Galactorrhea is the medical term for milk discharge from the breast not associated with pregnancy or breastfeeding. While lactation typically occurs during pregnancy or after childbirth, galactorrhea can affect individuals of any gender or reproductive status. This article explores the causes of galactorrhea, including the potential role of birth control.
What is Galactorrhea?
Galactorrhea is the secretion of milky discharge from the breast not associated with childbirth or nursing. This discharge can be spontaneous or expressed, occurring from one or both breasts. While most commonly affecting women, including those who have never been pregnant or have gone through menopause, galactorrhea can also occur in men and even infants. The discharge is typically milky white, but it can also appear yellowish or greenish.
Milk production is primarily regulated by prolactin, a hormone secreted by the pituitary gland. Elevated levels of prolactin, known as hyperprolactinemia, are a frequent underlying cause of galactorrhea. Although often benign, galactorrhea can sometimes signal an underlying health condition that warrants investigation.
Birth Control’s Connection to Lactation
Hormonal birth control methods, such as combined oral contraceptives, progestin-only pills, injections, and implants, can influence hormone levels. Estrogen, a component in many combined contraceptives, can stimulate prolactin production. This may lead to galactorrhea in some individuals, though it is considered an uncommon side effect.
Galactorrhea has also been observed more frequently after discontinuing oral contraceptive pills than during their prolonged use. While birth control can theoretically cause galactorrhea by affecting hormone levels, it is often due to an existing underlying condition that becomes unmasked rather than solely caused by the contraceptive.
Other Reasons for Unexplained Lactation
Beyond birth control, numerous other factors can lead to galactorrhea.
Medications
Certain medications are common culprits, as they can interfere with dopamine’s inhibitory effect on prolactin. These include some antidepressants, antipsychotics, blood pressure medications, opioids, and certain heartburn medications.
Medical Conditions
Pituitary Gland Tumors: Prolactinomas are non-cancerous tumors that secrete excessive prolactin, directly causing milk production.
Hypothyroidism: An underactive thyroid gland can lead to galactorrhea because elevated thyrotropin-releasing hormone (TRH) levels can stimulate prolactin release.
Chronic Kidney Disease: This condition can impair the body’s ability to clear prolactin from the system.
Other Factors
Excessive breast stimulation, such as from frequent self-exams or sexual activity, and significant stress can also trigger galactorrhea by impacting prolactin regulation.
When to Consult a Healthcare Provider
Consult a healthcare provider if you experience persistent or spontaneous milky discharge from one or both breasts and are not pregnant or breastfeeding. While galactorrhea is often benign, a medical evaluation is important to identify any underlying conditions that might require treatment. Seeking medical attention is particularly important if the discharge is accompanied by other symptoms such as headaches, vision changes, or irregular menstrual periods.
A healthcare provider will typically begin with a detailed medical history, including current medications, and a physical breast examination. They may order blood tests to measure prolactin levels and assess thyroid function. Depending on the findings, imaging tests like an MRI of the brain might be recommended to check for pituitary tumors. Treatment for galactorrhea depends on identifying and addressing its specific underlying cause.