Patient's question:
A 37-year-old woman with bilateral outer breast pain for 10 years, with a movable mass upon palpation. 10 days ago, she developed right nipple discharge. After examination at the hospital, she was diagnosed with hyperplasia of the breast lobules and prescribed the following medications: Ruan He Ne Xiao Ye, Xiao Yao Wan, and some Vitamin B1....Doctor's answer:
Nipple discharge; it is a common symptom of breast diseases. Milk secretion in women outside of lactation is called galactorrhea. Both unmarried women and married women who have given birth can experience this phenomenon. It is characterized by natural, small amounts of discharge from both nipples or, with a milky white or clear color without blood. It can also manifest as unilateral nipple discharge, unrelated to breast size. The cause of galactorrhea is excessive prolactin secretion in the body. The causes of hyperprolactinemia are complex and include both physiological and pathological factors. It can be due to systemic causes or local causes. First, giving birth and undergoing multiple induced abortions consecutively can lead to elevated prolactin levels in the body; poor sleep and long-term use of sedatives or sleeping pills; long-term use of anti-tuberculosis drugs for pulmonary or intestinal tuberculosis; married women who experience discomfort with intrauterine devices and need long-term oral contraceptives; additionally, pituitary hyperfunction, pituitary microadenomas, hypothalamic disorders, and the use of antihypertensive drugs. Physiological causes are often intense sexual stimulation, leading to a temporary increase in prolactin, which quickly returns to normal. If an unmarried woman experiences lactation accompanied by amenorrhea, it is called hyperprolactinemic amenorrhea, which can lead to infertility. Duct ectasia of the breast may also cause small amounts of milk-like discharge. Some women with breast hyperplasia may experience nipple discharge accompanied by breast tenderness, likely due to endocrine disorders. If the discharge is bloody or entirely bloody, it is important to be vigilant about the possibility of breast cancer. In summary, women with galactorrhea should not take it lightly but should also avoid panic. They should seek timely medical examination, such as smearing the discharge, fasting blood tests for prolactin, or even mammography, to identify the cause and receive appropriate treatment.