Galactorrhea: causes, symptoms, treatment

Contrary to the opinion of many, galactorrhea is not a disease, but a kind of symptom, or a condition in which there is a discharge from the milky mammary glands of a fluid that is close in composition to milk or colostrum.

Literally the term "galactorrhea" is translated from the Greek language as "the flow of milk". Most often it is a sign of an improper correlation of hormones in the body, but other factors of development are also not excluded.

The syndrome of galactorrhea develops as a consequence of increased prolactin levels in the bloodstream. More often this syndrome is diagnosed in women, but there are cases when children or men are ill.

The syndrome of galactorrhea-amenorrhea

Combined syndrome of galactorrhea-amenorrhea refers to pathological conditions in which there is no monthly breast cancer and infertility is diagnosed. The cause of this syndrome is hyperprolactinaemia, which, in turn, can be caused by tumor processes in the pituitary gland, disorders in the hypothalamus, primary hypothyroidism, psychotrauma, prolonged treatment with certain medications.

You can talk about a similar syndrome if you have amenorrhea and milk secretion from a woman who has stopped breastfeeding her baby (this is the so-called Chiari-Frommel syndrome).

Epidemiology

With galactorrhea, milk is excreted from the ducts of the mammary glands and this condition is not related to the stage of lactation. The volume and severity of secretions is different - from the detection of small spots on the bra or clothing, to a more intense expiration.

The pathological condition is one-sided or bilateral, and it is diagnosed mainly in women who are in reproductive age. However, the exception is not also men - they have a galactorrhea, although much less often.

According to statistics, the outflow of milk in women outside the period of feeding the baby happens in 20% of the fair sex, aged 25 to 40 years. In men, pathology is diagnosed in 0.07% of cases.

[1], [2], [3],

Causes of the galactorrhea

The primary causes of the development of galactorrhea can be:

• malignant, benign tumor processes affecting the pituitary gland;
• Chaotic reception of medicines, such as hormonal drugs, sedatives, antidepressants, narcotic analgesics, cardiovascular drugs;
• tumor processes affecting the hypothalamus, or the structure of the limbic system;
• insufficient thyroid function;
• disorders in the work of the adrenal glands;
• liver disease (especially chronic forms of pathology);
• mechanical injuries, injuries, burns, surgery, which caused damage to sensitive fibers of the sympathetic and parasympathetic nervous system;
• tumor processes affecting the spinal structures;
• hyperstimulation of the nipple area (with frequent sexual contacts, when using tight underwear, with allergies, etc.);
• after operations involving conductive spinal cord;
• bronchogenic cancer process;
• illness of Itenko-Cushing, Addison;
• taking medications or alternatives on the basis of fennel, anise, nettle leaf, fenugreek.

[4], [5], [6], [7]

Risk factors

There are several factors that do not in themselves cause a galactorrhea, but contribute to its appearance. These factors include:

• Stein-Leventhal syndrome (PCOS, accompanied by galactorrhea and amenorrhea);
• bladder skidding;
• uterine choriocarcinoma;
• inflammatory processes in the tissues of the mammary glands.

Galactorrhea refers to the norm, if observed within five months after the end of the lactation period. If the discharge is present for six months or more, then you can suspect the presence of pathology.

Allocations in infants during the newborn period are also considered a relative norm: this condition is associated with the concomitant influence of hormones that passed the baby from the mother. Such a phenomenon passes independently and does not require any treatment.

It should be noted that approximately every second patient can not establish the cause of the appearance of the galactorrhea, even after carrying out all diagnostic measures. In such a situation, the term "idiopathic galactorrhea" is used in the diagnosis.

[8], [9], [10]

Pathogenesis

Pathological galactorrhea most often becomes a consequence of diseases that are associated with abnormal work of the hypothalamus (inflammation, trauma), or pituitary (malignant and benign tumors, "empty Turkish saddle").

Increased synthesis of prolactin provokes the development of swelling, swelling and pain in the mammary glands. Perhaps the emergence of vegetative signs: migraine-like pain in the head, swelling of the extremities, unpleasant sensations in the abdominal region. A constant elevated level of prolactin becomes a chronic stimulating stimulus for the mammary glands, which causes the development of galactorrhea as a symptom. The primary cause can be a large number of pathologies and pathological conditions.

[11], [12], [13], [14], [15], [16]

Symptoms of the galactorrhea

The basic symptom, which determines the name of the pathology - is the expiration of a different volume of milk, or colostrum from the milky duct. Allocations can be observed constantly, or only occasionally. Their color is also different - from a translucent whitish to a yellowish-greenish hue.

Pathology can be accompanied by other signs that are dependent on the causative disease:

• pain in the head like a migraine;
• deterioration of vision;
• deterioration of the skin;
• tachycardia;
• a sharp change in body weight, in one direction or another;
• violation of libido.

The girls can simultaneously break the monthly cycle, there are unpleasant sensations in the vagina. Characteristic is also the excessive growth of hair in the region of the limbs, face, chest.

If the galactorrhea develops in men, then the first signs become typical:

• violation of potency;
• gynecomastia (swelling of the mammary glands);
• deterioration of state of health, fatigue, pain in the head.

For newborn infants, any symptomatology, except for direct secretions, is not characteristic.

Galactorrhea in adolescents

Liquid, resembling milk, sometimes can be allocated with the advent of the period of puberty. I mean age from 12 to 16 years. As a rule, the hormonal splash becomes a provoking factor, since there are usually no abnormalities in the formation of glandular tissues.

Other factors in the development of galactorrhea in adolescents can be:

• taking medicines, medicinal plants;
• the formation of tumors affecting the pituitary gland, the hypothalamus;
• decrease in the thyroid gland;
• elevated cortisol level on the background of disorders in the adrenal glands;
• pathology of the reproductive sphere, kidneys, liver;
• disorders in the spinal cord.

To determine the exact cause, a diagnosis should be made and consulted with individual specialists.

[17]

Galactorrhea in men

Adult males may also have problems with the flow of milk from the mammary glands. This pathology is called male hypogonadism and is associated with a shortage of testosterone in the body. In addition to galactorrhea, there are other signs:

• blunting of sexual desire;
• violation of erectile function;
• increase and swelling of the mammary glands.

Also, it is impossible to exclude the possibility of the influence of other factors, such as taking medications, the presence of tumors, thyroid pathologies, spinal cord injuries,

Galactorrhea and gynecomastia

The flow of milk fluid from the breast glands is not always accompanied by swelling. Gynecomastia is often either absent or present, but in mild or moderate form. The increase in glands is more often found in men: usually it is bilateral, there is a depression of libido.

In women, the galactorrhea is manifested by a slight increase in the volume and density of the glands. In some cases, the patient feels some tension and weak soreness. With unilateral lesion, milk secretion can be prolonged, without certain interruptions, or periodic. The latter usually does not depend on the phase of the monthly cycle, or occurs a few days before menstrual bleeding.

Galactorrhea and pregnancy

At the stage of preparation for pregnancy, the galactorrhea must be cured. Proceeding from the fact that the flow of milk from the breasts is associated with an increase in the secretion of prolactin, such an imbalance can become an obstacle to the conception of the baby, and in the future may jeopardize the normal course of the pregnancy itself.

If the galactorrhea was found already during gestation, then such a state can not be called critical. The woman's organism actively prepares for a birth of the kid - including, the hormonal system prepares for it also. As the date of birth approaches, the synthesis of hormones such as prolactin and oxytocin increases, so in many women, milk begins to be allocated well in advance of the onset of labor.

Nevertheless, the expectant mother must necessarily inform the doctor if she has a milk discharge from her breasts. After all, you can not completely exclude the possibility of developing pathology during pregnancy. Therefore, additional analyzes can not be ruled out.

Forms

Taking into account the severity of galactorrhea, the following stages of pathology are distinguished:

1. An easy stage - the droplet outflow of a characteristic liquid is observed only when the parotid zone is squeezed.
2. The middle stage - the liquid expires in a trickle when squeezing the parotid zone.
3. Severe stage - the liquid from the milk ducts spontaneously.

If the outflow is observed from one gland, then they speak of a unilateral defeat, and if of the two glands it is a bilateral defeat.

Also, the types of pathology are determined depending on the etiologic factor:

• galactorrhea associated with lactation;
• galactorrhea, not related to lactation;
• galactorrhea physiological (takes place during the bearing of the baby).

A galactorrhea that is not related to childbearing is not an independent disease. It develops as a result of any pathological processes inside the body - for example, as a result of endocrine disorders, oncology, or against frequent and excessive stimulation of the nipple area.

Episodically, there is another type of pathology of galactorrhea with normal prolactin. In a similar situation, often point to idiopathic - that is, an unidentified cause of the galactorrhea. The provoking factors in this may be expanded lacrimal canals, mastopathy, tumor processes in the mammary glands.

[18], [19], [20], [21], [22]

Complications and consequences

Since galactorrhea is only a condition that has its root causes, the probability of developing these or other complications depends on the initial pathology:

• In the case of tumoral processes affecting the pituitary gland, there is a great risk of vision loss, hemorrhage in the brain tissue, ischemic stroke.
• With tumor processes in the chest, there is a possibility of the spread of cancer cells with the formation of secondary malignant foci.
• In hypothyroidism, a hypothyroid coma can occur, a fluid accumulation in the pericardium or pleural cavity.

If the galactorrhea is caused by a hormonal imbalance, then for a woman it can result in infertility, or a violation of the processes of bearing a baby.

The listed complications develop, mainly, in neglected cases. Therefore, for their prevention, it is necessary to be examined in a timely manner and begin treatment of the underlying disease.

[23], [24], [25], [26]

Diagnostics of the galactorrhea

As a rule, it is not difficult to diagnose the galactorrhea syndrome: it is much more difficult to determine the cause of this condition. Therefore, all complex diagnostic procedures are aimed at determining the root cause of the syndrome.

The first stage of the diagnosis includes:

• questioning and examination of the patient (the doctor finds out all the circumstances in which the pathology arose);
• examination and palpation of the mammary glands;
• for women - a test for the presence of pregnancy.
• Analyzes are the next diagnostic stage, which includes:
• a general blood test;
• tests for the level of hormones in the blood;
• blood chemistry.

Instrumental diagnosis depends on what disease is suspected. So, the doctor can appoint:

• computer or magnetic resonance imaging of the skull;
• roentgenogram of the chest;
• mammograms;
• ultrasonography, ultrasound of mammary glands and reproductive organs;
• biopsy - if there are indications.

Consultations of narrow specialists may be required: endocrinologist, gynecologist, mammologist, surgeon.

[27], [28], [29]

Differential diagnosis

Differential diagnosis should be conducted with such pathologies:

• primary hypothyroidism (hypertension of tiroliberin);
• syndrome of sclerocystic ovaries;
• congenital hyperplasia of the adrenal cortex;
• tumor processes;
• iatrogenic conditions (reception of contraceptives, sedatives, antipsychotics, Dopegit, Cerucal, reserpine, cimetidine, and frequent hyperglycemic episodes in patients with Type I diabetes);
• breast trauma, mechanical irritation;
• fibrocystic mastopathy;
• various somatic pathologies.

Treatment of the galactorrhea

The main therapy for galactorrhea is aimed at eliminating the root cause of this condition - for example, the normalization of prolactin.

• Prescribed drugs that slow the secretory activity of the pituitary gland
• Surgical treatment is prescribed, or radiation treatment, if it is a question of tumor processes.
• If there are violations from the thyroid gland, then the endocrine pathology is treated.
• Correct the diet, lifestyle, review the advisability of taking the patient medications that could cause a galactorrhea.

Further, depending on the causes of the pathology, appropriate drug situations are prescribed:

	Dosing and Administration	Side effects	Precautionary measures
Bromocriptine	Take 2.5-7.5 mg per day, depending on the situation.	Rare manifestations: dyspepsia, lower blood pressure, pain in the head.	The drug is not combined with alcohol, it is not used with a tendency to low blood pressure.
Pergolide	Take 50-250 mcg per day. The exact dosage is determined by the doctor.	Sometimes - pain in the head, dizziness, lowering of blood pressure, indigestion.	The drug is not combined with neuroleptics, Metoclopramide.
Kabergolin	Treatment schedule is assigned individually. The amount of the drug should not exceed 3 mg per day.	Lowering blood pressure, peripheral vascular spasm, convulsions, muscle weakness, depression, insomnia.	The drug does not combine with macrolide antibiotics.
mastodinon	Take 30 drops or a pill twice a day, for 3-4 months.	Rarely - allergies, dyspepsia.	With oncology of the myocardium, the drug is not used.
Cyclidonone	Take 40 drops or one pill in the morning, for 3-4 months.	Allergy.	The drug is not used during pregnancy.

Vitamins

Most of the processes in the mammary glands occur under the direct influence of hormones. In this case, any change in the hormonal balance causes a response from the chest. Vitamins also participate in such mechanisms. For example, vitamin A has an anti-estrogenic effect, reducing the risk of epithelial tissue proliferation.

Vitamin A in the form of pharmaceutical preparations can be taken, but with great care. Excess retinol is able to accumulate, which increases the load on the liver. For this reason, it is safer to use additives with beta-carotene - provitamin A.

With galactorrhea appoint 50 thousand IU of vitamin A per day, for several months.

Tocopherol is an antioxidant that has a complex effect on the body. Including, this vitamin potentiates the production of progesterone, establishes fat metabolism, normalizes the monthly cycle and weakens the signs of premenstrual syndrome.

With galactorrhea, tocopherol is taken in an amount of 50-100 mg daily, for several months.

Ascorbic acid also serves as an antioxidant, and also simultaneously potentiates the action of other antioxidants, providing them with protection against destruction. In addition, ascorbic acid perfectly stimulates immunity in the body. Dosages of vitamin C with galactorrhea are determined individually.

Physiotherapeutic treatment

Patients who have a galactorrhea associated with fibrotic pathologies, cysts or tumor processes, it is undesirable to practice physiotherapy, and especially for warming procedures and compresses. This caution is associated with the stimulation of metabolic reactions in the impaired zone, which can lead to the development of adverse effects. There is no direct danger to the mammary glands with physiotherapy, but procedures can cause deterioration and aggravation of pathological processes.

Let's put it bluntly, with galactorrhea, medical specialists rarely write out the direction for physiotherapy. Ignoring this type of treatment is associated, first of all, with the fact that often physiotherapy provides a thermal and stimulating effect, which is extremely undesirable in galactorrhea. For the same reason, women are not recommended to visit the sauna, or stay for a long time in the sun.

The use of ultrasound, electrophoresis, shock wave therapy, mud therapy is allowed only in situations, if this really contributes to the successful elimination of the disease.

Alternative treatment

When it comes to the alternative treatment of galactorrhea, here experts advise to pay attention to plants containing phytohormones. Such herbs help stabilize the hormonal system and, on the whole, restore the body.

• The periwinkle plant regulates the level of prolactin, so it can stop the galactorrhea. At the same time, periwinkle can cure both men and women. In the evening, pour 2 tbsp. L. Herbs 0.5 liters of boiling water, cover the container with a warm kerchief and leave to infuse until the morning. All the infusion obtained should be drunk during the next day - about 150 ml three times a day in between meals. By the evening, a new portion of the preparation is brewed - and so they are treated for 1-2 weeks.
• Sage is used to eliminate galactorrhea in a woman who has completed breastfeeding, but milk continues to excrete. There are many recipes for sage application. For example, you can just swallow half a teaspoon of ground sage in the morning (before eating), washed down with warm water or tea. You can prepare the infusion: 1 tbsp. L. The plants are brewed in 250 ml of boiling water, they are drunk at a time instead of tea. Such a drink should be consumed 2-6 times a day, depending on the severity of the pathology.
• Sorrel - or rather, the root of the plant, grind, pour potable water at room temperature (1:20) and insist during the night. In the morning the drug is brought to a boil, after which it is removed from the fire, cooled and filtered. They drink 3 tbsp. L. Medicines three times a day after meals.
• Freshly cut jasmine flowers are fixed on the mammary glands and held for an hour. The procedure is repeated 2-3 times a day. Jasmine narrows the milk channels and helps stop the galactorrhea.

[30], [31]

Herbal Treatment

It is useful to add a mixture of herbs to the general treatment scheme. The multicomponent composition acts more efficiently, eliminating several problems that can lead to the development of galactorrhea.

• Collect 100 g of walnut leaves, 50 grams of gerbil grass, geranium leaves and lemon balm. Pour in a thermos 1 ½ tbsp. L. Collect 0.7 liters of boiling water, insist overnight. In the morning, the drug is divided into three parts, each of which is drunk after another meal. Duration of treatment may vary, depending on the intensity of the symptoms.
• Gather 100 grams of herbs of basil and parsley root, 50 grams of mint leaves, sage and periwinkle. Brewed 2 tsp. Mixture in 0.7 liters of boiling water, insist 10-15 minutes, filtered. Take between meals 1 glass.
• Collect 100 grams of rhizome, 50 grams of leaves of peppermint, thyme, yarrow, as well as 25 g of the hog uterus. Before going to bed, pour 30 grams of a mixture of 0.7 liters of water at room temperature. In the morning, the drug is brought to a boil on fire, cooled, filtered. Drink throughout the day. The course of such therapy lasts 2-3 weeks.

Homeopathy

Homeopathic treatment can be connected if the cause of galactorrhea is not a variety of tumor processes. If the tumor is excluded, then you can try the following homeopathic remedies:

• Allium sativum - helps to eliminate galactorrhea after the end of the period of breastfeeding.
• Calcium carbonate 6, 12 - improves the condition with swollen mammary glands with the release of watery milk.
• Cyclamen europeum - eliminates galactorrhea in girls or women, in the absence of pregnancy.
• Crocus sativus - facilitates the condition with the so-called "false pregnancy".
• Mercurius solubilis - can cure galactorrhea in makelks, or in girls during menstrual bleeding.
• Phytolacca decantra 3 - stops the galactorrhea associated with the development of inflammatory processes in the mammary glands.

Dosages of drugs are determined individually, taking into account the constitutional characteristics of the patient. Side effects during treatment are extremely rare, due to small dilutions of drugs.

Surgery

To help the surgeon resorted only in exceptional cases. It is believed that even in the presence of tumor processes, the operation is not always worthwhile: most tumors - including adenoma of the pituitary gland, are well amenable to drug treatment. If the patient is diagnosed with a macroadenoma that reacts poorly to taking medications, it is possible to consult a surgeon.

Prevention

To prevent galactorrhea, you must systematically take tests and undergo preventive examinations. Also, if possible, exclude such factors that are capable of provoking a hormonal failure in the body:

• stresses, excessive feelings;
• Unhealthy Lifestyle;
• malnutrition;
• overweight;
• diseases of the reproductive system.

In case of any unpleasant symptoms, the doctor should be contacted immediately, as the restoration of the hormonal balance can sometimes take a long time, as well as lead to undesirable and serious consequences.

[32], [33], [34], [35], [36]

Forecast

Such a condition as a galactorrhea, in itself, does not represent a danger to the life of the patient. However, its causes - for example, hormonal failure, can cause various adverse consequences, including infertility. Therefore, the prognosis for patients with galactorrhea should be considered in each individual case.

[37], [38]