Galactorrhea is relatively common in women: as many as 20%-25% of all women are affected at some point in their lives. Men can rarely have galactorrhea, most often from medications.
Galactorrhea may occur unilaterally or bilaterally. The discharge can have different colors (white, yellow, or green). Typically, blood is not present.
Risk factors for galactorrhea include the use of medication from certain classes (most commonly antipsychotics with antidopaminergic properties), as well as other medical conditions, such as hypothyroidism, hypothalamic-pituitary disorders, and chest wall irritation.
Pediatric Patient Considerations:
Galactorrhea can be physiologic in the first month of life.
O92.6 – Galactorrhea
78622004 – Galactorrhea not associated with childbirth
- Pregnancy – Pregnancy should always be considered. Unless the patient is postmenopausal or has had a hysterectomy, a pregnancy test is indicated.
- Prolactinoma – A pituitary tumor can secrete excess prolactin; may be identified on MRI of the brain.
- Medication side effect – Particularly with antipsychotic medications, but galactorrhea may also be seen with other medications and some herbal supplements.
- Hypothyroidism – May result in secondary hyperprolactinemia; detected by high thyrotropin level and low T4 level.
- Cushing disease – Hypercortisolism may result in secondary hyperprolactinemia; determined with 24-hour urine cortisol level.
- Acromegaly – Increased growth hormone from the pituitary may be associated with hyperprolactinemia; determined with serum growth hormone level.
- Chest wall irritation – Chest wall irritation from clothing or ill-fitting brassieres, herpes zoster, or atopic dermatitis may produce galactorrhea, as may breast implant surgery or reduction mammoplasty.
- Excessive nipple stimulation