Assessment and management of galactorrhea

Galactorrhea, inappropriate lactation, is a relatively common clinical sign encountered by primary health care providers. However, this physical sign is not synonymous with life-threatening breast or intracranial malignancy; rather, it may be physiologic, drug-induced or idiopathic. Given the 20 percent prevalence of pituitary adenomas in women with galactorrhea, the primary health care provider must rule out, in every case, intracranial causes for galactorrhea. This article reviews relevant physiopathology and develops an assessment and diagnostic protocol, which includes indications for urgent referral. It concludes with summaries of treatment modalities, outlining the role of the primary care provider throughout the diagnostic and treatment processes.