With galactorrhea, the external genitalia are not changed, the uterus and appendages are of normal size by palpation. When the nipple is compressed, milk appears.
• Laboratory research. For hyperprolactinemia, a single detection of a hormone level above 500 mU/l is sufficient. The levels of FSH, LH and estradiol in galactorrhea are minimally acceptable or reduced below normal. TSH, T4, ACTH, 17-OPG, IGF-1 are examined to differentially diagnose the causes of galactorrhea.
• Gynecological ultrasound. With galactorrhea, the size of the uterus and ovaries may be normal. In women with polycystic ovaries, they are enlarged in size, there is a large number of follicles; with hyperprolactinemia, the size of the ovaries is not changed, but the number of follicles may increase.
• MRI of the brain. Necessary for visualization of the pituitary gland region. With macroadenoma, a tumor formation is diagnosed, which can compress other brain structures and give corresponding symptoms.
• Laparoscopy. It is used when polycystic ovary syndrome is suspected to clarify the disease. Surgical treatment can be performed at the same time. Polycystic disease is characterized by ovaries with a large number of follicles under a dense white capsule.

Treatment

The goal of treatment for galactorrhea is to normalize hormone levels and restore fertility. Treatment methods are varied and depend on the causes of the disease. In case of tumor processes, preference is given to surgical methods of therapy. For galactorrhea that occurs secondary to other diseases, treatment of the underlying cause of hyperprolactinemia is necessary.

Conservative therapy

Drug treatment of galactorrhea is aimed at suppressing prolactin synthesis and restoring normal levels of sex hormones. Women are observed by a gynecologist at the antenatal clinic; hospitalization in the gynecology or endocrinology department is necessary only for invasive diagnostics. The following groups of drugs are used:

• Dopamine agonists. They act on dopamine receptors in the brain, suppressing the synthesis and release of prolactin. Cabergoline is preferred; bromocriptine acts non-selectively and therefore has a large number of side effects.
• Thyroid hormones. Levothyroxine sodium is prescribed for diagnosed hypothyroidism. In cases where elevated prolactin and galactorrhea persist during treatment, dopamine agonists are additionally used.
• Antiandrogens. Used for polycystic disease, which has caused galactorrhea. Combined oral contraceptives with a pronounced antiandrogenic effect are prescribed. They should contain cyproterone, chlormadinone, dienogest or drosperinone.
• Ovulation stimulants. After the hormone decreases to normal levels and galactorrhea stops, the cycle should be restored, and menstruation begins. If ovulation does not occur, clomiphene citrate or letrozole is used to stimulate it.

Surgery

Surgical treatment is carried out in the neurosurgery department. It is indicated for ineffectiveness of drug therapy or its intolerance, increased intracranial pressure, and signs of compression of the chiasm. Removal of the tumor is required when it grows progressively and liquorrhea appears. Dopamine agonists should not be used in patients with mental disorders, as this causes an exacerbation of the underlying disease. Pituitary macroadenoma cannot be operated on.

Radiation therapy

Prognosis and prevention

With galacothrea, the prognosis is favorable for general health and reproductive function. With timely treatment, the menstrual cycle normalizes, ovulation is restored, and pregnancy can be planned. Prevention of galactorrhea consists of timely consultation with a doctor in case of any endocrine disorders, prevention of traumatic brain injuries, and infectious diseases. Stress and nervous disorders can lead to galactorrhea, so it is recommended to prevent the occurrence of these conditions.

The discharge of milk or milky fluid from the nipples of the mammary glands, not associated with the lactation period, is termed galactorrhea. In most cases, it is diagnosed in women, both those who have given birth and those who have not had children.

Galactorrhea is not an independent pathology; it usually occurs as a result of certain diseases.

What is galactorrhea

Abnormal galactorrhea is said to occur if colostrum is formed in the mammary glands during periods not associated with pregnancy. Pathology occurs in 1-4% of female patients, and much less frequently in men.

In most cases, the disease is temporary, it does not pose any danger and stops on its own. But the abnormal production of an unusual secretion in the mammary glands can also be the main sign of serious diseases that require specific treatment.

Therefore, when detecting discharge from the nipples, an examination is necessary, especially in cases where the disease is combined with other changes in well-being.

Classification

Galactorrhea is divided into bilateral and unilateral. During the pathology, three degrees are distinguished:

• FIRST DEGREE. Characterized by the squeezing out of milk drop by drop when pressing on the nipple;
• AT SECOND DEGREE. Pressure leads to a stream of milk;
• THIRD DEGREE. Set if discharge occurs continuously without external stimulation.

ICD 10 code

In the international classification of diseases, pathological galactorrhea is designated by code O92.6.

Idiopathic type of galactorrhea

The reason for the abnormal secretion of milk from the mammary glands may not be precisely determined during the examination. In this case, galactorrhea is defined as idiopathic.

Increased milk secretion sometimes occurs due to hypersensitivity of breast tissue to prolactin, even if the secretion of the hormone is at normal levels.

Galactorrhea in men

Pathology in male patients often occurs due to testosterone deficiency (hypogonadism). The disease occurs with gynecomastia (engorgement and increase in the size of the mammary glands), and may be accompanied by a decrease in sexual desire and sexual dysfunction.

Galactorrhea in children

The pathology occurs in newborn babies. The appearance of milky fluid from the breast is caused by an increased level of prolactin in the blood of a pregnant woman.

Hormones easily penetrate the placenta, begin to circulate in the baby’s blood and after birth cause galactorrhea and enlarged glands. The condition is temporary and not dangerous for the child; it goes away on its own after a few weeks.

What is lactation

Lactation is the physiological formation and subsequent excretion of milk in the female mammary glands. Fluid production occurs in the glandular structures of the organ under the influence of several hormones:

• Somatotropin (GH) or otherwise growth hormone;
• Adrenal cortex hormone cortisol;
• Insulin;
• Thyroxine;
• Estrogens.

But still, prolactin has the main effect on milk secretion. Its production in normal times is suppressed by dopamine, a biologically active substance secreted by the hypothalamus.

By the end of pregnancy, the secretion of dopamine stops almost completely, so prolactin becomes tens of times greater, which enhances the process of milk formation. In the last weeks, colostrum begins to be released from the mammary glands, and after childbirth, milk.

When breastfeeding, the receptors in the nipples are irritated, and in response to this, more prolactin begins to be produced.

After stopping breastfeeding, milk may be released in small quantities for another 5-6 months. This is considered normal and does not require correction.

Causes of pathological galactorrhea

As has already been clarified, the formation of milk and its excretion from the milk ducts is regulated by a complex of hormones produced by the pituitary gland, ovarian tissues, pancreas and thyroid glands.

The nervous system also takes an active part in the process. Therefore, with abnormal galactorrhea, the cause of the disease must be sought at one of these levels.

Diagnosis does not always help to identify the causative factor. In this case, they speak of an idiopathic form of the disease, in which the formation of milk is most likely associated with the increased sensitivity of the mammary gland tissue to prolactin, which is produced in normal quantities.

Among the main causes of pathological galactorrhea are diseases of the pituitary gland and hypothalamus, disorders of hormone metabolism, severe damage to the liver and kidneys.

Pathologies of the hypothalamus

The hypothalamus is a small structure in the diencephalon endowed with dozens of functions. Damage to the hypothalamus occurs due to brain injuries, tumors, inflammatory processes, sarcoidosis, neurotuberculosis.

Pathological processes in the hypothalamus lead to the development of neuroendocrine disorders, which in turn can manifest as abnormal changes in water-salt and fat metabolism, hyper- and hypothyroidism.

Damage to the hypothalamus often causes a decrease in the secretion of dopamine, a hormone that inhibits the production of prolactin. Without restraining factors, the volume of prolactin in the body increases, which leads to the formation of secretion in the ducts of the mammary gland.

Pathology may indicate a syndrome referred to as Chiari-Frommel. An increase in the secretion of prolactin by pituitary tissues leads to the blocking of the release of follicle-stimulating hormone, that is, the follicles in the ovaries cease to mature.

Therefore, with Chiari-Frommel syndrome, pathological lactation is complemented by amenorrhea. Women may complain of headaches, blurred vision, hirsutism (excess hair growth), weight loss or gain, and insomnia.

Pituitary gland lesion

Excessive secretion of prolactin can be caused by a benign tumor of the pituitary gland - prolactinoma (microadenoma). It is more often detected in women.

Prolactinoma is a hormonally active formation, in most cases it does not lead to compression of nerve endings. It manifests itself as galactorrhea, absence of menstruation, infertility, symptoms of hyperandrogenism - excessive hair growth, acne. Hyperprolactinemia may be accompanied by osteoporosis.

In rare cases, a microadenoma transforms into a macroadenoma, which leads to compression of the nerve pathways passing near the pituitary gland. The main symptoms include headaches, visual impairment, apathy, etc.

Hyperprolactinemia can be caused by acromegaly, Addison's disease, Itsenko-Kushimng syndrome, hypothyroidism, metastases of malignant tumors of the mammary glands and lungs, and endocrine neoplasia.

Thyroid hormone metabolism disorder

Galactorrhea sometimes accompanies primary hypothyroidism, a pathology in which increased stimulation of the thyroid gland by the pituitary thyroid-stimulating hormone (TSH) does not lead to increased production of prolactin.

Increased secretion of TSH leads to hyperprolactinemia and, accordingly, galactorrhea. Hypothyroidism is also manifested by apathy, increased drowsiness, excessive hair loss, and the appearance of edema.

Increased production of TSH also causes hyperthyroidism, which occurs with tachycardia, sudden weight loss, and ophthalmopotia. In hyperthyroidism, galactorrhea occurs less frequently than in hypothyroidism.

Disturbances in estrogen metabolism

Hyperprolactinemia is characteristic of polycystic ovary syndrome and is detected in a third of cases during the development of this disease. The main reason for increased secretion of prolactin is a decrease in the effect of dopamine on pituitary tissue.

This causes disturbances in the formation of follicles and an imbalance in the production of hormones by the ovaries. Increased secretion of estrogen further enhances the formation of prolactin.

Galactorrhea also occurs with estrogen-producing formations of the adrenal glands. In men, abnormal milk secretion develops due to testosterone deficiency and is accompanied by gynecomastia and decreased potency.

Metabolic disorders

Galactorrhea can be caused by:

• Cirrhosis and other severe liver diseases. With liver failure in the cells of the organ, the inactivation of hormones is disrupted, and the level of prolactin in the blood increases;
• Renal failure, in which the elimination of hormone metabolites from the body slows down.

Prolactin production may not be pituitary, but ectopic. The hormone is produced during the formation of hypernephroma and bronchogenic sarcoma.

Other causes of galactorrhea

Other possible causes of abnormal milk production in the mammary glands include:

• Treatment with a number of medications. First of all, these are contraceptive pills, but the disease can also be provoked by taking antihypertensive drugs, antidepressants, tranquilizers;
• Excessive stimulation of the mammary glands. Occurs when wearing tight bras, with increased sexual activity, with irritation of the breast due to skin rashes, piercings;
• Damage to nerves in the chest and back;
• Spinal cord injuries;
• The influence of stressful situations;
• Severe forms of mastitis.

In newborns, increased secretion of milk-like liquid from the nipples is sometimes associated with the intake of lactogonic herbs by a nursing woman.

Symptoms

The main symptom of galactorrhea is the release of milk-like liquid from the juices, which can be unilateral or bilateral. The color of the secretion ranges from light transparent to rich milky. Fluid is released from the glands both spontaneously and when the nipples are stimulated.

Slight unilateral secretion production periodically appears in most healthy women; this is considered normal in the absence of other symptoms.

The secretion of galactorrhea from the mammary glands should not be bloody or greenish. Discharge with this shade indicates serious diseases that require careful diagnosis and treatment.

Abnormal nipple discharge may be accompanied by:

• Maceration of the area around the nipples;
• Enlargement of the mammary glands, their engorgement;
• Traces of discharge on underwear.

Determining the primary causes of galactorrhea is mandatory if the pathology is accompanied by:

• Amenorrhea;
• Visual impairment;
• Headaches;
• Drowsiness or, conversely, insomnia;
• Depression.

Periodically or constantly occurring abnormal secretion of milk from the mammary glands in the absence of pregnancy is a good reason to consult a doctor. The diagnosis will help to timely identify the causes of the disease that require specific treatment.

Which doctor should I contact?

If signs of galactorrhea appear, you can make an appointment with:

• Endocrinologist;
• Gynecologist;
• Gynecologist-endocrinologist;
• Mammologist;
• Reproductologist.

Any of the specialists will conduct an examination and prescribe diagnostic procedures, based on the results of which it will be possible to decide which specialist’s help the patient needs.

Diagnostics

The diagnosis is established on the basis of examination, collection of medical history, laboratory and instrumental examination methods.

During the examination, the doctor must verify the presence of discharge by pressing on the mammary gland. The released secretion must be taken for analysis. Palpation of the glands also allows you to detect compactions, painful areas, and bumps.

During the questioning you need to establish:

• Duration of galactorrhea;
• Circumstances conducive to its development;
• Past injuries;
• Presence of endocrine, gynecological diseases in the anamnesis, pathologies of the thyroid gland;
• Main complaints. The nature of galactorrhea is established, that is, fluid flows from the mammary glands spontaneously or spontaneously, whether other changes in the body are disturbing;
• Cyclicity of critical days.

After the initial examination, the patient is sent for laboratory tests:

• A blood test for prolactin in women is taken on days 5-8 of the cycle;
• Tests for thyroid hormones and sex hormones;
• Biochemical analysis to exclude severe pathologies of the liver and kidneys.

Of the instrumental research methods used:

• Mammography;
• Computed tomography if there is a suspicion of disturbances in the functioning of the hypothalamus and pituitary gland;
• Ultrasound of the mammary glands, pelvic organs.

Based on the test results, consultation with a neurosurgeon, ophthalmologist, neurologist, or endocrinologist may be required. The diagnosis is made after accurately determining the cause of galactorrhea.

Principles of treatment

Complete elimination of galactorrhea is impossible unless the underlying cause of the pathology is established. The treatment regimen is selected based on the diagnostic results obtained. First of all, it is necessary to eliminate the cause or minimize its negative impact on the body.

When the disease develops as a result of taking medications, they are discontinued and replaced with those that do not contribute to increased production of prolactin.

If hormone-dependent tumors are detected, the patient is prescribed:

• Parlodel;
• Bromergon;
• Serocriptine;
• Dostinex.

IMPORTANT: All medications are taken as prescribed by a doctor.

These drugs inhibit the production of prolactin, which allows normalization of the functioning of the mammary glands. For growing pituitary tumors, conservative therapy is not always effective, so surgical removal of the tumor and chemotherapy are prescribed.

If galactorrhea is a consequence of disorders of the thyroid gland, then treatment of the underlying disease is required. With the idiopathic type of pathology, the woman is usually monitored and recommended to repeat examinations every few months.

Treatment of galactorrhea in pregnant women

The secretion of milk-like liquid from the glands of a pregnant woman is not considered an abnormal condition. After conception, hormonal changes occur, the level of oxytocin and prostatitis increases - hormones, under the influence of which the process of milk maturation in the mammary glands begins.

In some pregnant women, galactorrhea occurs several weeks before childbirth, and sometimes in the first months of pregnancy. There is no need to panic about this, but the doctor should be aware of changes in the mammary glands.

If necessary, additional examinations are prescribed. The diagnosis of hyperprolactinemia during pregnancy is not made, since prolactin is always elevated during this period.

Hyperprolactinemia is not an obstacle to planning a child. But before conceiving, a woman must undergo all examinations and, if necessary, receive a course of treatment. The gynecologist monitoring the pregnant woman must be aware of the diagnosis, this is necessary in order to prescribe the appropriate tests and diagnostic procedures in a timely manner.

Traditional treatment

Abnormal galactorrhea in most cases develops due to malignant and benign formations and hormonal imbalance in the body. It is impossible to eliminate such disorders using folk methods, but herbal recipes can be used as an addition to the main therapy.

Before using them, you should consult a doctor, since not all grandmother’s treatment methods have a positive effect on hormonal levels.

When treating galactorrhea, the use of herbs with hormonal properties can help; they help normalize hormone levels.

Herbal medicines:

Phytoestrogens contain basil, periwinkle, hogweed, mint leaves, yarrow, sorrel and parsley root, Robert's geranium (leaves). You can prepare decoctions from these plants by mixing them together. It is better to use recipes that contain no more than 3-4 plants, since multi-component infusions and decoctions increase the likelihood of adverse reactions.

In addition to the main treatment, men with galactorrhea are recommended to take Adam's root alcohol tincture or drone homogenate internally. They increase testosterone levels and reduce prolactin secretion.

Complications and prevention

With pathological galactorrhea, the development of life-threatening complications cannot be ruled out. With pituitary tumors, as they progress, vision deteriorates and there may be hemorrhage with infarction of the meninges.

Hypothyroidism often ends in hypothyroid coma without treatment. In malignant neoplasms, metastases spread throughout the body.

There is no specific prevention of abnormal galactorrhea. The likelihood of pathology can be reduced if a woman wears appropriately sized underwear and performs self-examination of the mammary glands no more than once a month. Timely treatment of endocrine and gynecological diseases is also important in the absence of pathological discharge from the nipples.

Galactorrhea with normal prolactin levels

In some cases, an increase in prolactin is not detected during laboratory diagnostics, but galactorrhea continues to be a concern. The mechanism of development of this phenomenon has not been fully established, but a number of doctors associate it with ductectasia.

This term refers to the dilation of the ducts in the mammary gland, which occurs as a result of mastopathy and tumors of the mammary glands.

Galactorrhea and pregnancy planning

With elevated prolactin levels, anovulation and amenorrhea occur. That is, there are no conditions conducive to conception. Women with established hyperprolactinemia must first undergo a course of therapy and only after that plan a pregnancy.

Galactorrhea does not worsen your health and does not reduce your ability to work. But if you notice the appearance of secretions from the mammary glands, you should observe the changes occurring for several weeks and pay attention to other symptoms.

Repeated pathology can cause quite serious diseases, so the examination should not be delayed.

Galactorrhea is the release of milk from the breast not associated with childbirth. It most often occurs when there is an excess of pituitary prolactin in the blood, but it can also be caused by a tumor process of the mammary gland. Usually accompanied by sexual dysfunction in men and women. To learn more about how galactorrhea manifests itself, which specialist should treat you, and what the doctor will recommend, read more in the article.

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Causes of pathological galactorrhea

The secretion of milk and similar fluid can normally only occur in women after childbirth. One of the physiological (not associated with diseases) options is neonatal galactorrhea. It is associated with an excess of prolactin and estradiol received by the child from the mother before birth. All other cases are pathological. They occur in a wide variety of diseases. In about half of patients, the causes remain unknown.

In men

Occurs 40 times less frequently than in women. More often associated with increased production of prolactin by the pituitary gland. It stimulates the appearance of milk-like discharge from the nipples. This condition is caused by a tumor, as well as mixed adenomas that also produce other hormones. The increase in prolactin in the blood can be influenced by the following diseases:

• congenital defect of formation (it normally inhibits the formation of prolactin);
• compression of the pituitary stalk by a tumor, its damage during brain surgery, traumatic brain injury, high intracranial pressure;
• dysfunction of the kidneys and liver involved in the transformation and excretion of the hormone;
• tumors of the lungs, intestines, capable of hormonal synthesis, VIPoma of the pancreas (its VIP hormone increases the release of prolactin);

• severe or frequently repeated stress overexertion;
• tumors, infections in the pituitary-hypothalamic region, circulatory disorders;
• chronic prostatitis;
• dysfunction of the adrenal cortex (), thyroid gland, excess;
• injuries, herpetic rashes in the mammary glands;
• chronic alcoholism.

In order for galactorrhea to manifest itself, in addition to excess prolactin, a special hormonal background is needed - low progesterone and increased estradiol.

Medicinal

The use of certain medications may:

• stimulate the formation of prolactin;
• enhance the effect of the hormone on the mammary glands;
• inhibit the release of dopamine;
• suppress the activity of dopamine receptors in the brain.

Drugs that can cause galactorrhea include:

• neuroleptics (for example, Haloperidol, Triftazin);
• antidepressants (Anafranil, Amitriptyline);
• drugs to lower blood pressure (Dopegit, Clonidine);
• gastric medications (Cerucal, Ranitidine, Cimetidine with long-term use in high doses);
• anticonvulsants (Finlepsin);
• anabolic steroids (Methandrostenolone).

Often the cause of fluid discharge from the nipples is the use of contraceptives, especially those containing a lot of estrogens. Galactorrhea, not associated with childbirth, is also detected with abrupt discontinuation of birth control pills.

For hypothyroidism

With normal prolactin

In some women with galactorrhea, examination reveals normal prolactin. In this case, the reaction of the mammary gland to its action may be changed. One of the reasons for high sensitivity is a long period of breastfeeding after childbirth, as well as cysts and tumor lesions of the mammary glands, and deformation of the ducts.

It should also be taken into account that the concentration of prolactin in the blood is not constant, so it is possible that one test does not reflect actual changes in the level of the hormone. When making a diagnosis, it is recommended to repeat it at different times of the day at least twice with an interval of 3 weeks.

Forms of galactorrhea

Fluid can be released from only one gland. This form is called unilateral, it is usually caused by a local inflammatory or tumor process. Hormonal types of galactorrhea are usually bilateral.

Depending on the severity, the following course options are identified:

Pituitary prolactin has an inhibitory effect on the formation of follitropin and lutropin. This leads to inhibition of the functions of the gonads.

Therefore, with galactorrhea, signs of testicular and ovarian dysfunction are also found:

• In men– enlarged mammary glands, sexual weakness, low level of sexual desire, decreased motility and sperm count, infertility.
• Among women– extended menstrual cycle (33 days or more), bleeding occurs for 1-2 days, scanty, delays are possible. Heavy discharge appears only with hypothyroidism.

The absence of menstruation (amenorrhea) is so typical that they are often combined into one galactorrhea-amenorrhea syndrome. It usually occurs during emotional conflicts, stress, prolonged experiences, at the beginning of sexual activity, after childbirth, miscarriage, abortion, and surgery on the pelvic organs. In such cases, the manifestations are temporary and disappear after the general condition normalizes.

Women with persistent and prolonged forms of galactorrhea are often infertile and also experience the following symptoms:

• pain during sexual intercourse;
• low sex drive (frigidity) and lack of orgasms;
• increased growth of coarse hair around the nipples, along the midline of the abdomen;
• increased anxiety, irritability, tendency to depressive reactions;
• fatigue, low performance;
• pain in the heart area;
• swelling of the eyelids, legs;
• rapid weight gain.

Watch the video about increased prolactin in women:

The type of fluid released also matters. Milky or clear whitish discharge is characteristic of excess prolactin. During inflammatory processes, they can also have a brownish, greenish tint; they are extremely dangerous when bloody, since their appearance often indicates a malignant tumor.

Which doctor should I contact?

A mammologist deals with problems of lactation and the condition of the mammary glands. He prescribes a primary examination and, if necessary, refers you to a consultation with an endocrinologist or gynecologist. If there is a suspicion of the central nature of galactorrhea due to a disease of the pituitary gland or hypothalamus, then patients must be examined by a neurologist and an ophthalmologist.

Treatment of galactorrhea

The most successful therapy is aimed at eliminating the cause of galactorrhea. Medication and surgical techniques are used. In the dosage form, drug withdrawal is necessary.

Traditional methods at home

Herbal preparations will not help in the presence of a tumor process, inflammation of infectious or autoimmune origin. Their use is possible only with a normal level of prolactin in the blood to reduce its effect on the mammary glands and functional disorders (eg, stress, contraceptive withdrawal). For this use:

• cinquefoil root,
• cuff grass,
• comfrey root,
• raspberry leaf,
• peony root.

They are brewed at the rate of a tablespoon per glass of boiling water, kept in a water bath for 15 minutes and filtered. Take a third of a glass 3 times a day. After a month of use, you need a break for two weeks, and then, if necessary, the course continues, but it is better to use another plant.

There are also ready-made preparations on a natural basis - Cyclodinone, Prefemin and Mastodinone, Tazalok. Before starting to take herbs and dietary supplements, it is important to consult a doctor, since hormonal imbalance can cause the opposite effect.

Drugs for drug treatment

To reduce the formation of prolactin in the pituitary gland, the following agents are used:

• stimulating dopamine receptors - Alactin, Dostinex, Parlodel, Norprolac, their use helps even with pituitary tumors;
• dopamine precursor - Levodopa, increases the synthesis of a hormone that inhibits the formation of prolactin, is used for normoprolactinemic galactorrhea.

All these medications are taken under the control of blood tests. In the presence of pituitary prolactinoma, the course of treatment continues for at least 2 years. Patients undergo brain tomography at least once every 9-12 months.

If the cause of increased prolactin synthesis is a previously inactive pituitary tumor, then in exceptional cases Dostinex is used to correct hormonal levels under medical and laboratory supervision.

Possible complications without treatment

A mild degree of galactorrhea usually does not change the general condition of patients, but with heavy discharge, irritation of the skin of the nipple and the addition of a fungal or bacterial infection cannot be ruled out. The consequences of excess prolactin are much more serious. It disrupts the functioning of the reproductive system, which threatens:

• early menopause;
• destruction of bone tissue;
• increased levels of male hormones (increased hair growth);
• reduction in the size of the mammary glands, loss of their tone.

Watch the video about nipple discharge and what the color tells you:

A growing prolactinoma of the pituitary gland, if left untreated, can lead to loss of vision, as well as compression of brain tissue. If the hormone level remains elevated for a long time, this can lead to the following complications:

• tumor processes of the mammary gland, including cancer;
• disorders of fat metabolism - obesity, blockage of blood vessels with cholesterol plaques;
• changes in carbohydrate metabolism - prediabetes, .

Galactorrhea is manifested by fluid discharge from the nipples, which is not associated with childbirth. It occurs in women and men most often against the background of excess pituitary prolactin. Provoking factors include tumors, inflammatory and vascular disorders of the brain, hormonal imbalance, and the use of medications. Accompanied by sexual dysfunction. To identify the cause, a comprehensive examination is needed. Drug and surgical treatment are prescribed.