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