Galactorrhea – Diagnosis and Treatment

ByJanis Updated

Diagnosis

To find out why galactorrhea occurs, healthcare professionals follow several steps. They usually begin with a physical exam of the breasts, checking for any lumps, thickened areas, or abnormal tissue.

During the exam, they may gently press around the nipple to collect any milky discharge for further review.

A blood test plays an important role in the process. This test measures the amount of the hormone prolactin in the blood. High prolactin levels can indicate problems like pituitary tumors (prolactinomas), microadenomas, or other causes of hyperprolactinemia.

If prolactin is elevated, healthcare professionals may also check thyroid-stimulating hormone (TSH) to look for primary hypothyroidism or other thyroid issues.

Other tests often include:

  • Pregnancy test to rule out pregnancy.
  • Imaging tests like mammography or breast ultrasound if a lump or other changes are detected.
  • Magnetic resonance imaging (MRI) of the brain if elevated prolactin levels raise suspicion of pituitary gland growths or macroadenomas.
  • Visual field testing if a pituitary tumor is suspected.

These steps help determine if a hormone imbalance, pituitary adenoma, endocrine disorder, or another underlying health problem is present.

Treatment

Most treatment plans for galactorrhea focus on addressing the underlying cause of the milk-like discharge. If a medication causes the issue, a healthcare provider may recommend stopping it, reducing the dose, or switching to a different drug after careful evaluation.

Common drugs linked to galactorrhea include tricyclic antidepressants and some antihypertensive agents.

If an underactive thyroid gland is responsible, healthcare professionals prescribe thyroid hormone replacement like levothyroxine. For pituitary tumors called prolactinomas, treatment options include dopamine agonists.

These drugs lower prolactin levels in the blood. Possible side effects include nausea, headaches, and dizziness.

Surgeons may remove the tumor if it does not respond to medication. Rarely, radiation therapy may be used if medicines and surgery are not effective.

Simple Daily Tips for Managing Symptoms

Individuals can reduce unwanted milk secretion by minimizing direct contact with their breasts. Avoid handling or squeezing the nipples during both routine checks and sexual activity.

Limiting breast stimulation helps prevent extra milk production, which can be especially important for those taking oral contraceptives or dealing with hormonal changes like low estrogen or testosterone.

Good hygiene also decreases the risk of breast infections, including fibrosis or periductal mastitis.

Getting Ready for Your Visit

Steps to Take Before Seeing the Doctor

Being prepared helps make a medical visit more useful. The following steps can help:

  • Write down all symptoms. Even if a symptom seems small or unrelated, it may be important.

  • List important personal details. Stressful events or any recent life changes could be helpful to share.

  • Gather information about all supplements and medications. Include prescription drugs, over-the-counter medicines, vitamins, and herbal remedies. Note the dose and how often each is taken.

  • Prepare questions. It can be easy to forget questions in the office. Here are some questions that might help:

    • What might be causing these symptoms?

    • Are there other possible explanations?

    • Will I need any tests?

    • What are my treatment options?

    • Is there anything safe I can try at home?

Questions Your Provider May Ask

Healthcare providers often ask several questions to better understand the issue. Some questions may include:

  • What color is the liquid coming from the nipple?
  • Is the discharge from one breast or both?
  • Has there been any breast pain, lump, or swelling?
  • Do you regularly check your breasts at home?
  • Has there been any recent change in your breasts?
  • Are you currently pregnant or breastfeeding?
  • Are your periods regular?
  • Are there any problems getting pregnant?
  • What medicines or supplements are you taking?
  • Have you had headaches or changes in your vision?

Thinking ahead about these questions will help provide clear and quick answers during the appointment.

Things You Can Do While You Wait

You can try some simple steps before your appointment:

  • Avoid touching the breasts. Try not to rub or squeeze the nipples, even during physical activity or intimacy, as this can make discharge worse.
  • Use absorbent breast pads. Place these pads inside your bra to soak up fluid that might leak during the day, keeping clothes dry and comfortable.

If anything changes or gets worse, note it down to discuss at the visit.

Health Writer

Janis's areas of expertise include nutrition, exercise, stress management, and mental health. She is passionate about educating and empowering people to take control of their health and make positive changes that can last a lifetime. Janis believes that small, sustainable changes are the key to long-term success, and she works with her clients to develop personalized plans that fit their individual needs and lifestyles.