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Galactorrhea

Definition:

Galactorrhea is a discharge of milk or a milk-like secretion from the breast in the absence of parturition or beyond six months' post-partum in a nonbreastfeeding woman. The condition is more common in women who are 20 to 35 years of age and in previously parous women. It is less common in children and nulligravid women. Galactorrhea also can occur in men. After infancy, galactorrhea usually is medication-induced. The most common pathologic cause of galactorrhea is a pituitary tumor. Other causes include hypothalamic and pituitary stalk lesions, neurogenic stimulation, thyroid disorders, and chronic renal failure. Tests for pregnancy, serum prolactin level and serum thyroid-stimulating hormone level, and magnetic resonance imaging are important diagnostic tools that should be employed when clinically indicated. The decision to treat patients with galactorrhea is based on the serum prolactin level, the severity of galactorrhea, and the patient's fertility desires. Dopamine agonists are the treatment of choice in most patients with hyperprolactinemic disorders. Medications causing hyperprolactinemia should be discontinued or replaced with a medication from a similar class with lower potential for causing hyperprolactinemia. For women who cannot breastfeed after childbirth for some reasons, various pharmacologic and nonpharmacologic interventions have been used to suppress lactation and relieve associated symptoms. Pharmacological options mainly involve dopamine agonist medications.

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