Materiały źródłowe

• #1 Galactorrhea Causes, Symptoms, Diagnosis and Treatment – Cura4U

  https://cura4u.com/conditions/galactorrhea

  Galactorrhea affects around 20 to 25 % of women. Hyperprolactinemia is the cause in about 75% of the patients having galactorrhea with amenorrhea, of which 30% are attributed to prolactin-secreting tumors. […] The management focuses on identifying and treating the underlying cause.

• #1 Galactorrhea: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1200/galactorrhea.html

  Galactorrhea can occur in postmenopausal women and in men. […] The prevalence of galactorrhea is unknown, but the condition is estimated to occur in about 20% to 25% of women. […] Hyperprolactinemia may cause galactorrhea and is more common in women than men. The prevalence of hyperprolactinemia in women varies (0.4% of an unselected population, 5% of patients from a family planning clinic, 9% of women being evaluated for amenorrhea, and 17% of women with polycystic ovary syndrome).

• #2 Galactorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17924-galactorrhea

  Galactorrhea may affect up to 20% of women. […] People at higher risk for galactorrhea include women between the ages of 20 to 35 and those who have previously given birth. […] Galactorrhea often goes away without treatment. Avoiding things that cause galactorrhea is the best way to keep it from occurring. If a pituitary tumor is causing the condition, your healthcare provider may want you to have a yearly CT or MRI to look for signs of growth.

• #2 Galactorrhea

  https://mobile.fpnotebook.com/Gyn/Sx/Glctrh.htm

  Estimated lifetime Incidence in women: 20-25% […] Galactorrhea with Amenorrhea is pathognomonic for Hyperprolactinemia […] Galactorrhea without Amenorrhea is associated with normal Serum Prolactin.

• #3 Galactorrhea | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688531/all/Galactorrhea

  Predominant age: 15 to 50 years (reproductive age), most commonly ages 20 to 35 years. […] Third most common breast complaint in women. […] Approximately 20-25% of women experience galactorrhea in their lifetime.

• #4 Galactorrhea | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688531/all/Galactorrhea

  Predominant age: 15 to 50 years (reproductive age), most commonly ages 20 to 35 years. […] Third most common breast complaint in women. […] Approximately 20-25% of women experience galactorrhea in their lifetime.

• #5 Galactorrhea | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22024

  Hyperprolactinemia is more common in women. The prevalence of hyperprolactinemia ranges from 0.4% in an unselected normal adult population to as high as 9 to 17% in women with reproductive disorders. Its prevalence was found to be as high as 17% among women with polycystic ovary syndrome. […] Galactorrhea is nonlactational production of milk. Prolactin, estrogens, and TRH all play a role in the production of milk from the breast. The condition is often managed by an interprofessional team that consists of a radiologist, endocrinologist, neurosurgeon, neurologist, and an internist.

• #6 Hyperprolactinemia – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/hyperprolactinemia/

  Hyperprolactinemia is the most common form of hyperpituitarism. […] 0.4% of the general population. […] Epidemiological data refers to the US, unless otherwise specified.

• #7 Galactorrhea hyperprolactinemia – Wikipedia

  https://en.wikipedia.org/wiki/Galactorrhea_hyperprolactinemia

  Hyperprolactinemia occurs more commonly in women. The prevalence of hyperprolactinemia ranges from 0.4% in an unselected normal adult population (10,000 normal Japanese adults working at a single factory) to as high as 9 to 17% in women with reproductive disorders. […] Its prevalence was found to be 5% in a family planning clinic population, 9% in a population of women with adult-onset amenorrhea, and 17% among women with polycystic ovary syndrome.

• #8 Galactorrhea: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1200/galactorrhea.html

  Galactorrhea can occur in postmenopausal women and in men. […] The prevalence of galactorrhea is unknown, but the condition is estimated to occur in about 20% to 25% of women. […] Hyperprolactinemia may cause galactorrhea and is more common in women than men. The prevalence of hyperprolactinemia in women varies (0.4% of an unselected population, 5% of patients from a family planning clinic, 9% of women being evaluated for amenorrhea, and 17% of women with polycystic ovary syndrome).

• #9 Galactorrhea hyperprolactinemia – Wikipedia

  https://en.wikipedia.org/wiki/Galactorrhea_hyperprolactinemia

  Hyperprolactinemia occurs more commonly in women. The prevalence of hyperprolactinemia ranges from 0.4% in an unselected normal adult population (10,000 normal Japanese adults working at a single factory) to as high as 9 to 17% in women with reproductive disorders. […] Its prevalence was found to be 5% in a family planning clinic population, 9% in a population of women with adult-onset amenorrhea, and 17% among women with polycystic ovary syndrome.

• #10 Galactorrhea: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1200/galactorrhea.html

  Galactorrhea can occur in postmenopausal women and in men. […] The prevalence of galactorrhea is unknown, but the condition is estimated to occur in about 20% to 25% of women. […] Hyperprolactinemia may cause galactorrhea and is more common in women than men. The prevalence of hyperprolactinemia in women varies (0.4% of an unselected population, 5% of patients from a family planning clinic, 9% of women being evaluated for amenorrhea, and 17% of women with polycystic ovary syndrome).

• #11 Galactorrhea | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22024

  Hyperprolactinemia is more common in women. The prevalence of hyperprolactinemia ranges from 0.4% in an unselected normal adult population to as high as 9 to 17% in women with reproductive disorders. Its prevalence was found to be as high as 17% among women with polycystic ovary syndrome. […] Galactorrhea is nonlactational production of milk. Prolactin, estrogens, and TRH all play a role in the production of milk from the breast. The condition is often managed by an interprofessional team that consists of a radiologist, endocrinologist, neurosurgeon, neurologist, and an internist.

• #12 Galactorrhea | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22024

  Hyperprolactinemia is more common in women. The prevalence of hyperprolactinemia ranges from 0.4% in an unselected normal adult population to as high as 9 to 17% in women with reproductive disorders. Its prevalence was found to be as high as 17% among women with polycystic ovary syndrome. […] Galactorrhea is nonlactational production of milk. Prolactin, estrogens, and TRH all play a role in the production of milk from the breast. The condition is often managed by an interprofessional team that consists of a radiologist, endocrinologist, neurosurgeon, neurologist, and an internist.

• #13 Galactorrhea hyperprolactinemia – Wikipedia

  https://en.wikipedia.org/wiki/Galactorrhea_hyperprolactinemia

  Hyperprolactinemia occurs more commonly in women. The prevalence of hyperprolactinemia ranges from 0.4% in an unselected normal adult population (10,000 normal Japanese adults working at a single factory) to as high as 9 to 17% in women with reproductive disorders. […] Its prevalence was found to be 5% in a family planning clinic population, 9% in a population of women with adult-onset amenorrhea, and 17% among women with polycystic ovary syndrome.

• #14 Galactorrhea | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22024

  Hyperprolactinemia is more common in women. The prevalence of hyperprolactinemia ranges from 0.4% in an unselected normal adult population to as high as 9 to 17% in women with reproductive disorders. Its prevalence was found to be as high as 17% among women with polycystic ovary syndrome. […] Galactorrhea is nonlactational production of milk. Prolactin, estrogens, and TRH all play a role in the production of milk from the breast. The condition is often managed by an interprofessional team that consists of a radiologist, endocrinologist, neurosurgeon, neurologist, and an internist.

• #15 Hyperprolactinemia: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/121784-overview

  This condition occurs in less than 1% of the general population and in 5-14% of patients presenting with secondary amenorrhea. Approximately 75% of patients presenting with galactorrhea and amenorrhea have hyperprolactinemia. Of these patients, approximately 30% have prolactin-secreting tumors. […] Mortality is unlikely, although a study by Soto-Pedre et al did report increased mortality depending on the cause of hyperprolactinemia. In cases where the condition is due to a large prolactin-secreting tumor, local mass effect can lead to significant morbidity. […] The aforementioned study by Soto-Pedre et al found that morbidity and mortality in hyperprolactinemia appears to differ according to the conditions etiology. The investigators reported no link between pituitary tumor-associated hyperprolactinemia and increased morbidity. In contrast, drug-induced hyperprolactinemia was found to be associated with a greater risk of diabetes, cardiovascular disease, infectious disease, and bone fracture. Moreover, the study found no increased mortality risk in hyperprolactinemia patients with pituitary microadenomas, while a greater risk of death was reported in subjects with pituitary macroadenoma or drug-induced hyperprolactinemia, as well as in patients with idiopathic hyperprolactinemia. However, the investigators stated that the morbidity and mortality increases observed in the study did not appear to be directly caused by the serum prolactin elevations themselves and that hyperprolactinemia could perhaps serve as a biomarker for greater morbidity risk.

• #16 Galactorrhea Causes, Symptoms, Diagnosis and Treatment – Cura4U

  https://cura4u.com/conditions/galactorrhea

  Galactorrhea affects around 20 to 25 % of women. Hyperprolactinemia is the cause in about 75% of the patients having galactorrhea with amenorrhea, of which 30% are attributed to prolactin-secreting tumors. […] The management focuses on identifying and treating the underlying cause.

• #17 Galactorrhea: Rapid Evidence Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/1200/galactorrhea.html

  Galactorrhea can occur in postmenopausal women and in men. […] The prevalence of galactorrhea is unknown, but the condition is estimated to occur in about 20% to 25% of women. […] Hyperprolactinemia may cause galactorrhea and is more common in women than men. The prevalence of hyperprolactinemia in women varies (0.4% of an unselected population, 5% of patients from a family planning clinic, 9% of women being evaluated for amenorrhea, and 17% of women with polycystic ovary syndrome).

• #18 Galactorrhoea: Causes and Treatment | Doctor

  https://patient.info/doctor/galactorrhoea

  Galactorrhoea is much more common in women than in men. It is most common in women of reproductive age, but can occur in nulliparous women, menopausal women, and men. […] The prevalence of non-pregnant hyperprolactinaemia is around 0.2% in the adult population with an incidence of 13.8 cases per 100,000 person-years and is 3.5 times higher in women than men. […] The epidemiology of hyperprolactinaemia over 20 years in the Tayside region of Scotland: the Prolactin Epidemiology, Audit and Research Study (PROLEARS).

• #19 Galactorrhea | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/1688531/all/Galactorrhea

  Predominant age: 15 to 50 years (reproductive age), most commonly ages 20 to 35 years. […] Third most common breast complaint in women. […] Approximately 20-25% of women experience galactorrhea in their lifetime.

• #20 Galactorrhea: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17924-galactorrhea

  Galactorrhea may affect up to 20% of women. […] People at higher risk for galactorrhea include women between the ages of 20 to 35 and those who have previously given birth. […] Galactorrhea often goes away without treatment. Avoiding things that cause galactorrhea is the best way to keep it from occurring. If a pituitary tumor is causing the condition, your healthcare provider may want you to have a yearly CT or MRI to look for signs of growth.

• #21 Emotionally induced galactorrhoea in a non-lactating female –“Pseudo- Lactation”? | BMC Endocrine Disorders | Full Text

  https://bmcendocrdisord.biomedcentral.com/articles/10.1186/1472-6823-14-98

  Galactorrhoea is a common clinical problem in endocrinology. […] Galactorrhoea is commoner among females aged 20 35 years particularly in previously parous women. […] Galactorrhoea is often secondary to hyperprolactinaemia. […] Emotionally induced pseudo lactation may be a rare but important cause for transient hyperprolactinaemia in a non-lactating female. […] Though a rare incident, we believe emotionally induced pseudo lactation may be an important secondary cause for transient hyperprolactinaemia in a non-lactating female. Consideration of this as a cause of galactorrhoea may lead to find similar cases in the future.

• #22 Galactorrhoea: Causes and Treatment | Doctor

  https://patient.info/doctor/galactorrhoea

  Galactorrhoea is much more common in women than in men. It is most common in women of reproductive age, but can occur in nulliparous women, menopausal women, and men. […] The prevalence of non-pregnant hyperprolactinaemia is around 0.2% in the adult population with an incidence of 13.8 cases per 100,000 person-years and is 3.5 times higher in women than men. […] The epidemiology of hyperprolactinaemia over 20 years in the Tayside region of Scotland: the Prolactin Epidemiology, Audit and Research Study (PROLEARS).

• #23

  https://link.springer.com/article/10.1007/s00406-021-01241-3

  Galactorrhea is a well-known adverse drug reaction (ADR) of numerous antipsychotic drugs (APD) and is often distressing for those affected. […] Data on APD utilization and reports of galactorrhea caused by APDs were analyzed using data from an observational pharmacovigilance program in German-speaking countries Arzneimittelsicherheit in der Psychiatrie (AMSP) from 1993 to 2015. […] A total of 170 events of galactorrhea caused by APDs were identified (0.97 cases in 1000 female inpatient admissions). […] The occurrence of galactorrhea presented with highly significant differences among age groups (Table 1; p<0.0001). [...] Galactorrhea was assessed as a severe ADR during antipsychotic treatment in 170 cases. [...] Most cases of galactorrhea occurred under treatment with risperidone while amisulpride had the highest relative risk for galactorrhea. [...] Overall galactorrhea is a severe and probably underestimated condition among patients treated with psychotropic, especially antipsychotic, drugs.

• #24 Galactorrhea during antipsychotic treatment: results from AMSP, a drug surveillance program, between 1993 and 2015

  https://epub.ub.uni-muenchen.de/76557/

  Galactorrhea is a well-known adverse drug reaction (ADR) of numerous antipsychotic drugs (APD) and is often distressing for those affected. […] Data on APD utilization and reports of galactorrhea caused by APDs were analyzed using data from an observational pharmacovigilance program in German-speaking countries-Arzneimittelsicherheit in der Psychiatrie (AMSP)-from 1993 to 2015. 320,383 patients (175,884 female inpatients) under surveillance were treated with APDs for schizophrenia and other indications. […] A total of 170 events of galactorrhea caused by APDs were identified (0.97 cases in 1000 female inpatient admissions). […] Most cases occurred during the reproductive age with the highest incidence among patients between 16 and 30 years (3.81 cases in 1000 inpatients). […] High dosages of the imputed APDs correlated with higher rates of galactorrhea. […] Galactorrhea is a severe and underestimated condition in psychopharmacology.

• #25

  https://link.springer.com/article/10.1007/s00406-021-01241-3

  Galactorrhea is a well-known adverse drug reaction (ADR) of numerous antipsychotic drugs (APD) and is often distressing for those affected. […] Data on APD utilization and reports of galactorrhea caused by APDs were analyzed using data from an observational pharmacovigilance program in German-speaking countries Arzneimittelsicherheit in der Psychiatrie (AMSP) from 1993 to 2015. […] A total of 170 events of galactorrhea caused by APDs were identified (0.97 cases in 1000 female inpatient admissions). […] The occurrence of galactorrhea presented with highly significant differences among age groups (Table 1; p<0.0001). [...] Galactorrhea was assessed as a severe ADR during antipsychotic treatment in 170 cases. [...] Most cases of galactorrhea occurred under treatment with risperidone while amisulpride had the highest relative risk for galactorrhea. [...] Overall galactorrhea is a severe and probably underestimated condition among patients treated with psychotropic, especially antipsychotic, drugs.

• #26 Galactorrhea during antipsychotic treatment: results from AMSP, a drug surveillance program, between 1993 and 2015. | EBSCOhost

  https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=09401334&AN=153369421&h=OpFNGSahpcnvfwYC%2BCkgBu5GKv0fzFWrREioQ%2Brsa5jwiv0j%2BwcSHunLUkqtwiRydXyBhN48A2MP2SJbQ4%2Bwrw%3D%3D&crl=f

  Galactorrhea is a well-known adverse drug reaction (ADR) of numerous antipsychotic drugs (APD) and is often distressing for those affected. […] Data on APD utilization and reports of galactorrhea caused by APDs were analyzed using data from an observational pharmacovigilance program in German-speaking countries—Arzneimittelsicherheit in der Psychiatrie (AMSP)—from 1993 to 2015. 320,383 patients (175,884 female inpatients) under surveillance were treated with APDs for schizophrenia and other indications. A total of 170 events of galactorrhea caused by APDs were identified (0.97 cases in 1000 female inpatient admissions). […] High dosages of the imputed APDs correlated with higher rates of galactorrhea. Galactorrhea is a severe and underestimated condition in psychopharmacology.

• #27 Galactorrhea during antipsychotic treatment: results from AMSP, a drug surveillance program, between 1993 and 2015

  https://epub.ub.uni-muenchen.de/76557/

  Galactorrhea is a well-known adverse drug reaction (ADR) of numerous antipsychotic drugs (APD) and is often distressing for those affected. […] Data on APD utilization and reports of galactorrhea caused by APDs were analyzed using data from an observational pharmacovigilance program in German-speaking countries-Arzneimittelsicherheit in der Psychiatrie (AMSP)-from 1993 to 2015. 320,383 patients (175,884 female inpatients) under surveillance were treated with APDs for schizophrenia and other indications. […] A total of 170 events of galactorrhea caused by APDs were identified (0.97 cases in 1000 female inpatient admissions). […] Most cases occurred during the reproductive age with the highest incidence among patients between 16 and 30 years (3.81 cases in 1000 inpatients). […] High dosages of the imputed APDs correlated with higher rates of galactorrhea. […] Galactorrhea is a severe and underestimated condition in psychopharmacology.

• #28 Galactorrhea during antipsychotic treatment: results from AMSP, a drug surveillance program, between 1993 and 2015

  https://epub.ub.uni-muenchen.de/76557/

  Galactorrhea is a well-known adverse drug reaction (ADR) of numerous antipsychotic drugs (APD) and is often distressing for those affected. […] Data on APD utilization and reports of galactorrhea caused by APDs were analyzed using data from an observational pharmacovigilance program in German-speaking countries-Arzneimittelsicherheit in der Psychiatrie (AMSP)-from 1993 to 2015. 320,383 patients (175,884 female inpatients) under surveillance were treated with APDs for schizophrenia and other indications. […] A total of 170 events of galactorrhea caused by APDs were identified (0.97 cases in 1000 female inpatient admissions). […] Most cases occurred during the reproductive age with the highest incidence among patients between 16 and 30 years (3.81 cases in 1000 inpatients). […] High dosages of the imputed APDs correlated with higher rates of galactorrhea. […] Galactorrhea is a severe and underestimated condition in psychopharmacology.

• #29 Hyperprolactinaemia and galactorrhoea with combined oral contraceptive pill use: A refresher

  https://www1.racgp.org.au/ajgp/2022/june/hyperprolactinaemia-and-galactorrhoea

  Galactorrhoea is a milk-like discharge from the nipples when the patient is neither pregnant nor breastfeeding. It happens when abnormally high levels of serum prolactin stimulate the lactotroph cells in the mammillary glands of the breast, resulting in galactorrhoea. Prolactin secretion is regulated by stimulatory or inhibitory hormones produced in the hypothalamus. Physiological causes include pregnancy, stress and nipple stimulation. Pathological causes of hyperprolactinaemia are due to anti-dopaminergic medications, such as antipsychotics. In the absence of these medications, pituitary tumours account for approximately 50% of hyperprolactinaemia cases. Additionally, subclinical hypothyroidism has been found to be associated with hyperprolactinaemia. […] […] The incidence of COCP-associated galactorrhoea is unclear due to lack of recent data on newer agents. Literature from the 1980s suggest that 10-19% of women on a COCP experience galactorrhoea, with up to 30% experiencing hyperprolactinaemia. Some studies have found that COCPs use can increase serum prolactin levels, whereas other studies do not show any effect on prolactin levels. Galactorrhoea is usually seen in COCPs containing high oestrogen doses (35 g), and is most apparent in the week of the placebo pills. In recent newer contraceptives with lower oestrogen doses, this is rarely observed. The proposed mechanism is the stimulatory effect of oestrogen and progesterone on prolactin secretion and the oestrogen-induced proliferation of lactotroph in the anterior pituitary gland. […]

• #30 Prolactinoma: Early Detection, Evaluation and Management – The ObG Project

  https://www.obgproject.com/2017/04/18/prolactinoma-early-detection-evaluation-and-management/

  The prevalence of prolactinomas is reported to be between 35 to 50 per 100,000. They are most commonly seen in women (10:1 ratio female/male) and the usual age range is between 20 to 50 years of age. […] Fortunately, only a minority of microadenomas will continue to grow (< 10%) but early detection, monitoring and a management plan, which may be multidisciplinary, is required for good outcomes. Consider accessing expertise in endocrinology and radiology to ensure correct differential between prolactinoma and non-secreting pituitary adenoma as treatment for the latter is usually surgical, not medical.

• #31 Prolactinoma: Early Detection, Evaluation and Management – The ObG Project

  https://www.obgproject.com/2017/04/18/prolactinoma-early-detection-evaluation-and-management/

  The prevalence of prolactinomas is reported to be between 35 to 50 per 100,000. They are most commonly seen in women (10:1 ratio female/male) and the usual age range is between 20 to 50 years of age. […] Fortunately, only a minority of microadenomas will continue to grow (< 10%) but early detection, monitoring and a management plan, which may be multidisciplinary, is required for good outcomes. Consider accessing expertise in endocrinology and radiology to ensure correct differential between prolactinoma and non-secreting pituitary adenoma as treatment for the latter is usually surgical, not medical.

• #32 Galactorrhea and Headaches in a Nonpregnant Woman

  https://www.patientcareonline.com/view/galactorrhea-and-headaches-nonpregnant-woman

  Galactorrhea occurs in up to 80% of women with prolactinomas. […] Prolactin levels often correlate with the size of the tumor. […] A random prolactin level of more than 100 ng/mL is consistent with a prolactinoma; macroadenomas often produce levels of more than 200 ng/mL. […] Although this patient’s prolactin level is less than 100 ng/mL, it is still significantly above normal. Together with negative results on the rest of her endocrine workup, it is sufficient to diagnose prolactinoma. […] The goals of treatment are: To lower prolactin levels. To decrease tumor size. To reduce galactorrhea. To restore menses and fertility. […] Regardless of their size, prolactinomas are initially treated with dopamine agonists, such as bromocriptine or cabergoline. […] Common adverse effects of both dopamine agonists include nausea and postural hypotension.

• #33 Galactorrhea and Headaches in a Nonpregnant Woman

  https://www.patientcareonline.com/view/galactorrhea-and-headaches-nonpregnant-woman

  Galactorrhea occurs in up to 80% of women with prolactinomas. […] Prolactin levels often correlate with the size of the tumor. […] A random prolactin level of more than 100 ng/mL is consistent with a prolactinoma; macroadenomas often produce levels of more than 200 ng/mL. […] Although this patient’s prolactin level is less than 100 ng/mL, it is still significantly above normal. Together with negative results on the rest of her endocrine workup, it is sufficient to diagnose prolactinoma. […] The goals of treatment are: To lower prolactin levels. To decrease tumor size. To reduce galactorrhea. To restore menses and fertility. […] Regardless of their size, prolactinomas are initially treated with dopamine agonists, such as bromocriptine or cabergoline. […] Common adverse effects of both dopamine agonists include nausea and postural hypotension.

• #34 Galactorrhea | GLOWM

  https://www.glowm.com/section-view/heading/Galactorrhea/item/305

  Considerable difference of opinion exists as to when radiographic surveillance should be instituted. Many reproductive endocrinologists believe that a CT or MRI scan should be performed in patients with prolactin levels of 100 ng/mL or greater. Most reproductive endocrinologists would institute radiographic surveillance at levels of 50 ng/mL. However, we recommend that radiographic surveillance be undertaken if a persistent hyperprolactinemia is demonstrated at any level. […] Both CT and MRI scans are adequate for the diagnosis of both microadenomas and macroadenomas. Both of these radiographic techniques can detect a pituitary tumor as small as 2 mm.

• #35 Volume 5, Chapter 32. Galactorrhea

  https://www.glowm.com/resources/glowm/cd/pages/v5/v5c032.html

  Hyperprolactinemia has been demonstrated in up to 57% of patients undergoing in vitro fertilization. […] The patient who presents with galactorrhea should undergo an extensive history and physical examination to determine the cause of the problem. […] Considerable difference of opinion exists as to when radiographic surveillance should be instituted. […] Most reproductive endocrinologists would institute radiographic surveillance at levels of 50 ng/mL. […] Both CT and MRI scans are adequate for the diagnosis of both microadenomas and macroadenomas. […] Patients with hyperprolactinemic syndromes require lifelong follow-up. […] The patient with no radiographic evidence of a pituitary tumor should be followed on an annual basis. […] The patient with a macroadenoma requires lifelong suppressive therapy with bromocriptine or another second-generation dopamine agonist.

• #36 Galactorrhea | GLOWM

  https://www.glowm.com/section-view/heading/Galactorrhea/item/305

  Considerable difference of opinion exists as to when radiographic surveillance should be instituted. Many reproductive endocrinologists believe that a CT or MRI scan should be performed in patients with prolactin levels of 100 ng/mL or greater. Most reproductive endocrinologists would institute radiographic surveillance at levels of 50 ng/mL. However, we recommend that radiographic surveillance be undertaken if a persistent hyperprolactinemia is demonstrated at any level. […] Both CT and MRI scans are adequate for the diagnosis of both microadenomas and macroadenomas. Both of these radiographic techniques can detect a pituitary tumor as small as 2 mm.

• #37 Galactorrhea | GLOWM

  https://www.glowm.com/section-view/heading/Galactorrhea/item/305

  Considerable difference of opinion exists as to when radiographic surveillance should be instituted. Many reproductive endocrinologists believe that a CT or MRI scan should be performed in patients with prolactin levels of 100 ng/mL or greater. Most reproductive endocrinologists would institute radiographic surveillance at levels of 50 ng/mL. However, we recommend that radiographic surveillance be undertaken if a persistent hyperprolactinemia is demonstrated at any level. […] Both CT and MRI scans are adequate for the diagnosis of both microadenomas and macroadenomas. Both of these radiographic techniques can detect a pituitary tumor as small as 2 mm.

• #38 Volume 5, Chapter 32. Galactorrhea

  https://www.glowm.com/resources/glowm/cd/pages/v5/v5c032.html

  Hyperprolactinemia has been demonstrated in up to 57% of patients undergoing in vitro fertilization. […] The patient who presents with galactorrhea should undergo an extensive history and physical examination to determine the cause of the problem. […] Considerable difference of opinion exists as to when radiographic surveillance should be instituted. […] Most reproductive endocrinologists would institute radiographic surveillance at levels of 50 ng/mL. […] Both CT and MRI scans are adequate for the diagnosis of both microadenomas and macroadenomas. […] Patients with hyperprolactinemic syndromes require lifelong follow-up. […] The patient with no radiographic evidence of a pituitary tumor should be followed on an annual basis. […] The patient with a macroadenoma requires lifelong suppressive therapy with bromocriptine or another second-generation dopamine agonist.

• #39 Volume 5, Chapter 32. Galactorrhea

  https://www.glowm.com/resources/glowm/cd/pages/v5/v5c032.html

  Hyperprolactinemia has been demonstrated in up to 57% of patients undergoing in vitro fertilization. […] The patient who presents with galactorrhea should undergo an extensive history and physical examination to determine the cause of the problem. […] Considerable difference of opinion exists as to when radiographic surveillance should be instituted. […] Most reproductive endocrinologists would institute radiographic surveillance at levels of 50 ng/mL. […] Both CT and MRI scans are adequate for the diagnosis of both microadenomas and macroadenomas. […] Patients with hyperprolactinemic syndromes require lifelong follow-up. […] The patient with no radiographic evidence of a pituitary tumor should be followed on an annual basis. […] The patient with a macroadenoma requires lifelong suppressive therapy with bromocriptine or another second-generation dopamine agonist.

• #40

  https://www.kuh.ku.edu.tr/mayo-clinic-care-network/mayo-clinic-health-information-library/diseases-conditions/galactorrhea

  Galactorrhea Last Updated on May 15, 2024 Overview Galactorrhea (guh-lack-toe-REE-uh) is a milky nipple discharge unrelated to the usual milk production of breastfeeding. Galactorrhea itself isn’t a disease, but it could be a sign of another medical condition. It usually happens in women, even those who have never had children or who have gone through menopause. But galactorrhea can happen in men and babies. […] Excessive breast stimulation, medicine side effects or conditions of the pituitary gland all may contribute to galactorrhea. Often, galactorrhea results from increased levels of prolactin, the hormone that stimulates milk production. […] Risk factors Anything that triggers the release of the hormone prolactin can increase the risk of galactorrhea. Risk factors include: Certain medicines, illicit drugs and herbal supplements. Conditions that affect the pituitary gland, such as noncancerous pituitary tumors. Certain medical conditions, such as chronic kidney disease, spinal cord injury, injuries to the chest wall and underactive thyroid. A lot of touching and rubbing of the breasts. Stress.

• #41 Hyperprolactinemia: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/121784-overview

  This condition occurs in less than 1% of the general population and in 5-14% of patients presenting with secondary amenorrhea. Approximately 75% of patients presenting with galactorrhea and amenorrhea have hyperprolactinemia. Of these patients, approximately 30% have prolactin-secreting tumors. […] Mortality is unlikely, although a study by Soto-Pedre et al did report increased mortality depending on the cause of hyperprolactinemia. In cases where the condition is due to a large prolactin-secreting tumor, local mass effect can lead to significant morbidity. […] The aforementioned study by Soto-Pedre et al found that morbidity and mortality in hyperprolactinemia appears to differ according to the conditions etiology. The investigators reported no link between pituitary tumor-associated hyperprolactinemia and increased morbidity. In contrast, drug-induced hyperprolactinemia was found to be associated with a greater risk of diabetes, cardiovascular disease, infectious disease, and bone fracture. Moreover, the study found no increased mortality risk in hyperprolactinemia patients with pituitary microadenomas, while a greater risk of death was reported in subjects with pituitary macroadenoma or drug-induced hyperprolactinemia, as well as in patients with idiopathic hyperprolactinemia. However, the investigators stated that the morbidity and mortality increases observed in the study did not appear to be directly caused by the serum prolactin elevations themselves and that hyperprolactinemia could perhaps serve as a biomarker for greater morbidity risk.

• #42 Hyperprolactinemia: Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/121784-overview

  This condition occurs in less than 1% of the general population and in 5-14% of patients presenting with secondary amenorrhea. Approximately 75% of patients presenting with galactorrhea and amenorrhea have hyperprolactinemia. Of these patients, approximately 30% have prolactin-secreting tumors. […] Mortality is unlikely, although a study by Soto-Pedre et al did report increased mortality depending on the cause of hyperprolactinemia. In cases where the condition is due to a large prolactin-secreting tumor, local mass effect can lead to significant morbidity. […] The aforementioned study by Soto-Pedre et al found that morbidity and mortality in hyperprolactinemia appears to differ according to the conditions etiology. The investigators reported no link between pituitary tumor-associated hyperprolactinemia and increased morbidity. In contrast, drug-induced hyperprolactinemia was found to be associated with a greater risk of diabetes, cardiovascular disease, infectious disease, and bone fracture. Moreover, the study found no increased mortality risk in hyperprolactinemia patients with pituitary microadenomas, while a greater risk of death was reported in subjects with pituitary macroadenoma or drug-induced hyperprolactinemia, as well as in patients with idiopathic hyperprolactinemia. However, the investigators stated that the morbidity and mortality increases observed in the study did not appear to be directly caused by the serum prolactin elevations themselves and that hyperprolactinemia could perhaps serve as a biomarker for greater morbidity risk.

• #43 From Galactorrhea to Osteopenia: Rethinking Serotonin–Prolactin Interactions | Neuropsychopharmacology

  https://www.nature.com/articles/1300412

  The widespread use of the selective serotonin reuptake inhibitors (SSRIs) has been accompanied by numerous reports describing a potential association with hyperprolactinemia. […] A growing number of case reports and small studies have described PRL abnormalities and/or manifestations such as galactorrhea, amenorrhea, and breast tenderness in association with the use of SSRIs in women. […] Possible long-term clinical consequences of hyperprolactinemia, including decreased bone density and a potential increased risk of breast cancer, are only beginning to be investigated. […] The classic manifestations of hyperprolactinemia are galactorrhea, amenorrhea, infertility, and decreased libido in women, and erectile dysfunction, hypogonadism, and infertility in males. […] Long-term clinical consequences of hyperprolactinemia are less obvious, and include osteopenia in men and women and the possibility of an increased risk of breast cancer in women.

• #44 MD Consult – Book Text

  https://www.rima.org/web/bcmonline/16339.html

  The diagnosis of pituitary tumor rests essentially on the results of the serum prolactin determination and on radiographic evidence. […] In most cases the galactorrhea does not require treatment for its own sake. […] If amenorrhea accompanies hyperprolactinemia, as is often the case, then patients are at increased risk for development of osteoporosis. […] The dopamine agonists such as bromocriptine are more effective than other forms of treatment in lowering serum prolactin, stopping galactorrhea, and restoring ovulatory menses in patients with hyperprolactinemia.

• #45 Volume 5, Chapter 32. Galactorrhea

  https://www.glowm.com/resources/glowm/cd/pages/v5/v5c032.html

  Hyperprolactinemia has been demonstrated in up to 57% of patients undergoing in vitro fertilization. […] The patient who presents with galactorrhea should undergo an extensive history and physical examination to determine the cause of the problem. […] Considerable difference of opinion exists as to when radiographic surveillance should be instituted. […] Most reproductive endocrinologists would institute radiographic surveillance at levels of 50 ng/mL. […] Both CT and MRI scans are adequate for the diagnosis of both microadenomas and macroadenomas. […] Patients with hyperprolactinemic syndromes require lifelong follow-up. […] The patient with no radiographic evidence of a pituitary tumor should be followed on an annual basis. […] The patient with a macroadenoma requires lifelong suppressive therapy with bromocriptine or another second-generation dopamine agonist.

• #46

  https://step2.medbullets.com/evidence/22962879

  Galactorrhea is commonly caused by hyperprolactinemia, especially when it is associated with amenorrhea. Hyperprolactinemia is most often induced by medication or associated with pituitary adenomas or other sellar or suprasellar lesions. […] After pathologic nipple discharge is ruled out, patients with galactorrhea should be evaluated by measurement of their prolactin level. Those with hyperprolactinemia should have pregnancy ruled out, and thyroid and renal function assessed. Brain magnetic resonance imaging should be performed if no other cause of hyperprolactinemia is found. […] Patients with prolactinomas are usually treated with dopamine agonists (bromocriptine or cabergoline); surgery or radiation therapy is rarely required. Medications causing hyperprolactinemia should be discontinued or replaced with a medication from a similar class with lower potential for causing hyperprolactinemia. Normoprolactinemic patients with idiopathic, nonbothersome galactorrhea can be reassured and do not need treatment; however, those with bothersome galactorrhea usually respond to a short course of a low-dose dopamine agonist.

• #47 Galactorrhea and Headaches in a Nonpregnant Woman

  https://www.patientcareonline.com/view/galactorrhea-and-headaches-nonpregnant-woman

  Once treatment is begun, monitor symptoms, prolactin levels, and medication adverse effects regularly. […] Transsphenoidal resection is reserved for patients with progressive neurological symptoms and for those who cannot tolerate or who fail to respond to dopamine agonists. […] The epidemiology of prolactinomas.

• #48 Hyperprolactinemia, galactorrhea : Guidelines, reviews, epidemiology

  https://www.gfmer.ch/Guidelines/Menstruation_disturbances_female_gonadal_disorders/Hyperprolactinemia_galactorrhea.htm

  Galactorrhea during antipsychotic treatment: results from AMSP, a drug surveillance program, between 1993 and 2015 [2021] […] Galactorrhoea- Treating the right way [2020] […] Global Prevalence of Macroprolactinemia among Patients with Hyperprolactinemia: A Systematic Review and Meta-Analysis [2020] […] Clinical Presentations of Drug-Induced Hyperprolactinaemia: A Literature Review [2023] […] Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement [2023] […] Clinical guidelines for diagnosis and treatment of prolactinoma and hyperprolactinemia [2013] […] Galactorrhea: Rapid Evidence Review [2022]

• #49 Galactorrhea | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22024

  Hyperprolactinemia is more common in women. The prevalence of hyperprolactinemia ranges from 0.4% in an unselected normal adult population to as high as 9 to 17% in women with reproductive disorders. Its prevalence was found to be as high as 17% among women with polycystic ovary syndrome. […] Galactorrhea is nonlactational production of milk. Prolactin, estrogens, and TRH all play a role in the production of milk from the breast. The condition is often managed by an interprofessional team that consists of a radiologist, endocrinologist, neurosurgeon, neurologist, and an internist.

• #50 Galactorrhea: Causes, Symptoms & Treatment Options | Medanta

  https://www.medanta.org/pillar/galactorrhea-symptoms-types-causes-diagnose-and-treatment

  Hypothyroidism, characterized by an underactive thyroid gland, hampers hormonal dynamics. […] Chronic stress may elevate prolactin levels, adding to the manifestation of galactorrhea. […] Galactorrhea can be managed and possibly prevented by taking proactive steps to maintain hormonal equilibrium. […] The galactorrhea diagnosis involves a thorough medical history, physical examination, hormonal testing (particularly prolactin levels), and possibly imaging studies like MRI to detect pituitary tumors. […] Galactorrhea treatment may depend on the underlying cause. It may be medicines, surgical interventions, or lifestyle changes. […] Galactorrhea is often a symptom of an underlying condition such as pituitary tumors, thyroid disorders, or hormonal imbalances.

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