Patient's question:
Please ask the expert: How can galactorrhea be defined in non-lactating women? Is it considered galactorrhea if the nipples are often dry and scaly?Doctor's answer:
Nipple discharge is diverse and can be categorized into two types: physiological discharge and pathological discharge. Physiological discharge refers to lactation during breastfeeding, nipple discharge caused by oral contraceptives or sedatives, as well as minor nipple discharge in women before or after menstruation. This physiological discharge is mostly bilateral, multi-duct non-hemorrhagic discharge from the breast. Clinically, the term "discharge" generally refers to pathological discharge, which is nipple discharge caused by diseases, mostly presenting as unilateral, single-duct discharge from the breast (rarely multiple-duct discharge), and may be bloody. Diseases that cause nipple discharge include extramammary diseases and intramammary diseases. Extramammary diseases are primarily caused by hypothalamic-pituitary lesions, such as tumors, leading to hyperprolactinemia. Nipple discharge caused by extramammary diseases often manifests as bilateral, multi-duct non-hemorrhagic discharge from the breast. In contrast, intramammary diseases mainly include intraductal papilloma, duct ectasia, proliferative changes, breast cancer, and inflammatory lesions.Galactorrhea: Occurs in women during non-breastfeeding periods, sometimes persisting for several years after weaning. Most cases involve bilateral discharge, which can either leak naturally or be expressed by squeezing the breast. The volume of discharge can vary, appearing milky in color, with a positive lactose test, and may be persistent or intermittent. Breast development is usually normal, but enlargement or atrophy may also occur. It is recommended to seek medical treatment.