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Galactorrhea

Sarah E. Barker, DO, Chandini Rathee, MD and Kelley V. Lawrence, MD, IBCLC, FAAFP, FABM Reviewed 06/2019
 


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:

    • Acromegaly

    • Adrenal insufficiency

    • Chest wall conditions

    • Hypothyroidism

    • Polycystic ovarian syndrome

HISTORY

  • Usually bilater...

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. [View Abstract on OvidMedline]
2
Pipaliya N, Solanke D, Rathi C, et al. Esomeprazole indu...

ADDITIONAL READING

Patel BK, Falcon S, Drukteinis J. Management of nipple discharge and the associated imaging findings. Am J Med.  2015;128(4):353–360. [View Abstract on OvidMedline] 

SEE ALSO

Hyp...

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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