Galactorrhea is considered one of the disturbing manifestations of the mammary gland – the secretion of milk or liquid similar to it outside the lactation period. The severity of discharge varies greatly: from a couple of drops on linen to a rather active discharge of liquid. A similar problem is associated with an imbalance of hormones, which is often the case with pituitary adenoma, medication or thyroid gland disorders. There are other reasons.
Galactorrhea or lactation?
The breast of a woman is a special gland, it is intended by nature for feeding children after their birth. In order to carry out this function even in the period of pregnancy under the action of specific hormones, changes in the tissues are formed, which, after giving birth, trigger lactation. From the moment the baby is born, lactation begins with the release of colostrum, then turning into the release of mature milk. Lactation lasts a different time – from several months to a couple of years, depending on how long the mother is breastfeeding. As breastfeeding collapses, lactation fades away and the breast becomes functionally inactive. Slight discharge of liquid similar to colostrum for several months after completion is acceptable. lactation, but its volume is negligible. If milk or fluid is detected, it is colostrum-like in a non-pregnant and unborn woman, or one whose children have long grown and are not breastfeeding, this is referred to as pathology, which is called galactorrhea.
The mechanism of galactorrhea: the effect of hormones
Galactorrhea is divided into unilateral or bilateral (from one or both glands), and it is mainly formed in women of reproductive age, less often in those who have entered menopause. In men, this is extremely rare, and it always says that the body’s hormones are significantly changed, and there is a serious pathology. Among women, this phenomenon is observed in 15-20%, depending on age, and this condition always requires examination.
The origin of galactorrhea is easier to understand if you figure out how hormones affect lactation, and breast milk is formed in normal conditions. Its secretion is stimulated by prolactin, a special hormone that is secreted in the pituitary gland, a special gland of the brain. Prolactin is secreted by the action of another endocrine gland, the hypothalamus. In addition, stimulation of milk synthesis is also supplemented by reflex irritation of the breast during sucking a child. After completion of feeding, this process is gradually suppressed for 4-5 months, and the breast stops producing milk.
Additional stimuli for the activation of prolactin are also hormones that regulate the functioning of the thyroid gland (thyrotropic), respectively, problems of the thyroid gland can lead to galactorrhea.
Pituitary adenoma as the cause of galactorrhea
When excessive secretion of prolactin occurs, the launch of mechanisms similar to the process of lactation in the chest. This is possible with the development of pituitary adenoma, which produces hormones. However, not all tumor formations can lead to the formation of a secret in the breast, but only hormonally active pituitary adenoma, which synthesizes prolactin – prolactinoma. It belongs to benign processes, not turning into cancer, but leads to the fact that an excess of secreted hormone affects the formation in the breast fluid, like milk. Such education occurs in the overwhelming number of women with adenomas, it grows slowly or does not grow at all. However, pituitary adenoma leads, in addition to galactorrhea, due to an excess of prolactin, also to menstrual dysfunction and infertility. In addition, there may be androgenic manifestations with male-pattern hair growth and the appearance of acne on the skin.
Medication as a reason for excretion of milk.
Often, increased prolactin levels are stimulated by some drugs that are used in the treatment of certain pathologies. Hyperprolactinemia (an increase in the level of prolactin in the blood) is usually a side effect of therapy, and you should always remember these nuances when prescribing. The main drugs that are capable of such effects are dopamine antagonists, cimetidine, or antidepressants. In addition, drugs that contain estrogen (including some of the types of oral contraceptives), as well as opiate drugs, can have a similar effect. verapamil or reserpine. Due to their metabolism in the body, they lead to an increase in the level of prolactin, which can cause the development of galactorrhea. It usually stops after drug withdrawal at the end of the course of treatment.
Thyroid problems
Galactorrhea can be observed in certain pathologies in which the thyroid gland and its hormone production are affected. It is most likely during the formation of hypothyroidism, when the thyroid gland functions are sharply reduced, and to stimulate the hypothalamus it produces elevated concentrations of thyroid stimulating hormone (TSH). The same hormone affects the synthesis of prolactin, which leads to the secretion of breast fluid, like milk.
Typically, manifestations of reduced thyroid function are fairly typical – this is the formation of apathy and constant sleepiness, the development of edema, hair loss on the head and body, weight gain. Against this background, there may be changes in the chest with the phenomenon of galactorrhea.
Much less often, an increase in the level of TSH can lead to hyperfunction of the thyroid gland (hyperthyroidism), which results in pronounced weight loss with a bug-eye, an increase in body temperature and palpitations, sweating and trembling hands. In such states, galactorrhea is less typical, and its manifestations are usually minor.
Against the background of the treatment of pathologies in which the thyroid gland suffers, and the normalization of the level of both tropic hormones and those produced by it, galactorrhea disappears without a trace. Treatment should be carried out strictly under the supervision of an endocrinologist and only after detailed laboratory and instrumental diagnostics.