Galactorrhea

Galactorrhea is milky breast discharge that happens in women who aren’t pregnant or breastfeeding. It affects as many as 1 out of every 4 or 5 women. It can happen at any age, even after menopause, and even if you’ve never had children. Often it’s caused by excess levels of prolactin, the hormone that triggers milk production. Prolactin is produced by the pituitary gland, a small gland at the base of your brain. You may find that your menstrual periods stop or become less frequent while you have the milky discharge.

There can be a number of underlying factors at work, such as:

• excessive stimulation of the breasts either as part of sexual activity, during frequent breast self-exams, or due to certain articles of clothing (such as rubbing against a sports bra during high-impact exercise)
• use of certain medications, including antidepressants, sedatives, antipsychotics, or high blood pressure drugs
• use of certain herbal supplements, such as fennel or anise
• an underactive thyroid gland
• disorders affecting the pituitary gland, such as a noncancerous tumor
• birth control pills

Your doctor will work with you to figure out what may be causing the milky discharge. In addition to taking your medical history and examining your breasts, your doctor may order tests such as:

• analysis of the nipple discharge
• a blood test to measure levels of prolactin and possibly of thyroid-stimulating hormone (if a thyroid problem is suspected)
• imaging tests such as mammogram and/or ultrasound, to examine the breast tissue
• an MRI (magnetic resonance imaging) study to check your pituitary gland

Your treatment depends on the underlying cause of the discharge. Stopping certain medications or herbal supplements often improves symptoms. If you have an underactive thyroid gland, you can take medication to boost low hormone levels (thyroid replacement therapy). For a pituitary tumor, your doctor may prescribe medication to shrink it or recommend surgical removal.

A medication called cabergoline (brand names: Dostinex, Cabaser) can also be used to lower prolactin levels. Another option is bromocriptine (brand names: Cycloset, Parlodel), but significant side effects are more common with this medication.

In many cases of galactorrhea, no definite cause can be identified and the condition simply goes away on its own. A comfortable bra and nipple pads (like those used by women while breastfeeding) can be helpful in the meantime.