Breast Milk Production and Menstrual Irregularities

Breast milk, menstrual period?

Hello Doctor, my menstrual cycle is usually very regular, and I have only experienced irregularities twice.
My last period started on March 19, and it typically lasts about 9 days.
The doctor mentioned that I should be fine since I have had a liver transplant and a cesarean section, as long as my cycles are regular.
I had a transvaginal ultrasound on April 2, and the endometrial thickness was 1.1, which the doctor said is normal.
However, my period came early on April 12, and today, May 17, my period has not arrived yet.
Additionally, my breasts have noticeably increased in size over the past month, which is unusual for me before my period.
On May 10, during intercourse, my husband mentioned that he noticed some milk, and when I squeezed both breasts today, I indeed expressed a significant amount of milk.
I had a tubal ligation 8 years ago, so pregnancy seems unlikely, right? I'm extremely worried.
Is it normal to have milk in the breasts? Is it normal to have milk in the breasts only before menstruation? Please help clarify my concerns, thank you.

Wenwen, 40~49 year old female. Ask Date: 2018/05/17

Dr. Huang Jianzhong reply Obstetrics and Gynecology

My menstrual cycle is usually very regular, and I have only experienced irregularities twice.
My last period started on March 19, and it typically lasts about 9 days before it completely stops.
The doctor mentioned that I should be fine since I have undergone a liver transplant and a cesarean section, as long as my cycles are regular.
I had a transvaginal ultrasound on April 2, and the endometrial thickness was 1.1, which the doctor said is normal.
However, my period came early on April 12, and today, May 17, my period still hasn’t arrived.
Over the past month, I’ve noticed that my breasts have significantly increased in size, which is unusual for me before my period.
Additionally, on May 10, during intercourse, my husband mentioned that he could taste breast milk.
I also expressed both breasts today and confirmed that there is indeed a significant amount of milk.
I have been sterilized for 8 years, so pregnancy seems unlikely, but I am extremely worried.
Is it normal to have milk in my breasts? Is it normal to have milk only when my period comes? Answer: It is normal not to have milk when menstruating; having milk in the breasts is not normal and requires a blood test to check prolactin levels.

Reply Date: 2018/05/17

More Info

Breast milk production and menstrual irregularities can be complex topics influenced by various factors, including hormonal changes, medical history, and physiological responses. Based on your description, it seems you are experiencing some unusual symptoms, including breast enlargement and milk secretion, which can understandably cause concern.

Firstly, it’s important to note that breast milk production is primarily regulated by the hormone prolactin, which is secreted by the pituitary gland. Prolactin levels can increase due to various reasons, including pregnancy, breastfeeding, stress, certain medications, and hormonal imbalances. Even though you mentioned having undergone a tubal ligation eight years ago, which significantly reduces the chances of pregnancy, it is still possible, albeit rare, for some women to experience a phenomenon known as "pregnancy after tubal ligation." However, it’s also essential to consider other factors that could lead to milk production.

Regarding your menstrual cycle, you mentioned that your periods have been regular, but you have recently experienced some irregularities, such as an early period and a missed period. The menstrual cycle can be influenced by numerous factors, including stress, changes in weight, hormonal fluctuations, and underlying medical conditions. Given your history of liver transplantation and cesarean section, it’s possible that your body is experiencing some hormonal adjustments that could affect your menstrual cycle and breast changes.

The breast enlargement you are experiencing could be due to hormonal changes in your body, which can occur for various reasons, including the menstrual cycle itself. Typically, many women experience breast tenderness and swelling in the days leading up to their period due to increased estrogen and progesterone levels. However, if you are noticing significant changes in breast size and the presence of milk, it may indicate elevated prolactin levels or other hormonal imbalances.

It is also worth noting that certain medications, including hormonal treatments, can lead to side effects such as breast tenderness and milk production. If you are taking any medications, it would be prudent to review these with your healthcare provider to determine if they could be contributing to your symptoms.

In your case, since you are experiencing milk secretion from both breasts, it would be advisable to consult with a healthcare professional, preferably an endocrinologist or a gynecologist, who can evaluate your symptoms more thoroughly. They may recommend blood tests to check your hormone levels, including prolactin, estrogen, and progesterone, as well as imaging studies if necessary.

In summary, while breast milk production can occur due to various reasons, including hormonal changes, it is essential to investigate the underlying cause, especially given your medical history. Irregularities in your menstrual cycle, combined with breast changes, warrant a professional evaluation to ensure that there are no underlying health issues that need to be addressed. Please consider scheduling an appointment with your healthcare provider to discuss your symptoms in detail and receive appropriate guidance and care.

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