Lactating breasts are only normal after the delivery of a baby. It is abnormal for breast milk to be produced at other times. The following medical conditions have to be considered that could cause this: hypothyroidism, trauma to the chest wall, prescription drug side effects or prolactin production from a pituitary gland tumor (called “prolactinoma“, Ref. 3,p.199).
The diagnostic tests would include TSH level and prolactin level, and with elevated prolactin a pituitary gland MRI. If a benign prolactin producing adenoma is found, this can be observed as they often resolve spontaneously (Ref. 13).
However, if it does not resolve or worsens, a referral to a neurosurgeon specializing in this type of surgery (removal of adenoma) would be needed. Replacement with thyroid hormone would be necessary in the case of hypothyroidism. A variety of drugs can cause breast milk flow such as estrogens, cimetidine, tricyclic antidepressants, methyldopa, verapamil, even opiates and cocaine (Ref. 12, p. 883). Therapy in this case would be to discontinue the offending drug.
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