Galactorrhea: Difference between revisions
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==Overview== | ==Overview== | ||
'''Galactorrhea''' or '''galactorrhoea''' is the spontaneous flow of [[milk]] from the [[breast]], unassociated with [[childbirth]] or nursing. | '''Galactorrhea''' or '''galactorrhoea''' is the spontaneous flow of [[milk]] from the [[breast]], unassociated with [[childbirth]] or nursing. Contemporary Maternal-Newborn Nursing Care defines galactorrhea as "[[nipple discharge]]." <ref>Ladewig, P., London, M., Davidson, M. (2006). ''Contemporary Maternal-Newborn Nursing Care'' (6th ed.). New Jersey: Pearson Education, Inc. ISBN 0131703927.</ref> | ||
==Causes== | |||
== | |||
It can be due to dysregulation of certain [[hormone]]s or local causes such as excessive nipple stimulation. | It can be due to dysregulation of certain [[hormone]]s or local causes such as excessive nipple stimulation. | ||
Lactation requires the presence of [[estrogen]], [[progesterone]] and [[prolactin]], and the evaluation of galactorrhea includes eliciting a history for various medications or foods ([[methyldopa]], [[opiates]], some typical [[antipsychotic]]s, as well as [[licorice]]) and for behavioral causes (stress, and breast and chest wall stimulation), as well as evaluation for pregnancy, [[pituitary adenoma]]s (with overproduction of [[prolactin]] or compression of the pituitary stalk), and [[hypothyroidism]]. Adenomas of the anterior pituitary are most often prolactinomas. Overproduction of prolactin leads to cessation of menstrual periods and [[infertility]], which may be a diagnostic clue. Galactorrhea may also be caused by hormonal imbalances owing to birth control pills. | Lactation requires the presence of [[estrogen]], [[progesterone]] and [[prolactin]], and the evaluation of galactorrhea includes eliciting a history for various medications or foods ([[methyldopa]], [[opiates]], some typical [[antipsychotic]]s, as well as [[licorice]]) and for behavioral causes (stress, and breast and chest wall stimulation), as well as evaluation for pregnancy, [[pituitary adenoma]]s (with overproduction of [[prolactin]] or compression of the pituitary stalk), and [[hypothyroidism]]. Adenomas of the anterior pituitary are most often prolactinomas. Overproduction of prolactin leads to cessation of menstrual periods and [[infertility]], which may be a diagnostic clue. Galactorrhea may also be caused by hormonal imbalances owing to birth control pills. Galactorrhea is also a side effect associated with the use of the second-generation [[H2 receptor antagonist]] [[Cimetidine]] (trade name: Tagamet). | ||
Galactorrhea is also a side effect associated with the use of the second-generation [[H2 receptor antagonist]] [[Cimetidine]] (trade name: Tagamet). | |||
== | == Differentiating Galactorrhea from other Diseases == | ||
In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref> | In alphabetical order. <ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref> | ||
Revision as of 17:52, 19 September 2012
| Galactorrhea | |
| ICD-10 | N64.3, O92.6 |
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| ICD-9 | 611.6, 676.6 |
| DiseasesDB | 6314 |
| MeSH | D005687 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Synonyms and keywords: Galactorrhoea-Hyperprolactinaemia; hyperlactation; hyperprolactinaemia; lactation, increased; galactorrhea-hyperprolactinemia
Overview
Galactorrhea or galactorrhoea is the spontaneous flow of milk from the breast, unassociated with childbirth or nursing. Contemporary Maternal-Newborn Nursing Care defines galactorrhea as "nipple discharge." [1]
Causes
It can be due to dysregulation of certain hormones or local causes such as excessive nipple stimulation.
Lactation requires the presence of estrogen, progesterone and prolactin, and the evaluation of galactorrhea includes eliciting a history for various medications or foods (methyldopa, opiates, some typical antipsychotics, as well as licorice) and for behavioral causes (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. Adenomas of the anterior pituitary are most often prolactinomas. Overproduction of prolactin leads to cessation of menstrual periods and infertility, which may be a diagnostic clue. Galactorrhea may also be caused by hormonal imbalances owing to birth control pills. Galactorrhea is also a side effect associated with the use of the second-generation H2 receptor antagonist Cimetidine (trade name: Tagamet).
Differentiating Galactorrhea from other Diseases
In alphabetical order. [2] [3]
- Drugs
- Fibrocystic Disease
- Hyperprolactinemia
- Idiopathic (with menses)
- Inflammation
- Intraductal papilloma
- Malignant neoplasm
- Oral contraceptives
- Recently preceded pregnancy
- Trauma
References
- ↑ Ladewig, P., London, M., Davidson, M. (2006). Contemporary Maternal-Newborn Nursing Care (6th ed.). New Jersey: Pearson Education, Inc. ISBN 0131703927.
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
- ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X