Galactorrhoea is a state of inappropriate lactation from the breasts.
This can be caused by medications such as certain anti-depressants and contraceptive pills. However, it can also occur due to the presence of Hyperprolactinemia (raised Prolactin levels).
Hyperprolactinaemia is most commonly occurs as a consequence of pregnancy and lactation. It can also occur as a result of stress. The most important diagnosis to exclude however is Hyperprolactinaemia due to a Prolactin producing brain tumour.
The presentation of Galactorrhoea in young patients is rare and the opinion threshold for investigation by general practitioners to such a symptom should be set very low. Initial investigation should check Prolactin levels by a simple blood test. A blood test showing raised Prolactin levels should prompt a competent GP to repeat these usually 2 to 4 weeks later and if they remain elevated, result in a routine referral to an endocrinologist. Accompanying visual disturbance, headaches or being systemically unwell would make a competent general practitioner increase the expediency of the referral by making the referral urgent as these symptoms may be suggestive of brain tumour.
Consequently the diagnosis of hyperprolactinemia and subsequent referral to an Endocrinologist should not be delayed.