Galactorrhea (Nipple Discharge)
What is galactorrhea?
If you have a milklike discharge of fluid from the breast nipples and you are not breast-feeding or pregnant, the discharge is called galactorrhea. The discharge may be from one or both breasts.
Galactorrhea may be a symptom of a condition that needs medical treatment. It is important to see your healthcare provider to determine the cause of the discharge.
How does it occur?
Some of the possible causes of a milklike discharge from the nipples when you are not pregnant or breast-feeding are:
- birth control pills and other medicines
- an underactive thyroid gland
- problems with the pituitary gland or hypothalamus in the brain
- some brain diseases, such as meningitis
- a cyst under the darkened area around the nipple (called a galactocele)
- shingles caused by the chickenpox virus in the chest wall
- surgery on the chest
- other medical problems such as kidney failure, liver disease, lung disease, and Cushing's disease of the adrenal gland
The cause of galactorrhea cannot be found in about half of the cases.
How is it diagnosed?
Your healthcare provider will examine your breasts. Your provider will also ask about your medical history. He or she will ask if you have stopped having menstrual periods, are having trouble getting pregnant, or are having headaches or vision problems. Your provider will also ask about what medicines you are taking.
The color and consistency of the discharge, as well as whether it comes from 1 or both breasts, help your healthcare provider know what is causing it.
You may have the following tests:
- lab tests of the discharge
- blood tests
- mammogram (X-ray of the breasts)
- ultrasound scan of your breasts
- CT scan (computerized X-rays) of your brain to look at your pituitary gland and hypothalamus
- MRI scan of the breasts
- biopsy of lumps
How is it treated?
The treatment depends on the cause. Sometimes no treatment may be needed.
If you have galactorrhea because you have a disorder such as thyroid problems or meningitis, your healthcare provider will treat the disorder.
If a galactocele is causing the nipple discharge, the cyst may be removed.
If the discharge is caused by a medicine you are taking, the discharge will probably stop when you stop taking the medicine. However, you may not have to stop the medicine. For example, you may keep taking birth control pills.
If the discharge is caused by a pituitary gland or hypothalamus tumor, you may need surgery, radiation, or drug treatment. Often these tumors grow slowly. Some stop growing after a while. Some can be treated with medicine.
Your healthcare provider may prescribe the medicine bromocriptine if a cause cannot be found. If you have gone through menopause and stopped having periods, bromocriptine may cause you to start having periods again. This means there’s a chance you could get pregnant if you are sexually active.
How long will the effects last?
Once the cause of the discharge is diagnosed and treated, the discharge may stop. However, if you have a pituitary tumor, you may need long-term treatment with bromocriptine or radiation because the tumor could come back.
How can I take care of myself?
- Follow your healthcare provider's recommendations for follow-up tests.
- If you are taking bromocriptine, be sure you take it according to your provider's instructions.
- If the galactorrhea is mild and a cause is not found, a tight fitting bra or a wide band wrapped tightly around the chest over the breasts may help stop the discharge.
