Galatorrhea

Etiology

  • Physiologic--> peri or post-partum
  • Hyperprolactinemia from pituitary prolactinoma (micro or macro)
  • Meds: antipsychotics, anti-depressants (MAOIs, TCAs), GI promotility (metoclopromide), others
  • Tumors or infiltrative processes (cranopharyngioma, sarcoid) affecting the pituitary stalk or hypothalamus
  • Primary hypothyroidism
  • Renal failure or hyper-estrogen states
  • Very strenuous exercise, stress, chest wall stimulation as w/trauma, burns, zoster

Symptoms

  • Typically bilateral and painless
  • Usually milky, but can be other colors
  • If large prolactin secreting macro adenoma, can have head ache, visual field loss (bi-temporal)
  • If hyperprolactinemia, can have infertility and irregular menses

Physical Exam Findings

  • May be able to express bilateral nipple d/c
  • No mass, no blood
  • Temporal field cuts if large pituitary macro adenoma
  • Other CN deficits