About galactorrhea-amenorrhea without pregnancy

What is galactorrhea-amenorrhea without pregnancy?

Ahumada-Del Castillo is a rare endocrine disorder affecting adult females, which is characterized by impairment in the function of the pituitary and hypothalamus glands. Symptoms may include the production of breast milk (lactation) not associated with nursing and the absence of menstrual periods (amenorrhea) due to the lack of monthly ovulation (anovulation).

What are the symptoms for galactorrhea-amenorrhea without pregnancy?

If you have a persistent, spontaneous Milky nipple discharge from one or both of your breasts and you're not pregnant or breast-feeding, make an appointment to see your doctor.

If breast stimulation — such as excessive nipple manipulation during sexual activity — triggers nipple discharge from multiple ducts, you have little cause for worry. The discharge probably doesn't signal anything abnormal, and this discharge often resolves on its own. If you have persistent discharge that doesn't go away, make an appointment with your doctor to get it checked out.

NonMilky nipple discharge — particularly bloody, yellow or clear spontaneous discharge that comes from one duct or is associated with a lump you can feel — requires prompt medical attention, as it may be a sign of an underlying breast cancer.

What are the causes for galactorrhea-amenorrhea without pregnancy?

Pituitary gland and hypothalamus

The pituitary gland and the hypothalamus are located within the brain and control hormone production.

Galactorrhea often results from having too much prolactin — the hormone responsible for milk production when you have a baby. Prolactin is produced by your pituitary gland, a small bean-shaped gland at the base of your brain that secretes and regulates several hormones.

Possible causes of galactorrhea include:

  • Medications, such as certain sedatives, antidepressants, antipsychotics and high blood pressure drugs
  • Opioid use
  • Herbal supplements, such as fennel, anise or fenugreek seed
  • Birth control pills
  • A noncancerous pituitary tumor (prolactinoma) or other disorder of the pituitary gland
  • Underactive thyroid (hypothyroidism)
  • Chronic kidney disease
  • Excessive breast stimulation, which may be associated with sexual activity, frequent breast self-exams with nipple manipulation or prolonged clothing friction
  • Nerve damage to the chest wall from chest surgery, burns or other chest injuries
  • Spinal cord surgery, injury or tumors
  • Stress

Idiopathic galactorrhea

Sometimes doctors can't find a cause for galactorrhea. This is called idiopathic galactorrhea, and it may just mean that your breast tissue is particularly sensitive to the milk-producing hormone prolactin in your blood. If you have increased sensitivity to prolactin, even normal prolactin levels can lead to galactorrhea.

Galactorrhea in men

In males, galactorrhea may be associated with testosterone deficiency (male hypogonadism) and usually occurs with breast enlargement or tenderness (gynecomastia). Erectile dysfunction and a lack of sexual desire also are associated with testosterone deficiency.

Galactorrhea in newborns

Galactorrhea sometimes occurs in newborns. High maternal estrogen levels cross the placenta into the baby's blood. This can cause enlargement of the baby's breast tissue, which may be associated with a milky nipple discharge. This milky discharge is temporary and resolves on its own. If the discharge is persistent, the newborn should be evaluated by a doctor.

What are the treatments for galactorrhea-amenorrhea without pregnancy?

When needed, galactorrhea treatment focuses on resolving the underlying cause.

Sometimes doctors can't determine an exact cause of galactorrhea. Your doctor might recommend treatment anyway if you have bothersome or persistent nipple discharge. A medication that blocks the effects of prolactin or lowers your body's prolactin level could help eliminate galactorrhea.

Underlying cause Possible treatment Medication use Stop taking medication, change dose or switch to another medication. Make medication changes only if your doctor says it's OK to do so. Underactive thyroid gland (hypothyroidism) Take a medication, such as levothyroxine (Levothroid, Synthroid, others), to counter insufficient hormone production by your thyroid gland (thyroid replacement therapy). Pituitary tumor (prolactinoma) Use a medication to shrink the tumor or have surgery to remove it. Unknown cause Try a medication, such as bromocriptine (Cycloset, Parlodel) or cabergoline, to lower your prolactin level and minimize or stop milky nipple discharge. Side effects of these medications commonly include nausea, dizziness and headaches. 

What are the risk factors for galactorrhea-amenorrhea without pregnancy?

Galactorrhea-amenorrhea without pregnancy, also known as galactorrhea-amenorrhea syndrome (GAMS), is a condition that causes the breasts to produce milk and the menstrual cycle to stop. Women with GAMS may experience breast pain, swelling, or discharge.

  • GAMS can be caused by an imbalance of hormones in the body due to tumors on the pituitary gland or ovaries. It can also be caused by medications that contain hormones, such as birth control pills or hormone replacement therapy drugs. GAMS can also be caused by a lack of estrogen production in women who have gone through menopause but still have functioning ovaries.
  • The exact cause of GAMEP remains unknown, but it's thought to be related to an overactive pituitary gland or an imbalance in estrogen and progesterone hormones.


There are many potential risk factors for GAMEP, including:

  • Breast enlargement and pain
  • Breast discharge that looks like cottage cheese or sour milk
  • Swelling of the breasts
  • Changes in your menstrual cycle (like no periods)
  • Having a family history of GAWNP
  • A personal history of depression or anxiety
  • Elevated prolactin levels (high levels of this hormone can lead to milk production)
  • Low estrogen production
  • Polycystic ovary syndrome (PCOS)
  • Polycystic ovary syndrome (PCOS), which is a hormonal imbalance that can cause irregular periods and excessive hair growth on the face and body
  • Pituitary tumor, which is an abnormal growth of cells in your pituitary gland
  • Taking certain medications, including birth control pills, hormone replacement therapy (HRT), antidepressants, antipsychotics, and chemotherapy drugs.


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)

Is there a cure/medications for galactorrhea-amenorrhea without pregnancy?

There are some medications that are used to treat Galactorrhea-amenorrhea without pregnancy, but there's no cure. The medications are usually taken for a long time, and they can have side effects like headache, nausea, and vomiting.

  • The goal of medical treatment is to reduce milk production to the minimum amount that a baby will need. It may also be used to help prevent further lactation during pregnancy and after delivery.
  • Medications that have been used to treat galactorrhea-amenorrhea include:
  • The first medication is Leuprolide, which is a form of hormone therapy that suppresses the production of estrogen. This medication can be used in both men and women.
  • Another option is Danazol, which is a synthetic male hormone that has been shown to improve symptoms of galactorrhea-amenorrhea without pregnancy in most cases. It is also used to treat endometriosis, fibrocystic breast disease and uterine fibroids.
  • Lactogogue: This medication will help your body produce more milk. It can be taken as a pill or an injection.
  • Dopamine agonists: These medications work by increasing dopamine levels in your brain and reducing prolactin levels. They are typically used to treat Parkinson's disease, but they may also be effective at treating galactorrhea-amenorrhea without pregnancy.
  • Gonadotropin-releasing hormone agonist (GnRH agonist) – These drugs work by reducing the amount of estrogen in your body, which in turn lowers the production of prolactin. They're a good choice if you have high levels of prolactin but no other symptoms.
  • Prolactin inhibitors: These drugs block the action of prolactin on breast tissue to decrease its effects on your reproductive system. They can take longer than GnRH agonists to work but may be more effective at treating severe cases or those with other symptoms such as headaches or vision changes.
  • Progesterone antagonists: These drugs inhibit the production of progesterone, which helps regulate your menstrual cycle. They're usually only prescribed when you have irregular periods—whereas GnRH agonists and prolactin inhibitors can be used in all cases.
  • Finally, bromocriptine can be used to treat symptoms of galactorrhea-amenorrhea without pregnancy. It works by reducing prolactin levels and improving milk production.


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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