Galactorrhoea

Question 1

What is Galactorrhoea?

Answer 1

Copious, bilateral, multi-ductal, milky discharge not associated with pregnancy or lactation

Question 2

What hormone primarily regulates lactation?

Answer 2

Prolactin

Question 3

What are the causes of galactorrhoea?

Answer 3

Hyperprolactinaemia due to idiopathic, pituitary adenoma, medications such as SSRIs, antipsychotics, H2 antagonists as stimulate prolactin release, neurological (inhibit dopamine levels) Hypothyroidism, renal failure or liver failure, pituitary stalk damage, or normoprolactinomaeic galactohoea,

Question 4

What are the clinical features of galactorrhoea?

Answer 4

multi-ductal milky white nipple discharge usually bilateral, may also get breast lumps, mastalgia, last menstual period

Question 5

What investigations should be done for galactorrhoea?

Answer 5

HCG to check for pregnancy, serum prolactin levels, thyroid function, liver function, renal function tests, endocrine tests, MRI head with contrast (pituitary tumour) breast imaging if palpable lumps or lymph nodes

Question 6

What is the management for galactorrhoea?

Answer 6

Treat cause, if pituitary tumour then dopamine agonist therapy and then potential sphenoidal surgery, bilateral total due excision