Why Am I Lactating Even Though I Am Not Pregnant?

Are your breasts leaking with no baby in sight? Whether you have noticed a few drops or an abundance, making breast milk when you don't expect it can cause a lot of frustration. Read on to learn why it happens, when it’s normal, and when it’s not.

Here's what is on today's agenda:

Understanding your body: why your breasts can make milk unexpectedly

The next steps: what to do when that happens

Treatments: how to put your body back in balance

Cancer, pregnancy, and more: why you shouldn’t panic yet

Lactating without pregnancy: 7 causes

Making breast milk without being pregnant or breastfeeding is called galactorrhea. Any nipple discharge outside of pregnancy and lactation needs to be evaluated by a healthcare provider to check for problems.

Even males can leak breast milk as they have small amounts of breast tissue, which can develop cancer or lactate. Testosterone deficiency may be a factor to consider.

Though galactorrhea is most common a bit later in life after a pregnancy, it can happen at any age if the right hormones are present, including during adolescence. This can be due to medication or a pituitary tumor.

Whether you’re male or female, your breast tissue responds to hormonal signals and can produce milk without pregnancy if the right signals are present. Your milk-producing hormones include prolactin, estrogen, and thyrotropin-releasing hormone, or TRH. Sometimes, you can make breast milk when hormones linger longer than expected after a past pregnancy.

There are many possible reasons for a hormone imbalance, including:

1. Stress. When it doesn't let up, it can cause unexpected changes in your body. You release many hormones as part of the stress response, including prolactin. If stress continues for long enough, your prolactin levels can get high enough to make milk.
2. Medications. According to the American Academy of Family Physicians, medication is the most common cause of galactorrhea.
3. Herbs. Some herbs, including anise, fennel, and fenugreek seed, could lead to galactorrhea.
4. Low thyroid hormone. Having low thyroid hormones — hypothyroidism — causes hormone imbalances that can lead to galactorrhea.
5. Kidney failure. With chronic kidney failure, your kidneys do not remove as much prolactin as usual, causing it to build up in your body.
6. Lesions and injuries. A painful wound, such as a burn or shingles outbreak, on your chest wall can sometimes lead to breast milk production. Scientists believe this is because of pain signals.
7. Pituitary tumor. Tumors on your pituitary gland affect milk-producing hormones. They can make prolactin (prolactinoma) or cause compression and change your hormone regulation, called a non-prolactin-secreting pituitary tumor. These types of tumors are not usually cancer.

What should you do?

While you may be able to keep your clothes dry with breast pads, don't ignore galactorrhea. You need to be evaluated to find out why you are making milk. Usually, the cause is very treatable.

See your healthcare provider

The first step is a visit with your healthcare provider. They will determine why you are making milk and work with you to formulate a treatment plan.

You can expect:

• A physical exam, including a breast or chest exam
• Laboratory testing
• Imagery to check for a pituitary tumor or signs of breast cancer
• Medication review

Get lab tests

Some lab tests you may get include:

• A pregnancy test with either blood or urine. It is not always easy to know if you are pregnant or not, especially early on. A blood test can be more sensitive than a home pregnancy test.
• Blood tests to evaluate hormone levels.

Check your medications and supplements

Medications can be a common reason for galactorrhea. Provide your doctor with a complete list of everything you take, including over-the-counter medications and supplements. If medications cause your symptoms, you may need to stop them or switch to different ones.

Some common culprits include:

• Antipsychotic medications, like those used to treat schizophrenia
• Antidepressants
• High blood pressure medications
• Hormone treatments

How to prevent lactation

Treatment to prevent galactorrhea will depend on the cause. Based on your test results, your healthcare provider will guide you and help you decide the best path. If your symptoms are not too bothersome and you have no dangerous underlying cause, your doctor may also recommend watching and waiting.

Galactorrhea can go away on its own. Avoid breast and nipple stimulation, which can trigger higher hormone production. Try breast shields or pads to reduce friction on your nipples and absorb discharge. Do not pump or remove the milk from your breast. Removing milk signals your body to make more.

Medication may help with galactorrhea. The most common medications are bromocriptine and cabergoline. They can shrink the size of a pituitary tumor and may also treat menstrual cycle problems if prolactin is normal. Side effects may include nausea, vomiting, drowsiness, headaches, and low blood pressure when changing positions. If you take cabergoline, your doctor may monitor your heart for valve problems. It is best to stay away from supplements and herbs that claim to regulate your hormones. You could make galactorrhea worse!

In some cases, your doctor may recommend surgery to remove a pituitary tumor if it does not respond to medication or is very large.

Risks to be aware of

The good news is that galactorrhea is not usually life-threatening. Most causes are very treatable. However, there are a few considerations to be aware of.

Rarely, nipple discharge may be an early warning sign of breast cancer. This type of discharge may be white or milky colored, or another color, like brown, green, yellow, or bloody.

Because it is often due to a hormonal imbalance, galactorrhea may come along with infertility. Treatment to resolve the underlying cause can balance your hormones and help.

Breastfeeding later on may or may not be affected by galactorrhea treatments. Milk production during breastfeeding is regulated by the same hormones that cause galactorrhea. Talk to your healthcare provider about any potential risks associated with recommended treatments.

Galactorrhea may seem alarming, but understanding what causes it can help your anxiety levels and be the key to the right treatment. Work with your doctor to investigate what is going on in your body and find the treatment that is best for you.