Am Fam Physician. 2022;106(6):online
Related article: Galactorrhea: Rapid Evidence Review
What is galactorrhea?
Galactorrhea (guh-LACK-toe-REE-uh) is a milky discharge from the breast that isn’t from breastfeeding or that happens at least one year after stopping breastfeeding. It usually happens in both breasts, but it can also happen in only one. Both women and men can have galactorrhea.
What causes it?
Usually galactorrhea is caused by a high prolactin level. Prolactin is a hormone that tells your body to produce milk. Prolactin is made by a part of the brain called the pituitary (pih-TOO-ih-TAIR-ee) gland. Some common causes of a high prolactin level include:
Pregnancy
Irritation of the chest or nipples
Some medicines for mental disorders, depression, and blood pressure
A problem with your thyroid gland
Kidney disease
Liver disease
Pituitary tumor (the most common pituitary tumor that causes galactorrhea is called a prolactinoma)
Other problems with parts of the brain that control the pituitary gland
Sometimes the cause of galactorrhea can’t be found.
What are the symptoms of a high prolactin level?
Milk white discharge from the nipples (it may also be yellow or greenish). If the discharge is red or bloody, it is probably not galactorrhea. Other symptoms you could have are:
Headaches (from a pituitary tumor)
Vision changes (from a pituitary tumor)
Menstrual periods might stop or change
Less interest in sex
Unable to get an erection
What tests will I need?
If you are a woman who has not reached menopause, you should have a pregnancy test. Your doctor will do a blood test to see if your prolactin level is high. If it is, other blood tests are usually done to figure out what is causing the high prolactin level, such as testing how your thyroid, kidneys, and liver are working. Your doctor might want you to get an MRI scan of your brain.
How is galactorrhea treated?
Treatment depends on what is causing the galactorrhea. Sometimes, if the galactorrhea does not bother you, it does not need to be treated. If a medicine is causing the galactorrhea, your doctor may change the medicine. If galactorrhea is caused by too much prolactin from a prolactinoma (a pituitary tumor), your doctor might prescribe medicine to shrink the tumor and lower the prolactin level.
Most tumors that cause galactorrhea are not cancerous and can be treated with medicine. Most people do not need surgery.
Where can I find more information?
Your doctor
National Institutes of Health
https://www.niddk.nih.gov/health-information/endocrine-diseases/prolactinoma