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Suffering from breast fluid discharge which is increasing day by day since last two months. Please help.

Last Updated - Fri, Mar 16 2018

Detailed Question:

Hi doctor,

Here are a few details of the patient: 
  • Age: 22 years
  • Sex: Female, 
  • Build: Medium  

Case history: Patient has been experiencing minuscule amounts of transparent-yellowish, mild salty -fluid discharge from right breast for 7-8 weeks. Discharge occurred when mild pressure was applied, and only once in a day.
A week ago patient had an allergic attack, with the diagnosis being "Allergic Asthma". Lots of medicines taken, including antibiotics and an inhaler Levolin(to be used whenever required). Around this time, patient notices the discharge from both sides, in the same amount. 
One Day ago patient checks for discharge, but this time discharge is in much larger amount, about a full teaspoon, from both sides.  
This alarms the patient, and she being unwilling to bring it up with parents, myself, a close friend, is hereby asking for your advice.
Please help.

Category: Gynaecology


Dr. Garima Sawhney

M.S.- Obstetrics &Gynaecology
Bharati Vidyapeeth Medical College & Hospital, Pune

 
You mentioned that your friend is since 2 months on duolin, for treating her Allergic asthma. Any form of asthma, will not cause this kind of nipple or breast discharge. This maybe due to an hormonal imbalance or due to an infection which must be detected and treated according to the diagnosis and not symptomatically. You can consult with the following tests as advised so that timely action can be taken before it gets worse. 
Get serum prolactin and CBC blood tests done.
If prolactin is high get her to consult an endocrinologist, or else consult a Gynecologist for treatment and further management.

Prolactin
Prolactin is a hormone produced by your pituitary gland which sits at the bottom of the brain. It causes breasts to grow and develop and causes milk to be made after a baby is born. 
Normally, both men and women have small amounts of prolactin in their blood. During pregnancy, prolactin levels go up. High prolactin levels trigger the body to make milk for breastfeeding. For normal women who are not pregnant, prolactin helps regulate the menstrual cycle. In men, it affects sperm production.



Hyperprolactinemia

Hyperprolactinemia is a condition of too much prolactin in the blood of women who are not pregnant and in men. Hyperprolactinemia is relatively common in women. About a third of women in their childbearing years with irregular periods but normal ovaries suffer from this disease. 
When this happens, a woman's breasts may start producing milk outside of pregnancy or face trouble getting pregnant. Ninety percent of women with galactorrhea also have hyperprolactinemia. High prolactin levels interfere with the normal production of other hormones, such as estrogen and progesterone. This can change or stop ovulation (the release of an egg from the ovary). It can also lead to irregular or missed periods. Some women have high prolactin levels without any symptoms.

In men, high prolactin levels can cause galactorrhea, impotence (inability to have an erection during sex), reduced desire for sex, and infertility. A man with untreated hyperprolactinemia may make less sperm or no sperm at all.



Common causes of Hyperprolactinemia

Some common causes are:

  • Pituitary tumors (prolactinomas)
  • Nipple stimulation
  • Hypothyroidism (underactive thyroid)
  • Medicines given for depression, psychosis, and high blood pressure
  • Stress or exercise (usually excessive or extreme)
  • Herbs, including fenugreek, fennel seeds, and red clover 
  • Irritation of the chest wall (from surgical scars, shingles, or even a too-tight bra)
  • Certain foods

No cause is found in about a third of all cases of hyperprolactinemia.


Treatment

The treatment depends on the cause. If no cause is found or you have a tumor of the pituitary gland, the usual treatment is medicine. Hypothyroidism is treated with thyroid replacement medicine, which should also make prolactin levels return to normal. 
If your regular medicine is the reason for your high prolactin levels, check with your doctor who would work with you to find a different medicine or add one to help your prolactin levels go down.

Dr. Garima Sawhney

M.S.- Obstetrics &Gynaecology
Bharati Vidyapeeth Medical College & Hospital, Pune

Dr. Garima Sawhney is a Gynecologist in Gurgaon. Her expertise and utmost care and compassion for her patients makes her one of the most sought-after Gynecologists.

About Author

The above medicine data is written by Dr. Garima Sawhney. It is edited, updated and maintained by JustDoc Quality Team. If you have any queries regarding the data, please email us at doctors@justdoc.com. Read about our Medical Team here.



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Dr. Garima Sawhney

M.S.- Obstetrics &Gynaecology

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Breast fluid discharge which is increasing day by day - Justdoc

Suffering from breast fluid discharge since last two months. First it was from single breast with less frequency, now increased frequency from both the breasts.
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