Do You Need to Check Prolactin Levels for Breast Discharge?

Is it necessary to check prolactin levels?

Hello doctor, sometimes I have white discharge from my nipples, and occasionally I experience sudden sharp pain in my head.
I previously thought it was a wisdom tooth issue and had it extracted, but the pain persists.
I have been aware of my polycystic ovary syndrome (PCOS) for a while; my menstrual cycle can be irregular, sometimes occurring once every three months or twice in a month.
Recently, I read online that it might be necessary to check for elevated prolactin levels or a pituitary tumor, but I'm unsure whether I should consult an obstetrician-gynecologist or a neurologist.
I'm also concerned that my symptoms may not be severe enough to warrant medical attention and don't want to waste healthcare resources, so I wanted to ask for your advice.
Thank you, doctor.

Yangyang, 20~29 year old female. Ask Date: 2018/01/22

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors that can affect the menstrual cycle are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraceptives, diet, polycystic ovary syndrome, uterine or cervical lesions, infections, ovulation, pregnancy, and breastfeeding, among others.
It is recommended that you consult a gynecologist for evaluation and assessment.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2018/01/22

More Info

When it comes to breast discharge, particularly if it is spontaneous and not associated with breastfeeding, it is indeed prudent to evaluate prolactin levels. Prolactin is a hormone produced by the pituitary gland, and elevated levels can lead to galactorrhea (the production of breast milk in individuals who are not breastfeeding) and can be indicative of various underlying conditions, including prolactinomas (benign tumors of the pituitary gland), hypothyroidism, or other endocrine disorders.

In your case, the white discharge from your nipples, combined with your history of polycystic ovary syndrome (PCOS) and irregular menstrual cycles, raises the possibility of hormonal imbalances. PCOS is often associated with elevated levels of androgens and can lead to irregular menstruation and other symptoms, including breast discharge. The fact that you also experience sudden headaches could be relevant, as they may suggest increased intracranial pressure or other neurological issues, although this is less common.

Given these symptoms, it is advisable to consult with a healthcare provider who specializes in endocrinology or obstetrics and gynecology. An endocrinologist can assess your hormonal levels, including prolactin, and determine if further imaging studies, such as an MRI of the pituitary gland, are necessary. This is particularly important if your prolactin levels are elevated, as it could indicate a prolactinoma or other pituitary disorders.

Additionally, it is important to consider other potential causes of nipple discharge, such as infections, duct ectasia, or even malignancies, although these are less common. A thorough clinical evaluation, including a physical examination and possibly imaging studies, will help rule out these conditions.

In summary, checking prolactin levels is a reasonable step in your evaluation, especially given your symptoms and medical history. It is not a waste of medical resources to seek help for these symptoms, as they can be indicative of underlying health issues that may require treatment. Therefore, I recommend making an appointment with an endocrinologist or a gynecologist who can guide you through the necessary tests and evaluations to address your concerns effectively.

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