What is galactorrhea?
Milky discharge from nipples is called galactorrhea. It is not the milk production during breastfeeding. It is a sign of an underlying disease. Sometimes the symptom goes on its own.
Most often its occurrence is seen in women, but can also occur in men and infants.
It can be a result of excessive breast stimulation, side effects of medicines, pituitary gland disorder or increased level of hormone prolactin.
PATHOPHYSIOLOGY
Hormones play a crucial role in galactorrhoea which is in excessive milk production. Galactorrhea occurs due to elevation in levels of serum prolactin. Prolactin is a hormone produced by lactotroph cells of the anterior pituitary gland.
The major role of prolactin hormone is to enhance breast development during pregnancy and to induce lactation.
Galactorrhea is a condition that occurs due to non-puerperal hyperprolactinemia. This non-puerperal hyperprolactinemia occurs in cases of pituitary lactotroph adenomas which produce prolactin. These lactotroph adenomas are called prolactinomas.
There may be other reasons also that lead to hyperprolactinemia such as pathological problems of the hypothalamic-pituitary such is the disturbance in a dopaminergic pathway. Dopamine is a protein which has the dominant influence over prolactin secretion.
Prolactin plays a critical role in stimulating breast epithelial cells, therefore, inducing milk production and maintaining milk production.
Primary hypothyroidism is another major factor leading to the high production of TRH (thyrotropin-releasing hormone) ultimately leading to hyperprolactinemia.
Age/sex affected by galactorrhea?
Galactorrhea is more common in females than in males.
Females who are already suffering from hormonal disturbance diseases such as amenorrhoea, oligomenorrhoea or infertility.
Galactorrhea is rare in women of postmenopausal age due to lack of estrogen hormone.
What are the causes of galactorrhea?
-no particular cause of Galactorrhea is known.-Herbal supplements.
-Birth control pills.
-Use of medicines, such as tranquillizers, antidepressants, and high blood pressure.
-PCOD.
-Chronic kidney disease.
-burns or other chest injuries.
-Spinal cord surgery, injury or tumours.
-Tumor or other diseases of the pituitary gland.
-Excessive breast stimulation, frequent breast self-examination or a skin rash.
-Galactorrhea in males occurs due to testosterone deficiency or gynecomastia.
-Galactorrhea in newborns occurs as a result of the mother’s estrogen hormone that crosses the placenta into the blood of the baby.
What are the symptoms of galactorrhea?
-Milky discharge from the breast that may be persistent or intermittent.
-One or both breasts are affected.
-Irregular menstrual periods.
-A patient may complain of a headache, dry skin and excessive sleepiness.
How to investigate galactorrhea?
-During the physical examination, the breast is checked for any lump or nodule and gently squeezing the nipple to reproduce the discharge.
-The discharge from the nipple is analyzed to see if there is a presence of blood in the fluid.
-Blood test to check prolactin level and TSH levels.
A pregnancy test is done because it may be one of the reasons of galactorrhea.
-Mammography.
-Ultrasound.
What treatment is to be given in galactorrhea?
-Medicines to decrease the level of prolactin.
-In case of tumour either medicines are given to shrink the size or surgery is done.
-If the underlying cause is a side effect of any medicine, it is recommended to immediately stop that medication.
-Medicines are given if an underlying cause is hypothyroidism.
-If there is no relief from medicines surgery is done to remove milk ducts.
What diet/management is to be followed during galactorrhea?
-Wear clothing that does not cause friction.
-Avoid performing breast self-examination.
-Avoid breast stimulation.
What are the homoeopathic medicines for galactorrhea?
-Borax veneta
-Calcarea carbonica
-Conium maculatum
-Secale cornutum
