Galactorrhoea

CLINICAL DIAGNOSIS MANUAL

Galactorrhoea is a condition characterised by the discharge of milk from the nipples in individuals who are not breastfeeding. It can affect both women and men, although it is more common in women. This discharge can be unilateral or bilateral and may vary in quantity and frequency. Galactorrhoea is not a disease in itself but a symptom that may be associated with various underlying pathologies or external factors.

Pathology	Symptoms and Clinical Signs	Diagnosis of Suspicion	Diagnosis of Confirmation
Primary Hyperprolactinaemia	Milk discharge, menstrual disturbances. Gynaecomastia in men.	Clinical history and physical examination. Elevated serum prolactin levels.	Confirmation with elevated serum prolactin levels.
Prolactinoma	Milk discharge, headaches, visual disturbances.	Clinical history and physical examination. Very high serum prolactin levels.	MRI of the sella turcica showing the pituitary adenoma.
Pregnancy	Amenorrhoea, pregnancy symptoms (nausea, fatigue). Milk discharge.	Clinical history. Positive pregnancy test.	Confirmation with positive pregnancy test and obstetric ultrasound.
Primary Hypothyroidism	Fatigue, weight gain, cold intolerance, goitre. Milk discharge.	Clinical history and physical examination. Elevated TSH levels, low free T4.	Confirmation with abnormal thyroid function tests.
Drugs	Milk discharge, history of using medications associated with galactorrhoea.	Clinical history and medication review.	Confirmation upon discontinuation of the causative medication and resolution of symptoms.
Idiopathic Galactorrhoea	Milk discharge without an apparent cause.	Clinical history and physical examination. Exclusion of other causes.	Confirmation by exclusion of other causes and clinical diagnosis.