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Help! My Breast Brings Out Milk and I'm Not Pregnant (Galactorrhea -- Causes, Symptoms & Treatment)

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Help! My Breast Brings Out Milk and I'm Not Pregnant (Galactorrhea -- Causes, Symptoms & Treatment)


MAIN SYMPTOMS: 

Galactorrhea - a disease that develops with an increase in the blood content of the hormone prolactin, against the background of which there is a release of milk or colostrum from the nipples. In most situations, this phenomenon occurs in women, but this does not mean that men and children cannot complain about the symptoms of the disease. 

Such a disorder is not considered an independent disease, because it develops due to the occurrence of pathological processes in the human body. Endocrine diseases, oncology and excessive nipple stimulation are considered the most common causes of galactorrhea. 

The symptoms of this condition are pronounced and specific. The main feature is milk secretions that are not related to childbirth and may have a yellowish or greenish tinge. The clinical picture consists of an increase in the volume of the mammary glands, headaches and impaired sexual function. 

The diagnosis of galactorrhea is made on the basis of data from a thorough physical examination and the results of a wide range of instrumental examinations. Consultations of specialists from different fields of medicine may be required. 

The methods of how to treat galactorrhea are strictly conservative, which means that treatment is based on taking medications and eliminating the underlying disease. 

In the international classification of diseases of the tenth revision, galactorrhea, not related to childbirth, has its own cipher. The ICD-10 code will be N64.3. However, pathology, which is related to the birth of a child, is marked O92.6. 

ETIOLOGY


The main adverse condition affecting the development of such a disease is the increase in serum prolactin level, which is called hyperprolactinemia. A large number of sources of violations of the synthesis of this hormone. 

Causes of galactorrhea are as follows: 


  • the formation of malignant or benign pituitary tumors;
  • uncontrolled medication, in particular hormonal substances, tranquilizers, sedatives, narcotic analgesics, antidepressants (Eglon), drugs aimed at normalizing blood tonus; 
  • oncological process in the hypothalamus or the limbic formation of the brain;
  •  hypothyroidism; 
  • pathology of the adrenal glands; 
  • liver damage, causing chronic liver failure; 
  • a wide range of injuries, burns and surgical interventions, due to which the sensitive fibers of the sympathetic and parasympathetic nerves were damaged; 
  • neoplasms of any nature with localization in the spinal cord; 
  • excessive stimulation of the nipples - may occur during sexual contact, frequent palpation of the mammary gland, amid allergic reactions or shingles , while wearing underwear that is incorrectly selected in size; 
  • surgeries performed on the spinal cord pathways;
  •  bronchogenic cancer ; 
  • acromegaly ; 
  • Addison's disease ; 
  • renal failure ;
  •  cirrhosis of the liver ;
  •  Cushing's disease ;
  • consumption of drugs or infusions based on plants such as fennel, anise, thistle, nettle, and fenugreek.


Women have several specific factors predisposing the development of galactorea: 

polycystic ovary syndrome - there is a syndrome of galactorrhea amenorrhea (in addition to milk secretions, there is a long absence of menstruation);
bubble skid ; 
choriocarcinoma; 
mastitis .

Lactation galactorrhea will be considered normal only for 5 months from the moment of termination of breastfeeding. If milk secretions are noted for more than six months, this may be a sign of one of the above diseases. 

With regard to the appearance of milk secretions in newborns, it is considered to be a completely natural process, which is associated with the residual effect of maternal hormones. It is worth noting that this anomaly passes on its own. 

It is noteworthy that in about half of the cases it is not possible to find out the causes of the appearance of pathology, which indicates its idiopathic nature. 

CLASSIFICATION 


According to its prevalence, the disease is: 

  • unilateral; 
  • two-way.


There are several degrees of severity of galactorrhea: 

  • easy - the release of a specific secret in the form of droplets is observed only when there is pressure on the area surrounding the nipple;
  • moderate - marked jet discharge of dairy fluid; 
  • severe - characterized by spontaneous discharge of fluid from the nipples.

Depending on the etiological factor, galactorrhea happens: 

  • lactation;
  •  not related to childbirth;
  •  physiological - if the characteristic symptoms appear during the carrying of the child.

SYMPTOMATOLOGY


The main clinical manifestation is the release of colostrum or milk, which may be of a permanent or periodic nature. In some patients, discharge from the nipples may become yellowish or greenish. It should be borne in mind that there should be no blood impurities in the excreted fluid. 

Symptoms of galactorrhea may be common to all patients or characteristic of members of a particular gender. The first category of external manifestations are: 

  • headaches; 
  • reduced visual acuity; 
  • the formation of black spots or acne; 
  • increased heart rate; 
  • decrease or increase in body weight; inflammation of the sebaceous glands; 
  • decrease in sexual desire.

In women, in addition to the above manifestations, are present: 

  • violation of the menstrual cycle;
  •  vaginal dryness;
  •  increase the amount of hair on the upper and lower limbs, face and chest.

Galactorrhea in men can be expressed by the following symptoms: 

  • lack of sex hormones; 
  • reduced potency ;
  •  an increase in the volume of the mammary glands - this condition is called gynecomastia;
  •  Erectile dysfunction.

In newborns, this disorder proceeds without any symptoms. 
Symptoms of galactorrhea 

DIAGNOSTICS 



 Due to the presence of specific clinical signs with the installation of the correct diagnosis is often not a problem. The complex of diagnostic measures aimed at stating the cause of galactorrhea. 

 Components of the first stage of the diagnosis process: 
  • studying the history of the disease - often galactorrhea syndrome is secondary; 
  • collection and analysis of life history - the most important is information regarding the administration of medicines, including Eglonil, because overdose with medicinal substances is one of the risk factors;
  •  palpation of the right and left mammary glands;
  •  pressure on the nipples - to set the intensity with which milk or colostrum is released; 
  • pregnancy test - shown only to women; assessment of the skin;
  •  Detailed patient survey - to determine the severity of symptoms.

Laboratory tests include: 
  • general clinical blood test;
  •  hormonal tests - galactorrhea in normal prolactin is observed only in the physiological form of the disorder and in newborns; blood biochemistry.

Instrumental procedures are represented by the following list: 
  • CT and MRI of the skull;
  •  chest x-ray; 
  • mammography;
  •  ultrasonography of the mammary glands and pelvic organs; biopsy - shown only when a seal is detected during palpation of the problem area.


 In addition to the therapist, the patient must be examined by an endocrinologist, a breast specialist and a gynecologist (if signs of galactorrhea syndrome and amenorrhea are noted in women). 

TREATMENT


 The main principle of therapy is the elimination of the main factor in the appearance of the disease (hyperprolactinemia). Treatment of galactorrhea will be as follows: 
  • taking medications aimed at reducing the production of prolactin by the pituitary gland;
  •  the use of hormonal substances that are able to normalize the content of sex hormones; 
  • neutralization of the underlying disease.

Surgical intervention is indicated in cases when during instrumental diagnostics a tumor was found in the organs of the endocrine system. Either open surgery is performed or radiation therapy is performed. 

 The operation may be resorted to in case of impossibility or ineffectiveness of the use of drugs. In such cases, conduct removal of the ducts of the breast. 

 PREVENTION AND PROGNOSIS 

 To date, no special measures have been developed for the prevention of galactorrhea. 

 However, the likelihood of anomalies can be reduced by following these recommendations: 
  • avoiding over stimulation of the nipples;
  •  wearing women selected bras made from natural fabrics;
  •  early detection and full elimination of diseases causing galactorrhea;
  •  taking medicines, in particular “Eglon”, strictly following the instructions of the attending physician; 
  • regular passage of a full preventive examination in a medical institution.


 Galactorrhea per se does not pose a threat to life, but can significantly reduce its quality. Such an anomaly does not interfere with pregnancy, but can cause spontaneous abortion or female infertility. 

 In addition, patients should not forget that every underlying disease that provokes galactorrhea can have its own complications and consequences.