Galactorrhea: symptoms, causes, diagnosis and treatment

This alteration in the production of body substances can be caused from the brain.

One of the main characteristics of humans as mammalian animals is the development of the mammary glands, whose sole function is to provide food for the young; hence, at least in the human species, babies are also called infants.

However, a series of alterations in the production of the hormones responsible for the secretion of milk may cause a phenomenon known as galactorrheawhich usually occurs in women but can also occur occasionally in men.

Definition of galactorrhea

Galactorrhea refers to the secretion of milk through the mammary gland after the puerperal period.This is six to eight weeks after delivery. In addition, this must remain for at least six months. Although, it is true that in certain women who have gone through several births, this phenomenon may occur without meaning that there is an underlying disease.

Galactorrhea cannot be considered a disease as such, but a sign that the person may be suffering from some other condition, usually producing secretion through both breasts.

This phenomenon is particularly prevalent in women between 20 and 35 years of age with previous pregnancies.. However, there are cases of galactorrhea present at other ages, in children and even in men.

As a general rule, between 20% and 25% of women with normal menstrual cycles and normal hormone levels experience galactorrhea at some point in their lives.

Symptoms of galactorrhea

Although galactorrhea is considered a sign of a larger disorder, it may be accompanied by other associated symptoms. These symptoms can be very varied in terms of type, frequency of occurrence, etc., depending on the causes of the galactorrhea itself.

The most common symptom signs are:

• Variations during menstruation.Irregular cycles or lack of menstrual cycle.
• Sensitivity to temperature changes
• Increased thirst and urge to urinate
• Headaches
• Vision problems such as blurred vision, double vision, or lack of vision.
• Erection problemserectile dysfunction and lack of sexual desire in men
• Acne and appearance of body hair

Causes

Apart from pathological circumstances, the production of milk in the breasts is caused by several hormones, among them prolactin plays the most important role.. This hormone is formed in a gland called the pituitary gland, which is located at the base of the skull. In addition, another hormone called placental lactogen is also involved.

Galactorrhea is caused by an imbalance in the production of these two hormones. This alteration can have numerous causes, although the truth is that in half of the cases the cause remains undetermined. The most common reasons for this phenomenon are:

• Appearance of tumors in the pituitary gland..
• Side effect of the consumption of some drugs. These drugs usually belong to the groups of antipsychotics, antidepressants, antihypertensives, opiate drugs, antivomitives and anovulatory drugs.
• Endocrine conditions that alter hormone production, such as primary hypothyroidism.
• Excessive nipple stimulation.
• Physical and psychological stress.
• Chronic kidney disease.
• Hepatic cirrhosis.
• Local breast infections.
• Hypothalamic alterations that alter the correct regulation of hormone release.
• Thoracic injuries or surgeries..
• Other conditions such as polycystic ovaries, hyperthyroidism, spinal cord injuries, etc.

Diagnosis

The first step in the diagnosis of galactorrhea is to rule out the fact that the secretion is of a kind other than lactic.. The reason is that any other type of discharge, with traces of blood, purulent or greenish tone are a sign of other important diseases such as breast cancer, so it is vital to go to a health center as soon as the discharge is detected.

The correct diagnosis of galactorrhea should include the preparation of a clinical history as thorough as possible, including the patient's menstrual history, in the case of a woman, to rule out the possibility that it is due to pregnancy. In addition, to investigate sterility, impotence or variations in sexual appetite.

In addition, a physical examination a physical examination for signs of any other disease such as hypothyroidism and a history of such as hypothyroidism and ask for a drug history to rule out this possible cause.

A Blood test is then necessary to check thyroid hormone and prolactin levels in the blood. As deemed necessary by the clinician, other tests such as urinalysis or chest and abdominal films may be performed.

If all of the above causes are excluded, prolactinoma is very likely to be present. Prolactinoma is a benign tumor that lodges in the pituitary gland.Although it is much more likely to occur in women, when it occurs in men it is more pernicious.

If galactorrhea is manifested together with very high concentrations of prolactin in the blood, some type of sexual dysfunction, infertility or hypogonadism, it is logical to assume that it is a prolactinoma; therefore, the specialist should perform a brain MRI to confirm the existence of a tumor.

Treatment

The intervention to be followed in cases of patients presenting galactorrhea will depend on the causes of the galactorrhea. In the case of isolated galactorrhea without high levels of prolactin in the blood, the most common is that it disappears in a natural way.no treatment is necessary.

The exception would be cases in which the secretion causes great discomfort, in which case the protocol calls for the administration of dopaminergic agonists, which increase the level of dopamine in the blood, a hormone that inhibits the formation of prolactin.

Likewise, when this phenomenon is associated with any other disease, the symptoms will subside when the main condition is treated. In the case that galactorrhea is produced by the effects of a drug, the suppression of the drug or a reduction in the dose should be sufficient for the symptoms to remit.

In people in whom the MRI does not detect the presence of a prolactinoma, it is necessary to undergo periodic check-ups to rule out the appearance and growth of a pituitary tumor.

Finally, in cases of prolactinoma, surgery is performed to remove the tumor,together with the administration of specific drugs and radiotherapy. and radiotherapy.