galactorrhea

Introduction

Expression of milk from the nipples of the breast or continued lactation after cessation of nursing. May be normal. May occur during puberty or pregnancy & may continue for months or years after cessation of lactation.

Etiology

• pharmacologic causes:
  • methyldopa
  • phenothiazines
  • tricyclic antidepressants
• hyperthyroidism or hypothyroidism
• pituitary adenoma (prolactin-secreting)

Clinical manifestations

• headaches, visual field disturbances or other neurologic symptoms suggest pituitary adenoma
• palpitations, weight change, or changes in skin or hair suggest thyroid disorder
• bilateral milky discharge from nipples

Laboratory

• pregnancy test
• serum prolactin
• thyroid function tests

Radiology

• magnetic resonance imaging (MRI) of sella turcica if serum prolactin is significantly elevated

Management

• observation if serum prolactin & thyroid function tests are normal
• bromocriptine for persistent galactorrhea not secondary to pituitary adenoma
• referral to an endocrinologist

More general terms

• sign/symptom