Diagnosed For Gastroentrotics, Nowadays Normal But Have Some Whitish Fluid Discharge From Nipples. Normal?
My wife recently diagnosed for gastroentrotics and nowadays she is normal and good. But yesterday she found that some whitish fluid is secreting from her nipples. Is it normal?
Little Amount Is Physiological. Need Proper Investigation.
Detailed Answer:
Hello,
Thanks for posting your query.
The term is gastroenteritis which your wife was suffering from. Hopefully, she is now well recovered.
As per clinical presentation, the condition is called galactorrhea (milky discharge from nipple) in medical term. It is commonly observed during pregnancy.
However, it is seen among some percentage of women (5-30%) in reproductive age without pregnancy. It occurs mostly due to elevation of prolactin hormone.
Little amount milky discharge is less significant and quite physiological. If it occurs in large amount or on regular basis or spontaneously, then underlying pathological conditions are needed to investigate properly. 50% of the cases are without any pathology.
CAUSES: 1) Excessive nipple stimulation or breast massage during sexual excitement 2) Hormonal causes like hyperprolactinemia & hypothyroid state with elevated levels of TSH or TRH hormones 3) Certain drugs (methyldopa, opiates, antipsychotics, serotonin reuptake inhibitors) 4) pituitary adenomas (causeing large amount of prolactin) or compression of the pituitary stalk.
Most adenomas of the anterior pituitary are prolactinomas. Increased prolactin level may cause amenorrhea and infertility. It may be occurred by using birth control pills or cimetidine like H2 blocker.
Here, she needs to undergo blood test for prolactin level, complete thyroid profile initially if she gets irregular period or amenorrhea. In addition, one CT scan of brain and ultrasound scan (USG) of breast are advisable in case of abnormal report of above mentioned tests.
Please, consult with your gynecologist regarding this for proper guidance. Proper treatment depends on etiology. In such case, I prefer to treat my patient with bromocriptine or cabergolin for milk suppression by lowering prolactin hormone. In severe case or failed medical therapy, surgical removal of prolactinoma (if detected) can be done.
She needs to avoid wearing tight breast support or excessive massaging. Hope, I have answered your query. Let me know, if you need any clarification.
Wish her good health. Good luck.
Regards,
Dr Soumen
Give attention to amount & frequency of discharge.
Detailed Answer:
Hello,
Thanks for your response. Followings are my comments:
1) You pay attention regarding amount of the milky discharge and frequency. If it is mild or occasional, then it could be physiological and normal thing.
2) However, you need to do above mentioned investigations if it is large in amount & frequently occurred. In such case, medical treatment is required and you have to contact with gynecologist.
Hope, I have cleared your doubts. If you don't have any other query, you can close the discussion.
All the best.
Regards,
Dr Soumen