Milk secretion from the mammary gland outside the puerperal period is called galactorrhea – the puerperium is the period of time that passes from the end of labor until 6-8 weeks postpartum and persists for more than 6 months.
It can be spontaneous or appear only after expression maneuvers. However, in women who have had several children there may be a minimal secretion after the expression of the breast, without this implying the presence of disease. It mainly affects women, especially those between the ages of 20 and 35 who have had previous pregnancies. However, it can also appear at other ages, in children and in men.
The galactorrhea is due to a deregulation of the secretion of these hormones, mainly prolactin, which is not equivalent to stating that in all cases of galactorrhea the secretion of prolactin is elevated.
On the other hand, the increase in prolactin does not always cause galactorrhea. The taking of drugs is the most frequent cause of elevated levels of prolactin in the blood. In some patients, it is recommended to avoid the use of clothing that stimulates or excessively irritates the nipple, since repeated mechanical stimulation of the latter is a cause of galactorrhea.
The most frequent causes of galactorrhea are:
- Prolactin-producing pituitary tumors (called prolactinomas) represent 25% of cases.
- Endocrine diseases: due to hormonal alterations.
- Stress of any kind, both physical and psychological, can produce an increase in blood prolactin levels.
- Chronic kidney disease: although up to 50% have high prolactin levels, the onset of galactorrhea is rare.
- Hepatic cirrhosis.
- Local infections (mastitis or inflammation of the breast, shingles or shingles).
- Hypothalamic processes: the hypothalamus is a region of the brain that, among many other things, regulates the release of hormones from the pituitary gland.
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