Galactorrhea: Symptoms, Causes, Diagnosis And Treatment

This alteration in the production of bodily substances can be caused from the brain.

Worried young woman.

One of the main characteristics of humans as mammalian animals is the development of the mammary glands, whose sole function is to provide food for the young; hence, at least in the human species, babies are also called infants.

However, a series of alterations in the production of the hormones responsible for the secretion of milk can cause a phenomenon known as galactorrhea, which usually occurs in women but can also occur occasionally in men.

Definition of galactorrhea

Galactorrhea refers to the secretion of milk through the mammary gland once the puerperal period has elapsed, that is, between six and eight weeks after delivery. Also, it must remain for at least six months. Although, it is true that in certain women who have gone through several deliveries this phenomenon can occur without these means that there is an underlying disease.

Galactorrhea cannot be considered a disease as such, but rather a sign that the person may be suffering from some other condition, with discharge usually occurring through both breasts.

This phenomenon occurs particularly in women between 20 and 35 years of age with previous pregnancies. However, there are cases of galactorrhea in those present in other ages, in children and even in men.

As a general rule, between 20% and 25% of women with normal menstrual cycles and hormonal levels experience a galactorrhea phenomenon at some point in their life.

Symptoms of galactorrhea

Although galactorrhea is considered a sign of a larger alteration, it may be accompanied by other associated symptoms. These symptoms can be very varied in terms of type, frequency of appearance, etc., depending on the causes of the galactorrhea itself.

The most common signs of symptoms are:

  • Variations during menstruation : irregular cycles or lack of menstrual cycle
  • Sensitivity to changes in temperature
  • Increased thirst and the urge to urinate
  • Headaches
  • Vision problems such as imprecise or blurred vision, double vision, or lack of vision
  • Erection problems, erectile dysfunction and lack of sexual desire in men
  • Acne and the appearance of body hair

Causes

Outside of pathological circumstances, the manufacture of milk in the breasts is caused by several hormones and of these prolactin is the one that has a more relevant role. This hormone is made in a gland called the pituitary, which is located at the base of the skull. In addition, the action of another hormone called placental lactogen also intervenes.

The cause of the appearance of galactorrhea is due to an imbalance in the production of these two hormones. This alteration can have numerous causes, although the truth is that in half of the cases the cause remains undetermined. The most common reasons why this phenomenon appears are:

  • Appearance of tumors in the pituitary.
  • Side effect of the consumption of some drugs. These drugs often belong to the groups of antipsychotics, antidepressants, antihypertensives, opiate drugs, antivomitives, and anovulatory drugs.
  • Endocrine conditions that disrupt hormone production, such as primary hypothyroidism.
  • Excessive nipple stimulation.
  • Physical and psychological stress.
  • Chronic kidney disease
  • Hepatic cirrhosis.
  • Local infections in the breast.
  • Hypothalamic alterations that alter the correct regulation of the release of hormones.
  • Thoracic injuries or surgeries.
  • Other conditions such as polycystic ovaries, hyperthyroidism, spinal cord injuries, etc.

Diagnosis

The first step in the diagnosis of galactorrhea is to rule out that this secretion is not other than milk. The reason is that any other type of discharge, with traces of blood, purulent or greenish in color, is a sign of other important diseases such as breast cancer, so it is vitally important to go to a health center as soon as the disease is detected. secretion.

The correct diagnosis of galactorrhea should include the preparation of a medical history as detailed as possible, which includes the menstrual history of the patient, if she is a woman, to rule out the possibility that it is due to pregnancy. Also, to investigate infertility, impotence or variations in sexual appetite.

Likewise, a physical examination should be performed to look for signs that betray any other disease such as hypothyroidism and request a history of drugs to rule out this possible cause.

Next, a blood test is needed to check the levels of thyroid hormones and prolactin in the blood. Depending on the specialist clinician deems necessary, other tests such as urinalysis or chest and abdominal films can be carried out.

If all the above causes are excluded, it is very likely that it is a prolactinoma. Prolactinoma is a benign tumor that lodges in the pituitary, and although it is much more likely to occur in women, when it occurs in men it does so in a more pernicious way.

If galactorrhea occurs together with very high levels of prolactin in the blood, some type of sexual dysfunction, infertility or hypogonadism, it is logical to assume that it is a prolactinoma; therefore, the specialist must perform a brain MRI to confirm the existence of a tumor.

Treatment

The intervention to be followed in the cases of patients who present galactorrhea will depend on the causes of this. In the event that this occurs in isolation and without high levels of prolactin in the blood, the most common is that it disappears naturally, not being necessary any type of treatment.

The exception would be cases in which the secretion is a great discomfort, in which case the protocol mandates the administration of dopamine agonists, which increase the level of dopamine in the blood, a hormone that inhibits the formation of prolactin.

Likewise, when this phenomenon is associated with any other disease, the symptoms will subside when treating the main condition. In the event that galactorrhea is produced by the effects of a drug, the suppression of this or a reduction in the dose should be sufficient to remit the symptoms.

In people in whom the MRI does not detect the presence of a prolactinoma, it is necessary to undergo periodic check-ups to rule out the appearance and growth of a pituitary tumor.

Finally, in cases of prolactinoma, surgery is carried out to remove the tumor, along with the administration of specific drugs and radiation therapy.

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