I AM NOT PREGNANT BUT MY BREAST IS DISCHARGING MILK...

Category: Medicine | Health | Wellness

BEWARE OF LONG SENTENCES. THIS POST HAS MANY OF THEM.

In early June, I received this rather terse SMS from someone:

“had a terrible day! was with a girl this morning and discovered her breasts had milk or something. she denied having a baby. i am scared!”

As many of my friends are in the habit of playing pranks on me (some of them no doubt returning favors similar to the ones I had previously done them), I decided that this was another prank and therefore thought nothing about it until, several text messages and phone calls later, I realized the dude was serious about being scared - of his girlfriend’s milk-making!!! 

I have just evaluated another patient this afternoon for a similar complaint. 

Between that SMS and today, I have seen at least 12 patients with the same problem - they are not breastfeeding mothers, yet their breasts are making (and oozing) milk. So yea, this deserves a post.

We think nothing of breastfeeding mothers. It is absolutely normal for a woman who has a child suckling at her breast to be able to discharge from that breast something that rewards the child for its suckling efforts, yea? However, we are worried when we manipulate our breasts - or breasts that, for whatever reason, we feel somewhat entitled to, albeit temporarily - and get for our efforts, nipples discharging fluid rather than nipples stiffening in anticipation...it bothers us because it is not the normal response that we are used to or that we have come to expect. It also bothers us because a lot of people have told us about breast lumps, breast cancers, and the like.

Well, that condition - the one where an adult non-pregnant female who is not breastfeeding, (whether she be in her reproductive years or long past them), has a milky discharge coming from her nipples, either of their own accord, or when someone manipulates them - that condition is called galactorrhea (or, in Britspell, galactorrhoea). 

Although I have specifically mentioned women in this definition, it may also occur in men. It may also occur in newborns, but that is usually because of a hormonal abnormality in the mother during her pregnancy.

Why does this condition occur?

Well, quite frankly, there are a number of things that may cause this. Sometimes, it may be possible to determine the cause, at other times not.

A lot of times however, the condition results when your body produces too much of the hormone that controls milk production when you have a baby. That hormone is called prolactin.

Now, why would your body just decide to go on a prolactin production bazaar? What could be responsible?

1. If you take cocaine or some other drugs like opioids, some antidepressants , or certain anti-kolo drugs among others, those may be responsible.
2. Certain herbal concoctions cause increased prolactin levels.
3. If you are taking oral contraceptive pills, be aware that some of them may be responsible.
4. If your brain has a kind of tumor called a pituitary tumor, that tumor may be producing high levels of prolactin which will lead to that milky breast discharge.

There are other reasons you may begin to notice a milky breast discharge, including:

1. use of certain medications against hypertension.
2. excessive breast stimulation by you or by your sexual partner(s) as part of foreplay.
3. excessive nipple manipulation during overzealous breast self-examinations.
4. the existence of a protracted kidney disease or of some diseases of the thyroid gland (the thyroid gland is a gland in the neck).
5. certain types of chest injuries as well as some spinal cord injuries.

Sometimes, in addition to the discharge from the breasts (it may affect either or both breasts), you may notice a headache. Your menstrual periods may or may not be affected - but you will not know for sure if your periods are affected and to what extent if you have the bad habit of not keeping a calendar!!!

What to do?

You should see a gynecologist. 

Before going to the gynecologist, however, 

1. take some time to look carefully at the discharge. You are looking to confirm that the discharge is all milk and no blood; note that it should be more important to you that there is no blood in the discharge than that it is all milk.
2. Note when the discharge started. Doctors just love to ask “when did this start?”. Humor them. They are not babalawos. If they were, you wouldn’t be wearing your shoes in their office.
3. Note any and all other symptoms you have, even if you think they are unrelated to this particular complaint. What you think and what the doctor knows to be the case may be very, very different.
4. Note the date of your last menstrual period and the date of the one before that and the one before that. Note also any changes in your period since you noticed the discharge. By changes I mean things like whether the flow is heavier, whether it is more or less painful than usual, you know, stuff like that.
5. Run a pregnancy test if you can. (You actually can).
6. Note all the medications you had taken before you noticed the discharge (and this includes all the herbals you have taken). If you had taken any medications after noticing the discharge, please note them too.
7. Oh, and puhleeeeaaaase, keep a menstrual calendar. You may not learn to do so from watching the Kardashians but then...

Sometimes, you cannot get to see a gynecologist as soon as you would like to. In cases like that,

1. adopt other methods of foreplay. Just leave the breasts alone.
2. stop traumatizing your breasts in the name of breast self-exams. Be more gentle in checking for lumps and so on. And perform those self-exams no more than once a month.
3. ease up on the cocaine, if you can. You may no longer get your highs, but then, there will also be no spilled milk to cry over.
4. get and use breast pads - especially if the discharge flows out even when you don’t squeeze. That way, you will not have to explain the cause of the embarrassing wetness that could appear on your clothes.

In fewer words,

If you have a breast discharge, or you notice that someone you care for has a breast discharge, examine the discharge. If it is clear, yellowish, or bloody, please check for any breast lumps and urgently see a doctor. It may be a sign of an underlying breast cancer. If it is milky however, it may not be cancerous, but you need to see a doctor all the same.

If you see a gynecologist and he examines you and conducts tests for you and determines that the breast discharge is nothing for you to worry about, then please quit worrying. Your worry will neither reduce the milkiness of the discharge nor its quantity.