Persistent Breast Milk Production: When to Seek Medical Advice?

Breast milk has not decreased?

Hello Doctor: I was born in 2019, breastfed for about 4 months, and my child is now almost 3 and a half years old.
I haven't breastfed for about three years, but I still have breast milk.
My menstrual cycle is irregular, but I still get my period every month.
I previously visited a gynecologist, but no tests were conducted.
The doctor there said that having breast milk continuously is not a problem, but sometimes my nipples feel dry and itchy.
I have taken lactation suppression medication once, but even after finishing it, I still have breast milk.
Should I go to a major hospital for further examination?

Miss Hsieh, 20~29 year old female. Ask Date: 2022/11/10

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is recommended to go to a large hospital for a blood test.
Wishing you good health.

Reply Date: 2022/11/10

More Info

Persistent breast milk production, also known as galactorrhea, can be a concerning issue for many women, especially if it occurs long after breastfeeding has ceased. In your case, it has been nearly three years since you last breastfed, yet you are still experiencing milk production. This situation, combined with irregular menstrual cycles and occasional itching of the nipples, warrants further investigation.

Galactorrhea can be caused by several factors, including hormonal imbalances, particularly elevated levels of prolactin, which is the hormone responsible for milk production. Prolactin levels can be influenced by various conditions, including pituitary tumors (prolactinomas), hypothyroidism, and certain medications. Stress and excessive stimulation of the breasts can also lead to increased prolactin levels and subsequent milk production.

Given that you have already consulted with a gynecologist and were told that persistent milk production is not a concern, it is still advisable to seek a second opinion, especially if you are experiencing discomfort or other symptoms. A comprehensive evaluation by an endocrinologist or a specialist in reproductive health may be beneficial. They can perform blood tests to measure your hormone levels, including prolactin, and assess whether there are any underlying conditions that need to be addressed.

In addition to hormonal evaluations, imaging studies such as an MRI of the pituitary gland may be necessary to rule out any structural abnormalities, such as tumors that could be contributing to elevated prolactin levels. It is essential to address any potential underlying causes, as untreated hormonal imbalances can lead to further complications, including fertility issues and bone density loss.

Regarding the itching of the nipples, this could be a separate issue, potentially related to skin conditions or irritation. It is essential to keep the area clean and moisturized, and if the itching persists, it may be worth discussing with a dermatologist.

In summary, while persistent breast milk production can sometimes be benign, your symptoms suggest that further evaluation is warranted. Seeking a consultation with a specialist who can conduct a thorough assessment and appropriate testing will help determine the cause of your symptoms and guide you toward the best course of action. Remember, it is always better to err on the side of caution when it comes to your health.

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