Q1: Dr I had my baby 2years ago and since then, I’ve been suffering from hormonal imbalance. My breast still discharges milk and my menstruation isn’t coming forth. I’m not able to conceive again. What is the way out? Thanks
Q2: Good day doc. Please a friend of mine has been experiencing water coming out of her breast lately and it’s affecting her menstrual flow as it’s no longer normal. What is the possible cause and what is the remedy medically. Thanks ma’am
A: A collection of tissues called the endocrine system is responsible for the production of hormones which control various functions in the body like metabolism, sexual reproduction, mood etc. Sometimes, these hormones are produced in excessive or too little amounts throwing the whole body off.
Treatment of hormonal imbalance is dependent on the cause. Excess weight can lead to high estrogen levels. So, exercise and weight loss can be beneficial here. High levels of thyroid hormones can be treated with drugs, radioactive iodine or surgery. The stress hormone, cortisol is produced when one is stressed and so treatment is focused on stress management techniques. The hormone, prolactin which is responsible for lactation in nursing mothers may be produced even when one is not lactating. Focus here is on reducing this hormone levels as will be described below. So, the doctor has to investigate to find out the exact cause of the imbalance and then treat accordingly.
Some women who are not pregnant may have milky fluid come out of their breasts when they are not breastfeeding or even in women who have never been pregnant. This is called galactorrhea (pronounced gulactoria). This is not a disease on its own but a symptom of a problem. The hormone, prolactin is usually produced in these cases.
This milky fluid can be expressed by pressing or it can spontaneously come out on its own. It can affect one or both breasts and usually there are no blood stains involved.
Sometimes, the cause of this discharge may not be known but some causes could be some medications, some drugs like cocaine, spinal cord injuries, some birth control pills, stress and even excessive stimulation during sexual intercourse.
Galactorrhea can also happen in men and new born babies! In new born babies this can happen if the mother has a high level of estrogen which crosses over into the baby and stimulates the formation of breast tissue and sometimes, some milky white discharge.
If you notice this, please visit your doctor who may try to express this discharge to study. The discharge may also be clear, bloody or even tinged yellow. These need further evaluation and the presence of lumps should also be checked for. The level of prolactin will also be assessed. This may, however, be normal in people who are overly sensitive to prolactin. In this class of people, prolactin level is normal but there is still milky discharge from the nipples.
To determine cause, the doctor may do a scan, take tissue sample to examine (biopsy) etc. Treatment depends on cause. If due to pregnancy or breastfeeding, it will eventually stop. If due to stimulation, the discharge will continue as long as the stimulation is present. If due to injury, it will also stop with healing. If the discharge is due to medication, stopping the medication is sufficient to bring this to a stop or switch to something else under the supervision of your physician (doctor). If there is a tumour producing prolactin, drugs can be taken to shrink it or surgery can be done. If no cause is found, drugs that reduce prolactin level are prescribed. Remember, that you could be pregnant and so a pregnancy test may not be out of place.
In the meantime, breast pads can be worn to prevent the embarrassing leaks from staining clothes, limit manipulation of breasts either by self-breast examination or during sexual activity and try not to wear clothes in which there would be friction between the nipples and the material.
Generally, causes of breast discharge include:
• Breastfeeding: The release of milk may also persist for a while even when breastfeeding has been stopped.
• Stimulation of the nipples during sexual foreplay or even pressing the nipple by people who are worried about the nipple discharge or friction between fabric and nipple can lead to nipple discharge.
• Breast abscess or infection
• Hormone imbalance
• Injury to the breast
• Some medications
• Cancer of the breast
Bloody discharge, discharge from one breast only and discharge that happens spontaneously without the breast being touched or pressed is likely to be abnormal. These should be checked out as soon as possible in the hospital.
If the discharge is present during a menstrual period and persists into the next cycle, please see your doctor too.
High prolactin levels are associated with infertility and so this could be a factor in your case. Please see your doctor who will take a proper and detailed history from you and decide on the best treatment option.
I hope this helps.
Have a great weekend y’all 😀