Galactorrhea

What is galactorrhea?

Galactorrhea (guh-lack-toe-REE-uh) happens when your breasts unexpectedly produce milk or a milk-like discharge. This nipple discharge may leak from your breast on its own or when touched. It’s not related to milk production in breastfeeding (chestfeeding) or pregnancy. Galactorrhea sometimes indicates an underlying health condition, but is most often caused by too much prolactin. Prolactin is a hormone that triggers milk production. It’s made by your pituitary gland, a gland at the base of your brain.

Who does it affect?

Galactorrhea occurs most often in women or people assigned female at birth (AFAB), but can also develop in men or people assigned male at birth (AMAB) and children. It’s most common in people who are of reproductive age (between 20 and 35) and who have been pregnant.

How common is galactorrhea?

Galactorrhea may affect up to 20% of people assigned female at birth.

What is the most common cause of galactorrhea?

The most common cause of galactorrhea is a benign (not cancerous) tumor on your pituitary gland. The tumor causes your pituitary gland to make too much prolactin (hyperprolactinemia). Prolactin is the hormone responsible for milk production after you give birth. Excess prolactin tricks your body into thinking it should lactate (or make milk), which is why you leak milk from your nipples.

Other causes include:

• Taking medications including birth control pills, blood pressure medicine or antidepressants.
• Overstimulating your breasts (through sexual activity, clothing or frequent breast self-exams).
• Thyroid disorders.
• Chronic kidney disease.
• Taking herbal supplements like fenugreek or fennel seed.
• Using opioids.
• Injury or trauma to your spinal cord.

What are the symptoms of galactorrhea?

The main symptom of galactorrhea is leaking a light white, milk-like discharge when you’re not breastfeeding or pregnant. It typically affects both breasts and may flow if you squeeze your nipple or leak on its own.

Other symptoms associated with galactorrhea may include:

• Amenorrhea (infrequent or stopped menstrual periods).
• Vaginal dryness.
• Headache.
• Reduced sex drive.
• New hair growing on your chest or chin.
• Acne.
• Erectile dysfunction.

Is galactorrhea life threatening?

Not usually. Galactorrhea is a highly treatable condition. If your galactorrhea is caused by a tumor on your pituitary gland, it’s typically a noncancerous tumor that responds well to treatment.

Does galactorrhea cause weight gain?

Galactorrhea doesn’t cause weight gain. However, excess prolactin and thyroid disorders are both associated with weight gain. If you’re gaining weight and have galactorrhea, it may be due to increased prolactin and irregular thyroid function.

Is galactorrhea actually milk?

The milk that leaks from your breasts when you have galactorrhea is considered milk because it’s produced by the same hormone (prolactin) that makes breastmilk in people who’ve just given birth.

Can newborn babies get galactorrhea?

Yes, but this is rare. It’s caused by estrogen crossing into your baby’s blood while they’re in your uterus. It usually resolves on its own shortly after birth; but you should let your child’s pediatrician know.

Can men get galactorrhea?

Yes, men or people assigned male at birth (AMAB) can get galactorrhea. It’s sometimes seen in people with gynecomastia (enlarged breast tissue) or low testosterone (hypogonadism).

How is galactorrhea diagnosed?

Healthcare providers diagnose galactorrhea through some of the following:

• A physical exam of your breasts and nipples.
• Analysis of nipple discharge.
• Review of your medical history including medications you take.
• Blood test to check levels of prolactin (milk-producing hormone) in your body.
• Blood test to check your thyroid function.
• A pregnancy test.
• Imaging tests such as mammogram or ultrasound to examine breast tissue.
• Imaging tests called CT (computer tomography) scan and MRI (magnetic resonance imaging) to look for a tumor in or near your pituitary gland.

How is galactorrhea treated?

Treatment for galactorrhea varies depending on the cause of the condition. In some people, it goes away on its own without any treatment.

To manage the condition, your provider may also recommend:

• Taking medications like cabergoline and bromocriptine to lower prolactin levels.
• Avoiding actions or activities that overstimulate your nipples.
• Stopping or changing medications.
• Taking medication to treat underactive thyroid if you have hypothyroidism.
• Wearing clothing that's loose-fitting to reduce friction on your nipples.
• Wearing breast pads to absorb leakage.

In cases where a pituitary tumor causes galactorrhea, the tumor is usually benign (not cancerous). If the tumor doesn’t cause any other complications, your provider may determine that treatment is unnecessary.

If treating a pituitary tumor is necessary, it usually involves medication to shrink the tumor. In rare cases, you may need surgery or radiation therapy to remove or shrink a pituitary tumor.

What complications are associated with galactorrhea?

Some medicines used to treat galactorrhea may involve complications including infertility and vision problems.

Sometimes a pituitary tumor causes estrogen levels to decrease. People with low estrogen levels are at an increased risk of developing osteoporosis (fragile and brittle bones). Your provider may recommend taking oral contraceptives containing estrogen to decrease this risk.

How long can galactorrhea last?

This varies depending on the cause. Once you receive treatment for galactorrhea, the milky discharge should subside. Treatment may take longer if the source of your galactorrhea is a pituitary tumor that needs medication, surgery or radiation therapy.

Can galactorrhea be prevented?

It’s difficult to prevent galactorrhea. The following tips could reduce your risk of developing it:

• Repeatedly stimulating your breasts and nipples.
• Conducting breast exams more often than one time per month.
• Wearing clothes that rub or scratch your breasts.

What are the risk factors for galactorrhea?

People at higher risk for galactorrhea include women and people assigned female at birth between the ages of 20 to 35 and those who have previously given birth.

What is the prognosis (outlook) for people with galactorrhea?

Galactorrhea often goes away without treatment. Avoiding things that cause galactorrhea is the best way to keep it from occurring. If a pituitary tumor is causing the condition, your healthcare provider may want you to have a yearly CT or MRI to look for signs of growth.

When can I go back to my regular activities?

Most people with galactorrhea don’t have to stop their regular activities. Some people use breast pads (absorbent liners placed in your bra) to contain milk leakage under their clothes.

When should I call my healthcare provider?

Contact a healthcare provider if one or both of your breasts unexpectedly begin producing milk. It may be due to overstimulation, which will resolve on its own if you avoid touching your nipples and breasts. However, if the discharge persists and isn’t happening because you touch your breasts too much, call your provider for an appointment.

If your nipple discharge is bloody or dark yellow, or you feel a lump in your breast it may be a sign of a more serious condition.

What questions should I ask my healthcare provider?

If you have galactorrhea, you may want to ask your provider:

• What is causing my breasts to leak milk?
• What lifestyle changes can I make to stop it from occurring?
• If I have a tumor, how likely is it that I have cancer?
• If a tumor is causing galactorrhea, what are my treatment options?

A note from Cleveland Clinic

Galactorrhea is a condition that causes your breasts to leak milk when you aren’t pregnant or haven’t recently given birth. While it may be embarrassing, it’s not a life-threatening condition and goes away with treatment. Try wearing breast pads under your clothes to absorb accidental leaks until you can talk to your healthcare provider. Galactorrhea is more common than you think, so don’t hesitate to seek treatment for your symptoms.