#Prolactin

[bilirubingal]

ok, so my prolactin is messed up again but i don't have time to see my psychoendocrinologist.. hopefully there will be a good one in the hospital i go to tomorrow!

[thescrumblingmidwife]

is it normal for your breasts to leak if you've never had kids? (17)

Hi Anon,

What you're referring to is called galactorrhea. We break the causes down into physiologic (caused by a normal physical process, usually pregnancy and lactation), pharmacologic (caused by a medicine), or pathologic (caused by an underlying disease or disorder somewhere in the body).

There are a few physiologic causes of galactorrhea in a nulligravid (never-pregnant) person, and sometimes the cause is just "idiopathic" (it's your normal but we don't know why). That said, it's not typical, and your doctor will want to rule out any pathologic causes. Most causes are totally benign (not a risk to your health), but it's good to know why it's happening.

Your doctor will want to take your medical history and ask you about your menstrual cycle, any other symptoms you might be having, as well as some questions about what the discharge is like, whether it comes from both breasts, whether you need to touch your breasts for it to come out or if it does it spontaneously, etc. Your doctor will also do an examination and a little bloodwork to see if you have hyperprolactinemia (too much of the hormone prolactin). If you do have elevated prolactin, they may want to do more bloodwork or imaging of your head to see if you have a small benign (noncancerous) tumor on the pituitary, called a prolactinoma. The treatment for this is usually just some medication. It's nothing to be afraid of.

Please let your pediatrician/doctor know the next time you see them!

[mcatmemoranda2]

Hmm. I have a pt with hx of PCOS who had B/L galactorrhea. I saw some milky discharge during the exam and checked her hormones. Prolactin level is normal. Apparently, you can still have galactorrhea even with normal prolactin levels and nothing needs to be done, but you could still give a PRL antagonist.

Incidence — The serum prolactin concentration is often normal in females who present with galactorrhea. In the largest series of patients presenting with galactorrhea, prolactin was normal in 46 percent. The likelihood that the prolactin is normal is even higher if menses are normal. No cause of this phenomenon has been documented, but often it represents persistent milk secretion following resolution of a previously elevated prolactin, most commonly after nursing or drug-induced hyperprolactinemia. Galactorrhea in the absence of hyperprolactinemia is not the result of any ongoing disease.

Diagnosis — The first step in diagnosis is to be sure the breast secretion is clear or milky. Green or black fluid also usually represents milk, which can be confirmed by staining the fluid for fat. Blood in the fluid is a reason for referral for evaluation of a breast tumor. If the fluid is milk, the next step is to measure the serum prolactin concentration. If the prolactin is elevated, the cause should be sought, as described above. If the prolactin is not elevated, there is no ongoing disease and no further tests are needed. Other causes of nipple discharge are discussed elsewhere.

Treatment — Galactorrhea in the absence of hyperprolactinemia usually does not need to be treated, because it is not associated with ongoing disease and it is usually not bothersome. For the unusual patient whose galactorrhea occurs spontaneously and to a degree that causes staining of the clothes, treatment with a low dose of dopamine agonist, such as 0.25 mg of cabergoline twice a week, will reduce the prolactin concentration to below normal and reduce or eliminate the galactorrhea.

[bilirubingal]

i need to re-do a prolactin blood test cause they didn't have enough biomaterial to get a proper result... i'm lucky i did it on the 3rd of my period so there's still time to go to the laboratory again tomorrow!

[libraford]

Great news everyone!

My blood test came back and I did so well that they want to test me again just to see if I can do it again!

[grandrebelfun]

I've been taking progesterone and am debating adding in the pill form of e for a few days to get my chest producing😅

[opens-up-4-nobody]

Thr thing abt me is that I want to know exactly how psychiatric medications work. I don't want the simplified version. Dont give me the "I'm talking to the public" answers. I want the specific mechanisms and how exactly it causes its side effects.

[lassie-farce]

i feel like roy kent definitely would’ve fucked the gaffer if only for scientific purposes

[bredforloyalty]

can somebody who has too much hope and joy transfuse some of it directly into me

[aturinfortheworse]

Learning about hormones is funny because they're all named after what they do (like "growth hormone." guess what that fucker does) so it should be easy to remember them, except that most of them have such specific niche jobs that's actually no help at all. Oh yeah sure "lutenizing hormone" I totally know what that means and what it does. I fucking love to lutenize. Catch me out here lutenizing all day long with my buddy Lutenizing Hormone.

[beautifullychaoticworld-blog]

I find it astonishing that researchers haven't found what causes pituitary tumors, prolactinomas in particular... would be amazing if they did more research on this... they told me it's from too much stress but our whole lives are full of stress unless you decide to do nothing with your life at all...

[absolutelyfibulas]

GP follow up today, being referred to endocrinology (scans were clear) and having another blood test done on Wednesday.

I also got vindication re: neck swelling that I keep second guessing myself on, because she palpated it and went "oh, yeah, I can feel something". So whomst the fuck knows what's going on in Chez Dutch, but I'm getting more tests done which is all that can be done rn.

[merlions]

ADHD never stops finding ways to piss me the fuck off. You're telling me I need dopamine in order to tell my pituitary not to make me just start lactating??? Cmon man

[ovaruling]

i think i’m one of the percentage of ppl who have experienced increase in breast tissue as a side effect of being on an antipsychotic……nothing else in my life has changed, hormones have remained the same (bloodwork confirms), and so i have no other explanation for how i went up like a full cup size and a half since last june

none of my sports bras fit anymore at all and of course this is escalated to a peak while im trying to run every day and am back to doing heavy olympic lifts. bodyweight resistance exercises have also become more awkward

so all this to say that whatever the cause is, antipsychotic or not, this litcherally could not be a worse time to be saddled with extra breast and it’s making me insane and panicky like i hate this so much this is why i got my breast reduction in the first place when i was 18 and i regret it for so many reasons it def contributed to the ruin of my life and body but like this IS what drove me to that and here it is again 12 years later 🤒😪🤧

[blubbed]

I’m on new medication that has lactation as a possible side effect and that made me think of your collage project. I think it’s very cool what you’re doing and maybe I’ll relate to it more soon

i hope not for ur sake unless ur into that in which case godspeed 🫡🫡🫡🫡

[lamelittlebunny]

im sorry for never drawing

im drunk and my tits keep milking all over my clothes