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Galactorrhea

Christine K. Jacobs, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Milky nipple discharge not associated with gestation or present >1 year after weaning. Galactorrhea does not include serous, purulent, or bloody nipple discharge.

  • System(s) affecte...

DIAGNOSIS

  • Findings vary with causes.

  • Look for signs/symptoms of associated conditions:

    • Adrenal insufficiency

    • Acromegaly

    • Hypothyroidism

    • Polycystic ovarian syndrome

    • Chest wall conditions

HISTORY

  • Usually bilat...

TREATMENT

  • Avoid excess nipple stimulation.

  • Idiopathic galactorrhea (normal prolactin levels) does not require treatment.

  • Discontinue causative medications, if possible.

  • If SSRI is implicated, trial of mi...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Outpatient care unless pituitary resection required

  • Bromocriptine patients need adequate hydration.

  • Dopamine agonist therapy should be discontinued in pregnancy.

Patient Monitoring

REFERENCES

1 Molitch M. Diagnosis and treatment of pituitary adenomas: a review. JAMA.  2017;317(5):516–524.
2 Huang W, Molitch ME. Evaluation and management of galactorrhea. Am Fam Physician. ...

ADDITIONAL READING

  • Lake M, Krook L, Cruz V. Pituitary adenomas: an overview. Am Fam Physician.  2013;88(5):319–327.

  • Patel BK, Falcon S, Drukteinis J. Management of nipple discharge and the associa...

SEE ALSO

Hyperprolactinemia 

CODES

ICD10

  • N64.3 Galactorrhea not associated with childbirth

  • N64.52 Nipple discharge

ICD9

  • 611.6 Galactorrhea not associated with childbirth

  • 611.79 Other signs and symptoms in breast

SNOMED

  • 78622004 Galactor...

CLINICAL PEARLS

  • Galactorrhea is a common disorder, affecting up to 50% of reproductive-age women.

  • Common causes include idiopathic, from excess nipple stimulation, dopamine-suppressing medications, or ...

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