Galactorrhea
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Galactorrhea or
galactorrhoea is the spontaneous flow of
milk from the
breast, unassociated with
childbirth or nursing. It can be due to dysregulation of certain
hormones or local causes such as excessive nipple stimulation.
Lactation requires the presence of
estrogen,
progesterone and
prolactin, and the evaluation of galactorrhea includes eliciting a history for various medications (
methyldopa,
opiates, some typical
antipsychotics) and for behavioral causes (including
licorice, stress, and breast and chest wall stimulation), as well as evaluation for pregnancy,
pituitary adenomas (with overproduction of
prolactin or compression of the pituitary stalk), and
hypothyroidism. Overproduction of prolactin leads to cessation of menstrual periods and
infertility, which may be a diagnostic clue.