Lactating But Not Pregnant: Causes And Ways To Treat It

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Lactation occurs naturally in women after childbirth. However, lactation without pregnancy is characterized by milk discharge from breasts even if one is not pregnant or nursing. It is not uncommon for mothers to experience breast milk production and leakage even one year after weaning the baby.

However, in some cases, lactation without pregnancy may be a side effect of certain medications or a symptom of a pituitary gland disorder. Read this post to learn about the symptoms, diagnosis, treatment, and prevention of lactation during pregnancy.

What Is Lactation Without Pregnancy?

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Some women may have a milky discharge from the breast even in the absence of pregnancy. Such a condition is called galactorrhea, which is experienced by around 20-25% of women at some point in their life (1).

It is common in women aged between 20 and 35 years. The milk secretion can be persistent or intermittent, abundant or scant, unilateral or bilateral.

So what could cause lactation when you are not pregnant or have recently delivered a child? Find out next.

Why Do You Lactate When You Are Not Pregnant?

Several causes that can cause lactation suppression or inappropriate milk discharge. We have categorized them into physiological and pathological reasons (2):

Physiological

• In the case of amenorrhea (absence of a monthly period), galactorrhea is usually caused by hyperprolactinemia, a condition when the level of prolactin hormone in the blood increases and stimulates breast milk production. The amount of lactation hormones remains high post delivery, which is normal (2).

• Nipple or breast manipulation during sex.

• Psychosocial stress (3)

Pathologic

• Endocrine disorders involving the hypothalamus or pituitary stalk. Suprasellar or sellar lesions of the pituitary stalk, which is also called ‘stalk effect,’ can lead to galactorrhea.

• Tumors that include craniopharyngiomaⁱXA rare, benign brain tumor that originates in the pituitary gland. , germinomaⁱXA specific kind of tumor that starts in sperm or egg-producing cells. , meningiomaⁱXA tumor that develops from the membranes that cover the brain and spinal cord.

• Infiltrative disorders like histiocytosisⁱXAn abnormal rise in the quantity of certain white blood cells known as histiocytes. , sarcoidosisⁱXA rare condition responsible for the development of small clumps of inflammatory cells in the body.

• Rathke’s cleft cystsⁱXNon-cancerous, fluid-filled cysts that grow between the base of the brain and the pituitary gland.

• Pituitary lesions like prolactinomaⁱXA noncancerous growth of the pituitary gland. (that causes hyperprolactinemia), acromegaly

• Chest wall lesions

• Breast surgery

• Burns

• Spinal cord injury

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• Herpes zoster

• Trauma

• Systemic disease like hypothyroidism, renal insufficiency

• Medication-induced hyperprolactinemia that includes antipsychotics, gastrointestinal motility medications (metoclopramide), antidepressants, antihypertensive medications (verapamil, methyldopa, reserpine), opioids, cocaine

• Idiopathic hyperprolactinemiaⁱXIncreased blood prolactin levels in the circulating blood with no or unknown underlying causes.

• Normoprolactinemic galactorrheaⁱXThe condition when galactorrhea coexists with normal prolactin levels.

• ThyrotoxicosisⁱXA clinical condition that occurs when the body's levels of thyroid hormones are abnormally high for any reason.

Quick fact

Certain medicines such as oral contraceptive pills, hormone treatments, antidepressants, blood pressure medicines, and sedatives may trigger galactorrhea (5).

Symptoms of lactation without pregnancy

Breast milk discharge in itself is a symptom of some other condition. Therefore, look for other symptoms to know the reason behind the inappropriate lactation (3):

In the case of pituitary or hypothalamic disease:

• Headaches
• Visual disturbances
• Temperature intolerance
• Seizures
• Disordered appetite
• PolyuriaⁱXUrine output that is greater than 3 liters each day.
• PolydipsiaⁱXChronic or temporary consumption of excessive water.

In the case of hyperprolactinemia:

• Decreased libido
• Infertility
• Oligomenorrhea
• Amenorrhea

In the case of hypothyroidism:

• Tiredness
• Cold intolerance
• Constipation

In the case of thyrotoxicosis:

• Nervousness
• Restlessness
• Increased sweating
• Heat intolerance,
• Weight loss despite increased appetite

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If any of the symptoms mentioned above or a discharge other than the milky secretion from the nipples bother you, then make sure to see a doctor or lactation consultant without delay. Early diagnosis and treatment can prevent the condition from worsening.

Quick fact

Vaginal dryness, reduced libido, acne, and new hair growth on chest or chin may be additional symptoms accompanying galactorrhea (4).

Diagnosis of lactation without pregnancy

The diagnosis for lactation without pregnancy includes a physical examination and a laboratory evaluation by a doctor or lactation specialist (3).

Physical examination:

• General test: The doctor determines your height, weight, and vital signs and examines the chest for any infection, irritation, or trauma. The doctor will also check for poor growth, gigantism/acromegaly, bradycardia, and tachycardia.

• Examination of the breast: The breast is examined for discharge and nodules. In the case of discharge, milk letdown, or milk ejection, it is essential to ascertain the nodules’ location and to determine if the secretion is through one or more milk ducts.

• Look for other signs: The doctor checks for other signs like visual field defect, cranial neuropathyⁱXA condition that affects the nerves in the brain or brainstem. , papilledemaⁱXSwelling of the optic disc due to high intracranial pressure. , goiter, dry skin, coarse hair, myxedema, and carotenemia.

Laboratory evaluation:

After the physical examination, the doctor may suggest a lab examination if there is still doubt regarding the nature of the discharge from the nipple. A microscopic examination of the fat globules in the discharge and an hCG test will be done to confirm pregnancy if any.

If necessary, the doctor may recommend further tests to ascertain the serum prolactin level. If the serum prolactin level is more than 200mg per ml (200 mcg/l), it indicates prolactinoma, which can cause galactorrhea.

In the case of elevated serum prolactin levels, and a suspected pituitary tumor, the doctor may suggest an MRI scan. Also, bone densitometry will be carried out if the patient is suspected of having osteopenia or osteoporosis.

The next section tells you about the different treatment options for lactation without pregnancy. Keep reading.

How Is Lactation Without Pregnancy Treated?

The treatment for galactorrhea depends on the serum prolactin level. If the symptoms of hyperprolactinemia become bothersome, then the following medicines are given to the patient (3):

• Dopamine agonists – It helps in suppressing the serum prolactin level, restoring the gonadal function, eliminating galactorrhea, and decreasing the size of the tumor. Bromocriptine (Parlodel) and cabergoline (Dostinex) are the FDA approved drugs used for this treatment.

• Surgical interventions – It is rarely the choice of treatment and is considered only if the medicines fail. Doctors would consider transsphenoidal surgery, which is a preferred, conventional method. Stereotactic radiosurgery is another popular method used for treating the condition.

• Radiotherapy – It is considered in patients with macroadenomasⁱXA tumor of the pituitary gland. , who could not be treated using medicines of surgery.

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If the patient has normal prolactin levels and the galactorrhea symptoms are not bothersome, then no treatment is suggested. But, the prolactin level will be periodically measured in such cases.

The section below mentions the preventive steps to avoid any occurrence of lactation without pregnancy and breastfeeding.

Prevention Of Lactation If You Are Not Pregnant

Here are some steps you can follow to prevent galactorrhea (4):

• Avoid wearing bras that irritate the nipple.

• Avoid too much breast stimulation during sex.

• Practice meditation, yoga, or engage in physical activities to relieve stress.

• Check for any lumps while doing a self-breast examination.

Point to consider

Avoid conducting breast exams more than once per month. Frequent examination may trigger galactorrhea (4).

Infographic: Can Galactorrhea Occur In Men?

The condition of galactorrhea can occur in men, and this infographic will help you understand why. So check it out to stay informed and help your male friends understand this rare occurrence.

Illustration: Momjunction Design Team

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Melissa KotlenBSN, RN, IBCLC

Melissa Kotlen has been advising mothers on breastfeeding issues for 20 years. She is an International Board Certified Lactation Consultant (IBCLC) and a Registered Nurse (RN), with additional background in Midwifery. Melissa also provides lactation guidance and assists with business development matters for MommaWork, a company focusing on supporting working mothers. Melissa assists women on breastfeeding issues in private, classroom,...more

shreeja pillaiMSc

Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs from the University of Mumbai. Before joining MomJunction, she worked as a research analyst with a leading multinational pharmaceutical company. Her interest in the field of medical research has developed her passion for writing research-based articles. As a writer of more than two years experience, she aims...more

Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU). She has been into health and...more

Reshmi DasMSc

Reshmi Das has over four years of experience as a clinical coordinator, medical content writer and medical conference coordinator. Her continuous interest in medical journals and writing makes her write well-researched articles for MomJunction. She writes health and wellness articles for children and pregnant and lactating women. Reshmi has completed her post graduation in Biotechnology from MITS School of Biotechnology,...more