Galactorrhea

Milky discharge from nipples is called galactorrhea. It is not the milk production during breast feeding. It is a sign of an underlying disease. Sometimes the symptom goes on its own.

galactorrhea

Most often its occurrence is seen in women, but can also occur in men and in infants.

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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 very important role in galactorrhoea that 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 occuring due to nonpuerperal hyperprolactinemia. This nonpuerperal hyperprolactinemia occur in cases of pituitary lactotroph adenomas which produce prolactin. These lactotroph adenomas are called as prolactinomas.

There may be other reasons also that lead to hyperprolactinemia such as pathological problems of the hypothalamic-pituitary that is the disturbance in a dopaminergic pathway. Dopamine is a protein which has the dominant influence over prolactin secretion.

Prolactin plays the very important role in stimulating breast epithelial cells, therefore, induce 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 of 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.

Race of Galactorrhea

Women and males of any race can be affected.
Galactorrhea occurs more common in developing countries due to high-stress levels.

Causes of Galactorrhea

• Galactorrhea sometimes occurs without any known cause, this condition is called idiopathic galactorrhea, and it may mean that breast tissue is particularly sensitive to the milk-producing hormone blood.
• Herbal supplements.
• Birth control pills.
• Use of medicines, such as tranquilizers, antidepressants, and high blood pressure.
• PCOD.
• Chronic kidney disease.
• Nerve damage to the chest wall from chest surgery, burns or other chest injuries.
• Spinal cord surgery, injury or tumors.
• Tumor or other diseases of the pituitary gland.
• Excessive breast stimulation, frequent breast self-examination, a skin rash on the chest or prolonged clothing friction.
• Galactorrhea in males occurs due to testosterone deficiency or gynecomastia.
• Galactorrhea in newborns occurs as a result of mother’s estrogen hormone that crosses the placenta into the blood of baby.

Signs and Symptoms of Galactorrhea

• Milky discharge from the nipple that may be persistent or intermittent.
• One or both breasts are affected.
• Irregular menstrual periods.
• A patient may complaints of a headache, dry skin and excessive sleepiness.

Investigations for Galactorrhea

• During the physical examination, breast is checked for any lumps present 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 level.
• Pregnancy test is done because it may be one of the reasons of galactorrhea.
•  Mammography.
• Ultrasound.

Treatment for Galactorrhea

• Medicines to decrease the level of prolactin.
• In case of tumor 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 a hypothyroidism.
• If there is no relief from medicines surgery is done to remove milk ducts.

Diet / management of Galactorrhea

• Wear clothing that does not cause friction.
• Avoid performing breast self-examination.
• Avoid breast stimulation.

Prognosis of Galactorrhea

The condition of galactorrhea goes away on its own. If it persists the prognosis depends on the underlying cause.

Homeopathic treatment for Galactorrhea

Borax veneta
• Well indicated medicine for galactorrhoea.
• While nursing the child pain in the opposite breast.
• There is vaginal discharge which is like white of an egg.
• There is the sensation of discharge as if warm water is flowing through the vagina.
• Also well indicated medicine for sterility.

Calcarea carbonica
• Milk from the breast is too abundant and disagreeable to the child.
• Sometimes deficient lactation with distended breasts in lymphatic women.
• There is hot swelling of breasts.
• Breast is tender, swollen before menses.
• There is excessive sweating around genitals.
• Leucorrhoea is milky.

Conium maculatum
• Breast is enlarged and become painful before and during menses.
• Wants to press the breast hard with the hand.
• Mammae lax and shrunken, hard painful to touch.
• There are stitches in the nipples.
• There are ill effects of repressed sexual desire or suppressed menses or from excessive indulgence.

Medusa
• Medicine is well indicating for marked action on the lacteal glands.
• The secretion of milk was established after lack of it in all previous confinements.
• The whole face of the patient is puffed and edematous, eyes, nose, ears, and lips.

Secale cornutum
• Medicine is well indicated for galactorrhoea.
• Also indicated for suppression of milk, breast does not fill properly.
• Dark offensive lochia.
• There are burning pains in the uterus.
• Also indicated for threatened abortion around the third month.

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