Galactorrhea: Symptoms, Causes, and Management

What is galactorrhea?

Galactorrhea refers to a condition where your nipples secrete a milky fluid that resembles breast milk, except you aren't pregnant or nursing. While this condition may be relatively painless and often benign, there could be serious underlying causes. Galactorrhea happens when your hormones are out of balance and can indicate problems with your thyroid gland. It’s important to note that this condition isn’t limited to just women — men and newborns are also susceptible to it.

The thyroid is part of your endocrine (hormone) system and secretes three different hormones, each responsible for an aspect of regulating your metabolism. These hormones are also responsible for development cues, such as the changes your body makes when pregnant and breastfeeding.

Symptoms of galactorrhea

The most obvious symptom of galactorrhea is secretions from your nipples. The secretions can be a little messy and a cause for concern for some women. Irregular menstrual cycle is a symptom that may accompany galactorrhea, as both can be caused by the same underlying condition.

Your doctor may order blood tests to determine the levels of estrogen in your blood, because low estrogen levels are also associated with galactorrhea.

If you notice persistent milky leakage from one or both breasts or heavier nipple discharge involving more than one milk duct, you probably have galactorrhea. It can affect one or both breasts, and leakage can occur spontaneously, without stimulation. Other times, manual palpation of the breasts results in discharge. You may also notice headaches or vision problems in conjunction with these symptoms; these can indicate a more serious underlying condition.

What causes galactorrhea?

One of the main causes of galactorrhea is hormones — specifically, an imbalance of two hormones secreted from the thyroid that regulate metabolism and development. Hormone imbalances can also affect sex drive.

Another cause of galactorrhea is hormonal, but is caused by a disorder in the pituitary gland. The pituitary gland is also part of your endocrine system and is responsible for regulating the male and female hormones in your body, including those that cue ovulation and stimulate breast milk production.

Side effects of certain medications for both men and women, infants who still have traces of estrogen and progesterone from their mother at birth, and overstimulation of the breasts can also result in galactorrhea. The exact causes aren’t always known, and sometimes the issue resolves itself. Other times, you’ll need medical intervention.

More serious underlying medical conditions can include breast cancer, kidney disease, and injuries to the chest or spinal cord. Heavy opioid users may also experience this condition.

How galactorrhea is diagnosed

A doctor can diagnose this condition. If the only discharge you notice, as a woman, is a small amount of milky substance during sexual activity, then you probably don’t have much to worry about, especially if there is no breast pain. But it’s still a good idea to consult your doctor to be on the safe side. 

Women will also receive a pregnancy test to rule this out as a cause. It’s a common side effect of the hormonal changes that occur during the second and third trimesters of pregnancy.

During the exam, your doctor will physically examine your breasts and express fluid from each. Depending on what the doctor decides, you may need a mammogram for a better look at the tissue or to detect any unusual lumps or bodies. The fluid expressed from your breasts will be sent to a lab. You’ll also have a blood test to check for amounts of prolactin. You may also have an MRI to examine your brain (the pituitary gland) and neck and throat area (where the thyroid is located).

Galactorrhea in males

Men with low testosterone may have a condition known as gynecomastia. This happens when male hormones drop and breast tissue — separate from simply gaining fat in the chest — occurs. Other symptoms alongside galactorrhea include erectile dysfunction and diminished libido.

Men are also susceptible to thyroid disorders and pituitary tumors, just like women.

Galactorrhea in newborns

Sometimes a newborn baby will have galactorrhea. This happens if the mother has high estrogen levels and the estrogen crosses through the placenta to the baby’s bloodstream. The baby's breast tissue will become enlarged. The sex of the baby doesn’t matter; this condition can affect any baby. The excess estrogen in the baby will cause their breast tissue to swell and produce a milky discharge. It’s temporary and should resolve itself on its own. If it doesn't, however, speak with your pediatrician.

Treatment for galactorrhea

Treating galactorrhea depends on who has it and what the underlying cause is. For men, a blood test to determine their levels of testosterone will give the doctor an idea of whether to simply prescribe testosterone supplements or to have a more aggressive intervention to reduce gynecomastia and eliminate the discharge. If a man has a pituitary tumor, then more aggressive treatment may be needed, possibly including surgery.

Determining the cause of galactorrhea is the first step towards getting treatment. If you’re pregnant, then there isn’t a cause for concern. You may wish to purchase nipple shields to prevent the discharge from leaking through your bra to your clothing. 

If your condition is caused by prescription medication, opioid use, or even supplements such as fennel, your doctor will recommend the best way to stop using the substance. This may mean prescribing a new medicine, eliminating the supplement, or helping you find treatment for opiate addiction.

For galactorrhea caused by an underactive thyroid, you’ll probably be prescribed medication to improve its function. This may also help you feel less tired, reduce cravings for unhealthy food, and find the energy to get more exercise. Underactive thyroids are associated with sluggishness and a slower metabolism. If you have a pituitary tumor, either medicine or surgery will be used to reduce or remove it.

Galactorrhea caused by overstimulation of the nipples can be treated by taking care of this sensitive part of your body. Reduce nipple stimulation during sexual activity and consider wearing nipple shields in your bra to reduce friction. For men, consider a compression undershirt or other protection, such as runner's guards. Avoid shirts made of rough or scratchy fabric. 

When to seek medical help

There are a few occasions where you should schedule an appointment with a gynecologist as soon as possible. If the discharge is thick and contains blood or thick yellowish fluid, you should see a doctor immediately. Likewise, if you feel a lump in your breast, you need to have a further examination. 

Discharge from your nipples may be harmless, or it could indicate a serious underlying health condition. For men, a visit to the doctor is always advised. Women should speak to their gynecologist about any unusual secretions or lumps in their breast tissue.