The discharge can occur from one or both breasts, in either small or large quantities and can be continuous or intermittent. The discharge can also be encouraged by massaging the breast and nipple. After infancy, the condition in women is usually brought on by medication and can in rare instances be stress related. The most common physical cause of galactorrhea is a pituitary tumor. Galactorrhea most commonly presents in women aged 20 to 35 years of age.

Additional symptoms that can accompany galactorrhea

Depending on the underlying cause of the condition, it can be accompanied by other symptoms that can help your doctor correctly identify the reason you’re experiencing galactorrhea. These can include;

• An absence of menstrual periods or periods that aren’t regular.
• Headaches.
• Vision loss.
• Decreased sex drive.
• Increase in hair growth on your chin or chest.
• Erectile dysfunction in men.
• Temperature intolerances
• Nervousness, restlessness and increased sweating

Potential underlying causes

• Pharmacological. Oral contraceptives are the most common pharmacologic cause of galactorrhea
• An increase in the hormone prolactin (a condition known as hyperprolactinemia), which produces milk.  Prolactin is produced by the pituitary gland, a small gland at the base of your brain. Related symptoms may include decreased libido, infertility, oligomenorrhea or amenorrhea, and impotence 
• Galactorrhea may occur if you take sedatives or marijuana. 
• High doses of estrogen can cause galactorrhea. Women who have this often have irregular menstrual periods or their periods have stopped.
• Galactorrhea can also, in some instances, be caused by a pituitary gland tumor. These tumors are rarely cancerous.
• Hypothalamic and pituitary stalk lesions with head-aches, visual disturbances, temperature intolerance, seizures, disordered appetite, polyuria, and polydipsia as related symptoms.
• Thyroid disorders with tiredness, cold intolerance, and constipation as associated symptoms. Nervousness, restlessness, increased sweating, heat intolerance, and weight loss despite an increase in appetite suggest thyrotoxicosis.
• Chronic renal (kidney) failure
• Chronic Stress that affects hormone levels

Medication’s associated with galactorrhea

If you’re taking any of the medications listed below, these could very possibly be the cause of your symptoms and this is one of the first avenues your doctor will explore in diagnosing your condition.

Pituitary Tumors

Pituitary tumors are the most common pathologic cause of galactorrhea. These can result in hyperprolactinemia by producing prolactin or blocking the passage of dopamine from the hypothalamus to the pituitary gland. Prolactinomas are the most common type of pituitary tumor and are associated with galactorrhea, amenorrhea, and marked hyperprolactinemia.

The serum level of prolactin usually correlates with the size of the tumor. A minority of patients have gigantism/acromegaly with elevated levels of prolactin and growth hormone. Macroprolactinomas are associated more often with visual field defects, headache, neurologic deficits, and loss of anterior pituitary hormones.

Hypothalmic and Pituitary Stalk Lesions

Hypothalamic lesions such as craniopharyngioma, primary hypothalamic tumor, meta-static tumor, histiocytosis X, tuberculosis, sarcoidosis and empty sella syndrome, and pituitary stalk lesions—traumatic or secondary to the mass effects of sellar tumors—are infrequent but significant causes of galactorrhea. These lesions destroy dopamine-producing neurons in the hypothalamus and block the passage of dopamine from the hypothalamus to the pituitary gland. This results in lifting of the inhibitory effect of dopamine on lactotrophs.

Thyroid disorders

Hypothyroidism (enlarged thyroid) is a rare cause of galactorrhea in children and adults. In patients with hypothyroidism, there is increased production of thyrotropin-releasing hormone, which may stimulate prolactin release. Hyperprolactinemia also may result from decreased hypothalamic dopamine secretion and decreased metabolic clearance of prolactin. Occasionally, galactorrhea may result from thyrotoxicosis, possibly because of an increase in estrogen-binding globulin or alterations in estrogen metabolism that change the free estrogen level.

Chronic Renal Failure

Approximately 30 percent of patients with chronic renal failure have elevated prolactin levels, possibly because of decreased renal clearance of prolactin. Although galactorrhea in these patients is rare, it can result from the elevated prolactin levels.

Neurogenic Causes

Neurogenic stimulation may repress the secretion of hypothalamic prolactin inhibitory factor, which results in hyperprolactinemia and galactorrhea. Galactorrhea may be caused by prolonged, intensive breast stimulation, such as from suckling, self-manipulation, or stimulation during sexual activity. Galactorrhea caused by breast stimulation is more common in parous (women who have given birth) women but has been reported in virgins, postmenopausal women, and men.

Neurogenic causes of galactorrhea include chest surgery, burns, and herpes zoster that affects the chest wall. Stimuli are thought to pass along the intercostal nerves to the posterior column of the spinal cord, to the mesencephalon, and finally to the hypothalamus, where the secretion of prolactin inhibitory factor is reduced. Galactorrhea may develop as a complication of spinal cord injury. Chronic emotional stress may be a neurogenic cause of galactorrhea.

Neonatal Galactorrhea

High levels of estrogens in the placental-fetal circulation can result in gynecomastia (enlarged breasts) in newborn infants. Enlargement of the breasts, which may be associated with secretion of milk (so-called “witch’s milk”), often is transient but may last longer in breastfed infants. In one large-scale study of 984 examinations of 640 healthy infants from birth to two months of age, galactorrhea was found in 45 examinations (4.6 percent) of 38 infants (5.9 percent)

Diagnosis and Treatment

Your doctor will do a physical exam and review your symptoms. He or she will ask about your health history and lifestyle, and what medicines you take. Your doctor may order blood tests to check your hormone levels. For women, your doctor may order a pregnancy test. Certain types of pregnancy tests can determine if you were pregnant and possibly miscarried without being aware of it.

If the doctor suspects a tumor, he or she can order an MRI (magnetic resonance imaging). This test scans your head to see if you have a tumor or defect of the pituitary gland. Your doctor can order a mammogram and/or ultrasound to check for cancer. A sample of the discharge can be checked onsite by your doctor to determine if there is fat present in the sample, a clear indicator of galactorrhea.

Treatment will largely be determined by the underlying cause of your condition. Benign tumors can be treated with medicine or surgery. Medicine can help if your body is producing too much of a hormone, such as prolactin. It also helps treat problems, such as hypothyroidism. If a certain medicine causes galactorrhea, your doctor may prescribe a different medicine.

In many cases, no treatment is necessary. Over time, the condition may go away on its own. Until then, there are some things you can do to help.

• Avoid stimulating your breasts.
• Avoid touching your nipples during sexual activity.
• Don’t do breast self-exams more than once a month.
• Avoid clothes that are too tight or rub and irritate your skin.
• Wear pads in your bra (women) to absorb the milky discharge.

The post Galactorrhea or Milky Nipple Discharge in Women appeared first on Medika Life.

If you’re a woman, you spend a great deal of time checking your breasts for lumps. If you don’t, it is a habit you should develop from a reasonably young age. In fact, the earlier you start the more familiar you will become with the feel of your breast. If you are intimate with how your healthy breast feels, then you are so much more likely to pick up any early changes or signs of trouble. 

What a lot of women don’t know, is that their nipples can also act as an early warning system for a host of breast related problems. Here are five potential issues that can affect your breasts and how these will affect your nipples. Many of these conditions, like Paget’s disease of the breast, can also affect men, but are far more rare.

Paget’s Disease

Not to be confused with Paget’s disease of the bone, Paget’s disease of the breast is a rare form of breast cancer. It starts on the nipple and extends to the dark circle of skin, the areola, around the nipple. The disease is most likely to affect women over the age of fifty. 

Women with Paget’s disease often have underlying ductal breast cancer or in rare instances, invasive breast cancer. Paget’s very rarely confines itself to only the nipple, so early detection is crucial and your nipples will provide you with warning signs if you know what to look for.

Symptoms of Paget’s disease of the breast

Signs and symptoms usually occur in only one breast and the disease typically starts in the nipple and may spread to the areola and other areas of the breast. It is easy to mistake the signs and symptoms of Paget’s for skin irritation (dermatitis) or another noncancerous (benign) skin condition. Signs and symptoms of Paget’s disease that are visible on your nipple include:

• Flaky or scaly skin on your nipple
• Crusty, oozing or hardened skin resembling eczema on the nipple, areola or both
• Itching
• Redness
• A tingling or burning sensation
• Straw-colored or bloody nipple discharge
• A flattened or turned-in (inverted) nipple

If you notice one or more of these symptoms, consult your doctor. They are more often than not, related to other conditions, but a doctor will be able to properly assess them. Early detection is critical with cancers.

Ectasia

First the good news, Ectasia isn’t cancerous. Usually affecting women who are entering menopause or older, ectasia is the natural widening or dilation of the milk duct in aging women. The mammary ducts are located under the nipple and in some cases, this dilation can lead to blockages of the ducts.

Fluid build up can leak into adjoining tissue and cause infection, chronic inflammation or an abscess. Infections from this process are called periductal mastitis and can result in scar tissue forming. This process will draw your nipple inwards and can produce a thick, sticky nipple discharge. Your breast will also feel tender.

Treatment depends on the severity of your symptoms. A warm compress will offer relief and antibiotics will address the infection. For recurrent or serious cases surgery may be required to remove the duct.

Intraductal Papilloma

An intraductal papilloma is a small, usually harmless wart-like growth (tumor) that bumps out into the breast ducts near the nipple. Although the condition is mostly benign, a study in 2017 found approximately 17% of these growths to be atypical or cancerous. Papilloma’s cause a bloody or sticky discharge from the nipple. 

Any slight bump or bruise near the nipple can also cause the papilloma to bleed. If the discharge becomes annoying, the duct can be surgically removed. This can often be done without changing the look of the breast.

Single papilloma most often affect women nearing menopause. Multiple intraductal papilloma’s are however more common in younger women and often occur in both breasts. Multiple intraductal papilloma’s are more likely to be linked to a lump than with nipple discharge. Any papilloma linked to a lump is surgically removed. 

Papilloma’s are most likely to occur near the nipple, but can occur in the deeper tissue of the breast, more likely with multiple intraductal papilloma’s. This is also an indicator of an increased risk of breast cancer and you should discuss this with your doctor. The condition can also rarely occur in men. It can be painful and is occasionally accompanied by an itching sensation in the nipple.

Lactational Mastitis

Your nipples can produce discharge for a number of reasons. If the discharge is as a result of your breasts and nipples being squeezed or manipulated, then this probably isn’t reason for concern. When should you be worried about discharge?

Women who are breastfeeding may experience a lump under the areola in conjunction with discharge. This is not necessarily of concern as infections called lactational mastitis are quite common in breast feeding women. A pus filled abscess forms and treatment can be as simple as changing your breast feeding technique or in some instances, may require antibiotics.

When antibiotics are needed, those effective against Staphylococcus aureus (e.g., dicloxacillin, cephalexin) are preferred. This line of treatment is often accompanied by incising and draining pus from the affected ducts to reduce swelling and risk of further infection. Seek urgent medical attention if you suffer from this condition as delaying treatment can lead to the formation of an abscess which is harder to treat and leads to the formation of scar tissue in your breast.

If you are not breast feeding, then any discharge accompanied by a lump is cause for concern and you should seek immediate medical advice.

Galactorrhea

This mouthful sounds like an STD but is actually the term doctors use to refer to a milky discharge from the nipples in women that aren’t breastfeeding. This can occur for a number of reasons;

• An increase in the hormone prolactin, which produces milk. 
• Galactorrhea may occur if you take sedatives or marijuana. 
• High doses of estrogen can cause galactorrhea. Women who have this often have irregular menstrual periods or their periods have stopped.
•  Galactorrhea can also, in rare instances, be caused by a pituitary gland tumor. Your doctor will schedule an MRI if they suspect your pituitary gland may be involved.

How doctors assess nipple discharge

Nipple discharge can vary in consistency and color. It’s important to find out if the discharge is coming from one or many ducts. If multiple ducts are involved that is almost always a positive sign, as in most of these cases the cause is benign (not harmful cancers).

If a single duct is involved more tests may be required. Your doctor may schedule a mammography (breast scan) and may take a sample of the discharge for further lab analysis to confirm a diagnosis. If your mammography doesn’t display any abnormalities, then surgery usually isn’t required.

The post Five Things Your Nipples May be Trying to Tell You appeared first on Medika Life.