Galactorrhoea is the term for the flow of milk from the nipples in those who are not breastfeeding. It can happen in women who are not pregnant or breastfeeding, and sometimes in men, as well. It is typically caused by hormonal abnormalities, such as excess prolactin, but there are other causes, as well.
In order to produce breast milk, is it necessary to have prolactin, which is a pituitary hormone. Excess production of this hormone can lead to the issue of galactorrhoea. There are certain medications that may increase prolactin in a patient, such as beta blockers, antidepressants, contraceptives, danazol, haloperidol, cimetidine, sumatriptan, and valproate, to name a few. Additionally, illegal drugs like opiates, cannabis, and amphetamines can produce nipple discharge, as can herbal supplements like fennel, nettle, red raspberry, marshmallow, anise, red clover, and more. Patients with galactorrhoea will likely be asked by their doctor whether they have taken such drugs in the past, as this is often the most common cause of the condition.
If the nipple discharge is bilateral, or expressed from both nipples, it is usually treated as a hormonal problem. On the other hand, there are other causes of galactorrhoea and increased prolactin levels overall. They include high stress levels, renal failure, hypothyroidism, Cushing's disease, acromegaly, and breast stimulation, such as excessive sucking. Another hint that helps doctors diagnose increased prolactin levels is the absence of menstruation and ensuing infertility, since these traits can be caused by excessive prolactin. Additionally, newborn babies can get this condition from their mother before birth due to exposure to certain hormones, but no treatment is needed in such cases since it typically goes away on its own in infants.
On the other hand, discharge from just one nipple is typically not caused by increased prolactin levels. Instead, local breast disease could be the culprit, in which case the patient is usually examined closely to check for lumps, nodes, and whether the discharge is milky or blood-stained. If there is evidence to support possible breast disease, the patient is typically sent to a specialist. It should be noted that breast disease can also cause bilateral nipple discharge, not just unilateral, though it is rare.
Once the cause of galactorrhoea is determined, it can be treated by a medical professional. If drugs are considered the culprit of the condition, different medications will be prescribed. Some doctors also try hormone treatment, in which case females are given extra estrogen and males are given testosterone to try to decrease the symptoms.