If you’ve noticed milk coming out of your breast when squeezed, you probably have questions... especially if you aren’t preggo. An OB-GYN explains.
No matter where you are on your parenthood journey, there's a good chance you have plenty of questions about the many ways your body can change during and after pregnancy. Of course, it's normal for pregnancy to cause a boost in milk supply during pregnancy as your body prepares to feed baby, but did you know it's also possible to lactate even if you've never been pregnant?
While some new parents — including adoptive, foster, and trans parents — use medication to induce lactation so they can breastfeed their babies, it's possible for people who have never been pregnant to spontaneously experience milky discharge from their nipples, a condition called galactorrhea. According to Dr. Jill Purdie, OB-GYN and medical director at Pediatrix Medical Group, galactorrhea can occur in up to 20% of women, making it not as rare as you might expect.
What is galactorrhea, and how does it happen?
"Galactorrhea is the condition of having milky nipple discharge that does not occur during pregnancy or the postpartum period," Purdie tells Scary Mommy. It can affect individual or multiple milk ducts in either one or both breasts. It's typically caused by elevated levels of prolactin, the hormone "produced by the brain in the pituitary gland to aid in lactation. Prolactin may be elevated for a variety of reasons, including but not limited to frequent breast and nipple stimulation, certain medications (such as certain sedatives, antidepressants, antipsychotics, and high blood pressure drugs), endocrine disorders (such as hypothyroidism), or pituitary tumors," she says.
"Some other conditions that can also increase galactorrhea include too-tight bras, extreme exercise, and even some foods and herbal supplements," adds Dr. Felice Gersh, an OB-GYN and founder of the Integrative Medical Group in Irvine, California.
Because it's related to a change in hormones, galactorrhea is typically an underlying symptom of another hormonal condition, with both doctors noting that you'll want to see your doctor ASAP if you're unsure of the cause — i.e., you haven't been engaging in nipple/breast stimulation or wearing too-tight bras and/or tops. You'll also want to check in with your doctor if it's persistent and doesn't go away on its own.
"Anytime a person is experiencing nipple discharge unrelated to pregnancy or postpartum, they should see their physician," advises Purdie. "This is especially true if the nipple discharge is bloody or colored or if the person feels an associated breast lump."
"Many times, galactorrhea will resolve spontaneously," she adds. "However, it is important to have an evaluation with your physician to rule out an underlying cause. Galactorrhea can be associated with other underlying conditions such as thyroid disease or kidney disease. Galactorrhea is often caused by a pituitary tumor that would need treatment and/or monitoring. In addition, medication adjustments may be necessary to help the galactorrhea resolve."
What should you look out for?
"Other signs or symptoms that may be associated with galactorrhea include irregular menstrual cycles and/or loss of your period, headache, abnormal hair growth (especially on the face or chest), and increased acne. Men with galactorrhea may experience erectile dysfunction," says Purdie.
Yep, the condition can occur in people of all genders, though Purdie says it predominantly occurs in reproductive-aged women who have been pregnant at some point. It can also occur in infants and older children, though both experts note this is rare. The Mayo Clinic notes that in men or people assigned male at birth (AMAB), it's typically associated with a testosterone deficiency. In babies, it's due to high maternal estrogen levels crossing the placenta into the baby's blood, which can cause enlargement of the baby's breast tissue that can lead to milky nipple discharge.
And while this all sounds pretty scary, your doctor will be your best point of contact. They can answer any questions, run tests to rule out anything serious, and provide treatment options. According to the Cleveland Clinic, treatment might include avoiding any habits that stimulate the breast tissue (such as wearing looser clothing); adjusting current medications that might be causing the discharge; taking medications like cabergoline and bromocriptine to lower prolactin levels; and ensuring that hormone levels are properly balanced and in check.
There's nothing to be afraid or ashamed of, and your doctor is there to help assuage any worries you might have.