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?

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 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 this hormone remains high post delivery, which is normal (2).
  • Nipple or breast manipulation during sex.
  • Psychosocial stress (3)

Pathologic

  • 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 craniopharyngioma, germinoma, meningioma
  • Infiltrative disorders like histiocytosis, sarcoidosis
  • Rathke’s cleft cysts
  • Pituitary lesions like prolactinoma (that causes hyperprolactinemia), acromegaly
  • Chest wall lesions
  • Breast surgery
  • Burns
  • Spinal cord injury
  • 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 hyperprolactinemia
  • Normoprolactinemic galactorrhea
  • Thyrotoxicosis

Few of the causes mentioned above are associated with certain symptoms, which you may watch out for.

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
  • Polyuria
  • Polydipsia

In the case of hyperprolactinemia:

  • Decreased libido
  • Infertility
  • Oligomenorrhea
  • Amenorrhea

In the case of hypothyroidism:

  • Tiredness
  • Cold intolerance
  • Constipation

In the case of thyrotoxicosis:

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 without delay. Early diagnosis and treatment can prevent the condition from worsening.

Diagnosis of lactation without pregnancy

The diagnosis for lactation without pregnancy includes a physical examination and a laboratory evaluation (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 look 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, it is essential to ascertain the nodules’ location and to determine if the secretion is through one duct.
  • Look for other signs: The doctor checks for other signs like visual field defect, cranial neuropathy, papilledema, 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 macroadenomas, who could not be treated using medicines of surgery.

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 of 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.

Lactation without pregnancy or galactorrhea could be a sign of an underlying physiological or medical problem or a side effect of certain drugs. While some occurrences of galactorrhea may pose complications that necessitate immediate medical attention, not all galactorrhea symptoms are severe. Self-evaluation of symptoms associated with breast discharge may provide insight into the underlying reason, but it is best to confer with your doctor for a prompt diagnosis and treatment. Avoiding tight bras, excessive breast stimulation during sex, practicing yoga, and checking for lumps are possible ways to avoid the condition.

Key Pointers

  • Lactation without pregnancy or galactorrhea could be due to physiological factors or underlying pathological conditions.
  • A doctor may conduct a physical examination of the breast, check the other accompanying symptoms, or request lab tests of the nipple discharge to diagnose galactorrhea.
  • The treatment of galactorrhea depends on the cause.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. Oana Maria Patrascu et al.; Galactorrhoea: Report of Two Cases; NCBI (2015)
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5327809/
  2. Wenyu Huang Mark E. Molitch; Evaluation and Management of Galactorrhea; American Family Physicians
    https://www.aafp.org/afp/2012/0601/p1073.html#:~:text=Galactorrhea%20is%20commonly%20caused%20byother%20sellar%20or%20suprasellar%20lesions
  3. Alexander K.C. Leung Daniele Pacaud; Diagnosis and Management of Galactorrhea; American Academy of Family Physicians (2019)
    https://www.aafp.org/afp/2004/0801/p543.html
  4. Galactorrhea; Cleveland Clinic
    https://my.clevelandclinic.org/health/diseases/17924-galactorrhea
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Melissa Kotlen

(BSN, RN, IBCLC)
Melissa Kotlen has been advising mothers on breastfeeding issues for 17 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 pillai

Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs. 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, she aims at providing informative articles on health and pharma, especially related to... more

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