About galactorrhea-amenorrhea syndrome

What is galactorrhea-amenorrhea syndrome?

A prolactinoma is a benign tumor of the pituitary gland (adenoma) that produces an excessive amount of the hormone prolactin. In women, hyperprolactinemia is characterized by irregular menstrual periods (amenorrhea), infertility and production of breast milk in women who are not pregnant (galactorrhea). The most common symptom in men is impotence.

What are the symptoms for galactorrhea-amenorrhea syndrome?

Chiari-Frommel Syndrome is a rare disorder characterized by the abnormal production of breast milk (galactorrhea), and the absence of regular menstrual periods (amenorrhea) and ovulation (anovulatory) for more than 6 months after childbirth. These symptoms occur even though the mother is not nursing the baby. The pregnancy which precedes the onset of Chiari-Frommel Syndrome is usually normal, and childbirth and initial Lactation are uneventful. However, normal menstrual periods and ovulation do not resume, and persistent discharge from the nipples occurs, which can sometimes last for years. Other symptoms may include emotional distress, anxiety, headaches, backaches, abdominal pain, impaired vision, and occasionally obesity. Women who have Chiari-Frommel Syndrome for a long time may also have a loss of muscle tone in the uterus and diminished uterine size (atrophy).

What are the causes for galactorrhea-amenorrhea syndrome?

The exact cause of Chiari-Frommel Syndrome is not fully understood but may be related to an abnormality of the hypothalamus and/or pituitary glands. Some research suggests that microscopic tumors of the pituitary gland (microadenomas), stimulated by the hormones associated with pregnancy (e.g., prolactin, a stimulator of lactation) are responsible. When such microtumors grow, they may be detected by imaging techniques (CT scan or MRI). Approximately 50 percent of affected women eventually resume normal menstruation over a period of months or years.

The cause of the abnormal hormonal relationship between the pituitary and hypothalamus gland associated with Chiari-Frommel Syndrome is not known. Some studies suggest that microscopic lesions of the hypothalamus may also cause Chiari-Frommel Syndrome. An association with the use of oral contraceptives has also been suggested.

What are the treatments for galactorrhea-amenorrhea syndrome?

Some women with Chiari-Frommel Syndrome may have abnormally high levels of prolactin in the blood. Other women have normal prolactin levels. Additional laboratory findings may include abnormally low levels of estrogen and other hormones (gonadotropins) in the urine.

The drug bromocriptine may be prescribed to help reduce prolactin levels. When these levels are reduced, normal ovulation cycles may be restored along with regular menstrual periods.

If the symptoms persist for a long period of time, affected individuals should be monitored (CT scan or MRI) for the presence of a pituitary tumor. If a tumor is discovered, it may be difficult to treat if it is very small. Larger tumors may be surgically removed.

What are the risk factors for galactorrhea-amenorrhea syndrome?

Galactorrhea-amenorrhea syndrome is caused by a hormonal imbalance in the body. The most common cause of this condition is the combination of low thyroid and high estrogen levels. This can be caused by external factors, such as stress or dieting, or it can be caused by internal factors, such as tumors or genetic disorders.

The following risk factors can increase your chances of developing galactorrhea-amenorrhea syndrome:

  • Age: The disorder is most likely to occur in women aged 20-40 years old.
  • Family history: If someone in your family has galactorrhea-amenorrhea syndrome, your risk of also developing it increases.
  • Diabetes: Women with diabetes have an increased risk of developing galactorrhea-amenorrhea syndrome.
  • Breast enlargement (galactorrhea)
  • Milky discharge from breast (galactorrhea)
  • Inability to conceive a child (amenorrhea)
  • Missed periods or irregular periods (amenorrhea)
  • Cancers that produce hormones or affect hormone production
  • Brain tumors or other neurologic conditions that affect the pituitary gland
  • Infections that cause inflammation in the pituitary gland or hypothalamus
  • Inflammation from autoimmune diseases such as lupus erythematosus, rheumatoid arthritis, and sarcoidosis
  • Previous exposure to radiation therapy or chemotherapy
  • Pregnancy complications like preterm labor or placenta previa (when the placenta covers part of the cervix)
  • Pregnancy after age 40 or after having had a hysterectomy
  • Family history of autoimmune diseases (like lupus or rheumatoid arthritis)
  • A hormonal imbalance is the most common cause of galactorrhea-amenorrhea syndrome. This imbalance can be caused by an overactive thyroid gland (hyperthyroidism), which increases levels of the hormones thyroxine and triiodothyronine.
  • Other hormonal imbalances that may cause galactorrhea-amenorrhea syndrome include prolactinoma (a tumor on your pituitary gland), polycystic ovarian syndrome (PCOS), adrenal hyperplasia, hypogonadism, or excess progesterone.
  • Some medications can also cause galactorrhea-amenorrhea syndrome: these include antipsychotics, antidepressants, birth control pills, corticosteroids, thyroid medications and lithium carbonate.


Symptoms
Infections such as meningitis or encephalitis,Sleep disorders like narcolepsy and sleep apnea,Extreme stress,Seizures,Surgery on the hypothalamus or pituitary gland
Conditions
Common vaginal infection caused by an overgrowth of bacteria
Drugs
Bromocriptine,Chlorpromazine,Clomipramine,Gonadotropin releasing hormone agonists (GnRH agonist)

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