Galactorrhea (G) is a frequent symptom in endocrinology when breast are systematically examined. In literature there is few works about aetiologies of G. The aim of our work is to evaluate prevalence of G and to study its cause in 170 subjects with nipple discharge.
Our methodology is based on anamnestic history, clinical exam and a complete hormonal exploration. Women with normal cycle has a temperature curve, endometrial biopsy and progesterone evaluation. Patients who take medical treatment are excluded.
Results: In a personal consultation we have noticed 170 subjects with G among 686 patients who came for various symptoms=27.7%. Among our population 163 are females and 7 are males. Mean age is 28±8 years in women and 33±8 years in males. For aetiologies 93 subjects from 170 (54%) are hyper (H) prolactinemic (PRL) and in 46% PRL is normal. In male cases PRL is always high (6 prolactinomas and 1 craniopharyngioma). In women G with normal PRL are more frequent. Among this last group luteal insufficiency represents 88%, primary hypothyroïdism =9.7% and pituitary tumors =2.1% (Cushings disease, craniopharyngioma). In female HPRL G are due to hypothalamus and/or pituitary abnormalities (prolactinoma, GH adenoma and empty sella) in 78%, primary hypothyroidism in 21% and luteal insufficiency in 2.9%.
Conclusion: Galactorrhea is very rare in males and when this abnormality exist, its aetiology is represented by HPRL. In female cases, G with normal PRL are more frequent and among those luteal deficit is the first cause, while HRPL G are often due to hypothalamus and/or pituitary disorders.
01 - 05 Apr 2006
European Society of Endocrinology