Galactorrhea is a pathological spontaneous outflow of milk from the mammary glands , independent of the process of feeding the baby. It can be manifested both in women (including those who did not give birth after menopause ) and in men [2] . Estimates of the incidence of galactorrhea in women range from 0.1 to 32% [3] . This is due to differences in the definition of galactorrhea, the size of the examined groups and the research methodology.
| Galactorrhea | |
|---|---|
| ICD-10 | N 64.3 , O 92.6 |
| ICD-9 | 611.6 , 676.6 |
| ICD-9-KM | and |
| Omim | |
| Diseasesdb | 6314 |
| Mesh | D005687 |
Content
Etiology
In the neonatal period, galactorrhea can manifest itself under the influence of estrogen received by the newborn through the placenta before birth [4] . This phenomenon is called "witch's milk" [5] . Usually this is a temporary phenomenon that does not require medical intervention. It occurs in about 6% of newborns, regardless of gender [6] .
Pathological Causes
Medicines
Drugs that lower dopamine levels or block receptors for it can cause galactorrhea [2] [4] . Since dopamine controls the release of prolactin by the pituitary lactotrophs, blocking dopamine receptors leads to an increase in prolactin levels, which can cause galactorrhea [2] . Oral contraceptives containing estrogen can cause galactorrhea due to an increase in prolactin levels [4] .
Pituitary tumors
Pituitary tumors are the most common cause of galactorrhea [4] . They cause increased production of prolactin ( hyperprolactinemia ). An increase in prolactin levels most often correlates with tumor size.
Lesions of the hypothalamus
Lesions of the hypothalamus can lead to the destruction of neurons of the hypothalamus secreting dopamine. Dopamine has an inhibitory effect on the production of prolactin by the pituitary lactotrophs. A decrease in dopamine level or a violation of its delivery pathways from the hypothalamus to the pituitary gland leads to an increase in prolactin level [7] .
Thyroid Disease
Hypothyroidism can lead to galactorrhea associated with hyperprolactinemia [8] . The mechanism is an increase in the level of thyroliberin , which can both stimulate the production of prolactin and inhibit dopamine secretion.
Renal failure
Galactorrhea can occur in patients with renal failure due to a decrease in renal clearance of prolactin [9] .
Links
Notes
- ↑ Monarch Disease Ontology release 2018-06-29sonu - 2018-06-29 - 2018.
- ↑ 1 2 3 Huang W. , Molitch ME Evaluation and management of galactorrhea (Eng.) // American Family Physician. - 2012-06-01. - Vol. 85 , no. 11 . - P. 1073-1080 . - ISSN 1532-0650 .
- ↑ Sakiyama R. , Quan M. Galactorrhea and hyperprolactinemia (English) // Obstetrical & Gynecological Survey. - 1983-12-01. - Vol. 38 , no. 12 . - P. 689-700 . - ISSN 0029-7828 .
- ↑ 1 2 3 4 Leung AKC , Pacaud D. Diagnosis and management of galactorrhea (Eng.) // American Family Physician. - 2004-08-01. - Vol. 70 , no. 3 . - P. 543-550 . - ISSN 0002-838X .
- ↑ WITHOUT MILK in the medical encyclopedia . www.med-dic.ru. Date of treatment December 2, 2015.
- ↑ Madlon-Kay DJ 'Witch's milk'. Galactorrhea in the newborn (English) // American Journal of Diseases of Children (1960). - 1986-03-01. - Vol. 140 , no. 3 . - P. 252-253 . - ISSN 0002-922X .
- ↑ Benjamin F. Normal lactation and galactorrhea (English) // Clinical Obstetrics and Gynecology. - 1994 .-- December ( vol. 37 , no. 4 ). - P. 887-897 . - ISSN 0009-9201 .
- ↑ Molitch ME Disorders of prolactin secretion (English) // Endocrinology and metabolism clinics of North America: Journal. - 2001 .-- 1 September ( vol. 30 , no. 3 ). - P. 585-610 . - ISSN 0889-8529 . - DOI : 10.1016 / S0889-8529 (05) 70203-6 .
- ↑ Verhelst J. , Abs R. Hyperprolactinemia: pathophysiology and management (Eng.) // Treatments in Endocrinology. - 2003-01-01. - Vol. 2 , no. 1 . - P. 23-32 . - ISSN 1175-6349 .