Galactorrhea or galactorrhoea is the spontaneous flow of milk from the breast, unassociated with childbirth or nursing. It can be due to local causes or dysregulation of certain hormones.
Lactation requires the presence of estrogen, progesterone and prolactin, and the evaluation of galactorrhea includes eliciting a history for various medications (methyldopa, opiates, some atypical antipsychotics) and for behavioral causes (including licorice, stress, and breast and chest wall stimulation), as well as evaluation for pregnancy, pituitary adenomas (with overproduction of prolactin or compression of the pituitary stalk), and hypothyroidism. Overproduction of prolactin leads to cessation of menstrual periods and infertility, which may be a diagnostic clue.
Galactorrhea is the secretion of breastmilk in men, or in women who are not breastfeeding an infant.
Galactorrhea, or hyperlactation, however, is a rare condition that can occur in both men and women, where a white or grayish fluid is secreted by the nipples of both breasts.
The primary symptom of galactorrhea is the discharge of milky fluid from both breasts.
Galactorrhea is a reflection of an underlying endocrine disorder and is not associated with breast cancer or other mass lesions.
Galactorrhea has been recognized as an entity for thousands of years, but the first "modern" recognition of the common co-occurrence of galactorrhea and amenorrhea was reported by Chiari in 1855 and Frommel in 1882 103.
In the mid-20th century it was suggested that galactorrhea was caused by pituitary tumors that secreted prolactin, and in the 1970's when immunoassays for prolactin were developed, the connection between hyperprolactinemia and galactorrhea was confirmed 86.
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