Galactorrhea: Symptoms, Causes, Diagnosis And Treatment
One of the main characteristics of humans as mammalian animals is the development of mammary glands, whose only function is to provide food for their 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 milk secretion can cause a phenomenon known as galactorrhea which usually occurs in women but can also occur occasionally in men.
Galactorrhea refers to the secretion of milk through the mammary gland once the puerperal period has passed , that is, between six and eight weeks after delivery. Furthermore, this must remain for at least six months. Although, it is true that in certain women who have gone through several births this phenomenon can occur without it meaning that there is an underlying disease.
Galactorrhea cannot be considered a disease as such, but rather a sign that the person may be suffering from some other condition, with secretion usually occurring through both breasts.
This phenomenon occurs particularly 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 hormonal levels experience galactorrhea at some point during their lives.
Symptoms of galactorrhea
Although galactorrhea is considered a sign within a larger disorder, it can be accompanied by other associated symptoms. These symptoms can be very varied in terms of type, frequency of appearance, etc., depending on the causes of galactorrhea itself.
Outside of pathological circumstances, the production of milk in the breasts is caused by several hormones and of them prolactin is the one that has a more relevant role This hormone is formed in a gland called the pituitary gland, which is located at the base of the skull. In addition, the action of another hormone called placental lactogen also intervenes.
The cause of galactorrhea is due to 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 why this phenomenon appears are:
Diagnosis
The first step in diagnosing galactorrhea is to rule out that said secretion is not of any other kind than milky The reason is that any other type of secretion, with traces of blood, purulent or greenish in tone, is a sign of other important diseases such as breast cancer, so it is vitally important to go to a health center as soon as the infection is detected. secretion.
The correct diagnosis of galactorrhea must include the preparation of a medical history that is as thorough as possible, which includes the patient’s menstrual history, if she is a woman, to rule out the possibility that it is due to pregnancy. In addition, investigating sterility, impotence or variations in sexual appetite.
Likewise, it must be done a physical examination looking for signs that indicate any other illness such as hypothyroidism and request a drug history to rule out this possible cause.
Next, it is necessary to perform a blood test to check the levels of thyroid hormones and prolactin in the blood. As the specialist clinician deems necessary, other tests such as urine analysis or chest and abdominal films can be carried out.
If all the above causes are excluded, it is very likely that it is a prolactinoma. Prolactinoma is a benign tumor that lodges in the pituitary gland and although it is much more likely to occur in women, when it occurs in men it does so in a more pernicious way.
If galactorrhea appears 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 must perform a brain MRI to confirm the existence of a tumor.
Treatment
The intervention to follow in cases of patients who present galactorrhea will depend on its causes. In the event that this occurs in isolation and without high levels of prolactin in the blood, The most common thing is that it disappears naturally not being necessary any type of treatment.
The exception would be cases in which the secretion causes great discomfort, in which case the protocol requires the administration of dopamine 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 event that galactorrhea is caused by the effects of a drug, its suppression or a reduction in the dose should be sufficient for the symptoms to subside.
In people in whom 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,along with the administration of specific drugs and radiotherapy.
