Galactorrhea

Diagnosis

It can be hard to find the cause of galactorrhea because there are so many possible reasons for it.

Testing may involve:

• A physical exam. A healthcare professional may try to get some of the fluid from the nipple by gently squeezing the area around the nipple. This exam may include looking for breast lumps or other areas of thickened breast tissue.
• A blood test. This is to check the level of prolactin in your system. If your prolactin level is high, your healthcare professional may check your thyroid-stimulating hormone level, too.
• A pregnancy test. This is to rule out pregnancy as a cause of nipple discharge.
• Diagnostic mammography, ultrasound or both. You may have these imaging tests if your healthcare professional finds a breast lump or sees other breast or nipple changes during your physical exam.
• MRI of the brain. This is to check for a tumor or other issue of your pituitary gland if your blood test shows a high prolactin level.

Treatment

When needed, galactorrhea treatment aims to resolve the underlying cause.

Sometimes healthcare professionals can't find an exact cause of galactorrhea. Then you may have treatment if your nipple discharge bothers you. A medicine that blocks the effects of prolactin or lowers your body's prolactin level could help get rid of galactorrhea.

Underlying cause	Possible treatment
Medicine use	Stop taking medicine, change dose or switch to another medicine. Change medicines only if your healthcare professional says it's OK to do so.
Underactive thyroid gland, called hypothyroidism	Take a medicine, such as levothyroxine (Levoxyl, Synthroid, others), to help your thyroid gland make enough hormones. This is called thyroid replacement therapy.
Pituitary tumor, called prolactinoma	Take a medicine to shrink the tumor or have surgery to remove it.
Unknown cause	Try a medicine, such as bromocriptine (Cycloset, Parlodel) or cabergoline, to lower your prolactin level and lessen or stop milky nipple discharge. Common side effects of these medicines include nausea, dizziness and headaches.

Lifestyle and home remedies

Often, milky discharge linked with idiopathic galactorrhea goes away on its own. This is most likely if you don't handle your breasts a lot or take medicines that are known to cause nipple discharge.

To lessen breast stimulation:

• Try not to overdo touching the nipples during sexual activity.
• Avoid squeezing, pinching or otherwise handling your nipples.

Preparing for your appointment

You're likely to start by seeing your main healthcare professional or gynecologist. But you may be sent to a breast health specialist instead.

What you can do

To prepare for your appointment:

• Take note of all your symptoms, even if they don't seem linked to the reason for which you made the appointment.
• Review key personal information, including major stresses or recent life changes.
• Make a list of all medications, vitamins and supplements that you take, including how much you take and when you take them.
• Write down questions to ask your healthcare professional.

For galactorrhea, possible questions to ask include:

• What's likely causing my symptoms?
• Are there other possible causes?
• What tests might I need?
• What treatment approach do you suggest for me?
• Are there any at-home treatments I might try?

What to expect from your doctor

Your healthcare professional may ask you questions, such as:

• What color is your nipple discharge?
• Does nipple discharge come from one or both breasts?
• Do you have other breast symptoms, such as a lump or area of thickening?
• Do you have breast pain?
• How often do you do breast self-exams?
• Have you found any breast changes?
• Are you pregnant or breastfeeding?
• Do you still have regular menstrual periods?
• Are you having trouble getting pregnant?
• What medications do you take?
• Do you have headaches or trouble seeing?

What you can do in the meantime

Until your appointment, follow these tips to deal with unwanted nipple discharge:

• Don't handle your breasts. This can help to ease nipple discharge. For instance, don't rub your nipples during sex. Don't wear clothing that rubs on your nipples.
• Use breast pads. Small pads worn in the bra can soak up nipple discharge and prevent it from seeping through your clothes.