Galactorrhea

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Causes

By Mayo Clinic staff

Galactorrhea often results from too much prolactin — the hormone responsible for milk production (lactation) when you have a baby. Prolactin is produced by your pituitary gland, a marble-sized gland at the base of your brain that secretes and regulates several hormones.

Possible causes of galactorrhea include:

  • Medications, such as certain tranquilizers, antidepressants and high blood pressure drugs
  • Herbal supplements, such as fennel, anise or fenugreek seed
  • Birth control pills
  • A noncancerous pituitary tumor (prolactinoma) or other disorder of the pituitary gland
  • An underactive thyroid (hypothyroidism)
  • Chronic kidney disease
  • Excessive breast stimulation, which may be associated with sexual activity, frequent breast self-exams, a skin rash on the chest or prolonged clothing friction
  • Nerve damage to the chest wall from chest surgery, burns or other chest injuries
  • Spinal cord surgery, injury or tumors

Idiopathic galactorrhea
Sometimes doctors can't find a cause for galactorrhea. This is called idiopathic galactorrhea, and it may just mean that your breast tissue is particularly sensitive to the milk-producing hormone prolactin in your blood. If you have increased sensitivity to prolactin, even normal prolactin levels can lead to galactorrhea.

Galactorrhea in men
In males, galactorrhea may be associated with testosterone deficiency (male hypogonadism) and usually occurs with breast enlargement or tenderness (gynecomastia). Erectile dysfunction and a lack of sexual desire also are associated with testosterone deficiency.

Galactorrhea in newborns
Galactorrhea sometimes occurs in newborns. High maternal estrogen levels cross the placenta into the baby's blood. This can cause enlargement of the baby's breast tissue, which may be associated with a milky nipple discharge.

References
  1. Lobo RA. Hyperprolactinemia, galactorrhea, and pituitary adenomas: Etiology,
  2. differential diagnosis, natural history, management. In: Katz VL, et al., eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby; 2007. http://www.mdconsult.com/das/book/body/202383887-3/1002403495/1524/257.html#4-u1.0-B978-0-323-02951-3..50042-X_1261. Accessed May 24, 2010.
  3. Ferri FF. Galactorrhea. In: Ferri FF. Ferri's Clinical Advisor 2010. St. Louis, Mo.: Mosby; 2009. http://www.mdconsult.com/das/book/body/202383887-3/1002403495/2088/252.html#4-u1.0-B978-0-323-05609-0..00016-2--sc0010_5179. Accessed May 24, 2010.
  4. Snyder PJ. Causes of hyperprolactinemia. http://www.uptodate.com/home/index.html. Accessed May 24, 2010.
  5. Mancini T, et al. Hyperprolactinemia and Prolactinomas. Endocrinology and Metabolism Clinics of North America. 2008;37:67.
  6. Snyder PJ. Clinical manifestations and diagnosis of hyperprolactinemia. http://www.uptodate.com/home/index.html. Accessed May 24, 2010.
  7. Snyder PJ. Treatment of hyperprolactinemia due to lactotroph adenoma and other causes. http://www.uptodate.com/home/index.html. Accessed May 24, 2010.
  8. Iglehart JD. Diseases of the breast. In: Townsend CM, et al. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/202388075-8/0/1565/325.html?tocnode=54737836&fromURL=325.html#4-u1.0-B978-1-4160-3675-3..X5001-1--section7_1642. Accessed May 24, 2010.
  9. Pruthi S (expert opinion). Mayo Clinic, Rochester, Minn. June 3, 2010.
  10. Nippoldt TB (expert opinion). Mayo Clinic, Rochester, Minn. June 8, 2010.
DS00761 July 22, 2010

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