Galactorrhea: causes, symptoms, treatment

Contrary to what many people believe, galactorrhea is not a disease, but a kind of symptom or condition in which there is a secretion from the mammary glands of a fluid similar in composition to milk or colostrum.

Literally, the term "galactorrhea" is translated from Greek as "milk leakage". Most often, it is a sign of an incorrect balance of hormones in the body, but the participation of other development factors is not excluded.

Galactorrhea syndrome develops as a result of increased levels of prolactin in the bloodstream. More often, this syndrome is diagnosed in women, but there are cases when children or men are ill.

Galactorrhea-amenorrhea syndrome

Combined galactorrhea-amenorrhea syndrome refers to pathological conditions in which menstruation is absent despite the release of breast milk 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, psychological trauma, and prolonged treatment with certain medications.

A similar syndrome can also be discussed if amenorrhea and milk secretion occur in a woman who has stopped breastfeeding her baby (we are talking about the so-called Chiari-Frommel syndrome).

Epidemiology

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

The pathological condition can be unilateral or bilateral, and it is diagnosed mainly in women of reproductive age. However, men are not an exception – they also experience galactorrhea, although much less frequently.

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

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Causes galactorrhea

The primary causes of galactorrhea development may 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;
• underactive thyroid gland;
• adrenal dysfunction;
• liver diseases (especially chronic forms of pathologies);
• mechanical damage, injuries, burns, operations that caused damage to the sensory fibers of the sympathetic and parasympathetic nervous system;
• tumor processes affecting spinal cord structures;
• hyperstimulation of the nipple area (due to frequent sexual intercourse, wearing tight underwear, allergies, etc.);
• after operations affecting the spinal cord pathways;
• bronchogenic cancer process;
• Itsenko-Cushing's disease, Addison's disease;
• taking medications or folk remedies based on fennel, anise, nettle leaf, fenugreek.

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Risk factors

There are several known factors that do not cause galactorrhea in themselves, but contribute to its occurrence. 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 considered normal if it is observed within five months after the end of the lactation period. If the discharge is present for six months or more, then one can suspect the presence of pathology.

Discharge in infants during the neonatal period is also considered relatively normal: this condition is associated with the accompanying influence of hormones that the baby has received 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, the cause of galactorrhea cannot be determined, even after all diagnostic measures have been carried out. In such a situation, the diagnosis includes such a term as "idiopathic galactorrhea".

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Pathogenesis

Pathological galactorrhea most often results from diseases that are associated with impaired functioning of the hypothalamus (inflammation, injury) or the pituitary gland (malignant and benign tumors, “empty sella turcica”).

Increased synthesis of prolactin provokes the development of edema, swelling and pain in the mammary glands. The appearance of vegetative symptoms is possible: migraine-like headaches, swelling of the extremities, discomfort in the abdomen. Constantly increased levels of prolactin become a chronic stimulating irritant for the mammary glands, which causes the development of galactorrhea as a symptom. The root cause can be a large number of pathologies and pathological conditions.

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Symptoms galactorrhea

The basic symptom that determines the name of the pathology is the flow of different volumes of milk or colostrum from the milk duct. The discharge can be observed constantly or only occasionally. Their color can also be different - from translucent whitish to yellow-greenish tint.

The pathology may be accompanied by other symptoms that depend on the underlying disease:

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

Girls may simultaneously experience irregularities in their monthly cycle and discomfort in the vagina. Excessive hair growth in the limbs, face, and chest is also typical.

If galactorrhea develops in men, the following initial signs are typical:

• erectile dysfunction;
• 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 liquid that looks like milk can sometimes be released with the onset of puberty. This refers to the age of 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 detected.

Other factors that can contribute to the development of galactorrhea in adolescents include:

• taking medications, medicinal plants;
• formation of tumors affecting the pituitary gland, hypothalamus;
• decreased thyroid function;
• elevated cortisol levels due to problems with the adrenal glands;
• pathologies of the reproductive system, kidneys, liver;
• spinal cord disorders.

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

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Galactorrhea in men

Adult men can also have problems with milk leakage 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.

It is also impossible to 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 discharge of milky fluid from the mammary glands is not always accompanied by their swelling. Gynecomastia is often either absent or present, but in a mild or moderate form. Enlargement of the glands is more often found in men: it is usually bilateral, and suppression of libido is observed.

In women, galactorrhea manifests itself as a slight increase in the volume and density of the glands. In some cases, the patient feels some tension and slight pain. In case of unilateral damage, milk secretion is either prolonged, without any 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 treated. Based on the fact that milk leakage from the breasts is associated with increased secretion of prolactin, such an imbalance can become an obstacle to conceiving a baby, and in the future can threaten the normal course of pregnancy itself.

If galactorrhea is detected during pregnancy, then such a condition cannot be called critical. The woman's body is actively preparing for the birth of the baby - including the hormonal system. As the birth date 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, it is impossible to completely exclude the possibility of developing pathology during pregnancy. Therefore, additional tests are not excluded.

Forms

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

1. Mild stage – a drop-like flow of characteristic fluid is observed only when the areola is squeezed.
2. Middle stage – fluid flows out in a trickle when the areola is squeezed.
3. Severe stage – fluid from the milk ducts flows out spontaneously.

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

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

• lactation-associated galactorrhea;
• 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 some pathological processes inside 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, is occasionally encountered. In such a situation, idiopathic, i.e., an unspecified cause of galactorrhea, is often indicated. The 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 just a condition that has its own root causes, the likelihood of developing certain complications depends on the underlying pathology:

• In tumor processes affecting the pituitary gland, there is a high risk of vision loss, hemorrhage in the brain tissue, and ischemic stroke.
• In tumor processes in the breast, there is a possibility of the spread of cancer cells with the formation of secondary malignant foci.
• Hypothyroidism may result in hypothyroid coma, fluid accumulation in the pericardium or pleural cavity.

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

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

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Diagnostics galactorrhea

As a rule, galactorrhea syndrome is not difficult to diagnose: 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 diagnostics includes:

• questioning 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 step, which includes:
• general blood test;
• blood hormone level tests;
• biochemical blood test.

Instrumental diagnostics depends on what disease is suspected. Thus, the doctor may prescribe:

• computed tomography 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 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 thyroliberin);
• sclerocystic ovary syndrome;
• congenital adrenal hyperplasia;
• tumor processes;
• iatrogenic conditions (taking contraceptives, sedatives, neuroleptics, Dopegit, Cerucal, Reserpine, Cimetidine, as well as frequent hyperglycemic episodes in patients suffering from type I diabetes);
• chest trauma, mechanical irritation;
• fibrocystic mastopathy;
• various somatic pathologies.

Treatment galactorrhea

The main therapy for galactorrhea is aimed at eliminating the underlying cause of the condition – for example, normalizing prolactin levels.

• Drugs that slow down the secretory activity of the pituitary gland are prescribed
• Surgical treatment is prescribed, or radiation therapy, if we are talking about tumor processes.
• If there are any problems with the thyroid gland, then treatment for endocrine pathology is carried out.
• They adjust nutrition and lifestyle, and reconsider the advisability of the patient taking medications that could cause galactorrhea.

Next, depending on the causes of the pathology, medications appropriate to the situation are prescribed:

	Method of administration and dosage	Side effects	Precautionary measures
Bromocriptine	Take 2.5-7.5 mg per day, depending on the situation.	Rare manifestations: dyspepsia, decreased blood pressure, headache.	The drug is not compatible with alcohol and is not used if you are prone to low blood pressure.
Pergolide	Take 50-250 mcg per day. The exact dosage is determined by the doctor.	Sometimes – headaches, dizziness, low blood pressure, dyspepsia.	The drug is not combined with neuroleptics, Metoclopramide.
Cabergoline	The treatment regimen is prescribed individually. The amount of the drug should not exceed 3 mg per day.	Decreased blood pressure, peripheral vascular spasm, cramps, muscle weakness, depression, insomnia.	The drug is not compatible with macrolide antibiotics.
Mastodinon	Take 30 drops or one tablet twice a day for 3-4 months.	Rarely – allergy, dyspepsia.	The drug is not used for mammary gland cancer.
Cyclodinone	Take 40 drops or one tablet in the morning for 3-4 months.	Allergy.	The drug is not used during pregnancy.

Vitamins

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

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

For galactorrhea, 50 thousand IU of vitamin A is prescribed per day 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 simultaneously potentiates the action of other antioxidants, providing them with protection from destruction. In addition, ascorbic acid perfectly stimulates the body's immunity. Dosages of vitamin C for galactorrhea are determined individually.

Physiotherapy treatment

Patients whose galactorrhea is associated with fibrous pathologies, cysts or tumor processes are not recommended to practice physiotherapeutic procedures, and this especially concerns warming procedures and compresses. Such a warning is associated with the stimulation of metabolic reactions in the affected area, which can cause the development of adverse effects. There is no direct danger to the mammary glands during physiotherapy, but the procedures can cause a deterioration in the condition and aggravation of pathological processes.

Let's be honest, in case of galactorrhea, medical specialists very rarely prescribe a referral for physiotherapy. Ignoring this type of treatment is primarily due to the fact that physiotherapy often involves heat and stimulation, which is extremely undesirable in case of galactorrhea. For the same reason, women are not recommended to visit a sauna or stay in the sun for a long time.

The use of ultrasound, electrophoresis, shock wave therapy, and mud therapy is permitted only in situations where it will truly contribute to the successful elimination of the disease.

Folk remedies

When it comes to folk remedies for galactorrhea, experts advise paying attention to plants containing phytohormones. Such herbs will help stabilize the hormonal system and restore the body as a whole.

• 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 of the herb with 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 throughout the next day - about 150 ml three times a day between meals. In the evening, brew a new portion of the remedy - and so the treatment is carried out for 1-2 weeks.
• Sage is used to eliminate galactorrhea in women who have finished breastfeeding, but milk continues to be secreted. There are many recipes for using sage. For example, you can simply swallow half a teaspoon of ground sage in the morning (before meals), washing it down with warm water or tea. You can make an infusion: brew 1 tbsp. of the plant in 250 ml of boiling water, drink it at one 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, filled with drinking water at room temperature (1:20) and infused overnight. In the morning, the potion is brought to a boil, then removed from the heat, cooled and filtered. Drink 3 tbsp. of the medicine 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.

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Herbal treatment

It is useful to add herbal mixtures to the general treatment regimen. The multi-component composition acts more effectively, eliminating several problems at once that can lead to the development of galactorrhea.

• Collect 100 g of walnut leaves, 50 g each of chickweed, geranium and lemon balm leaves. Pour 1 ½ tbsp of the mixture into a thermos with 0.7 l of boiling water and leave overnight. In the morning, divide the potion 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 and parsley rhizomes, 50 g of mint, sage and periwinkle leaves. Brew 2 teaspoons of the mixture in 0.7 l of boiling water, leave for 10-15 minutes, filter. Take 1 glass between meals.
• Collect 100 g of sorrel rhizome, 50 g of mint leaves, thyme, yarrow, and 25 g of orthilia secunda. Before going to bed, pour 30 g of the mixture into 0.7 l of water at room temperature. In the morning, bring the potion to a boil over a fire, cool, and filter. Drink throughout the day. The course of such therapy lasts 2-3 weeks.

Homeopathy

Homeopathic treatment can be connected if the cause of galactorrhea is not various tumor processes. If the tumor is excluded, then you can try the action of the following homeopathic remedies:

• Allium sativum - helps to eliminate galactorrhea after the end of the breastfeeding period.
• Calcarea carbonica 6, 12 – improves the condition of swollen mammary glands with the secretion of watery milk.
• Cyclamen europaeum – eliminates galactorrhea in girls or women who are not pregnant.
• Crocus sativus – alleviates the condition of so-called “false pregnancy”.
• Mercurius solubilis - can cure galactorrhea in men, or in girls during menstrual bleeding.
• Phytolacca decantra 3 – stops galactorrhea associated with the development of inflammatory processes in the mammary glands.

Dosages of the 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.

Surgical treatment

The surgeon's help 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 the patient is diagnosed with a macroadenoma that does not respond well to medication, then it is possible to contact a surgeon.

Prevention

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

• stress, excessive anxiety;
• unhealthy lifestyle;
• poor nutrition;
• excess weight;
• diseases of the reproductive system.

If you experience any unpleasant symptoms, you should immediately contact a doctor, because restoring hormonal balance can sometimes take quite a long time and also lead to undesirable and serious consequences.

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Forecast

A condition such as galactorrhea does not pose a danger to the patient's life in itself. However, its causes - for example, hormonal imbalance - can cause various adverse effects, including infertility. Therefore, the prognosis for patients with galactorrhea should be considered on a case-by-case basis.

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