What causes breast discharge in an unmarried woman?

A woman’s breasts will only secrete milk after she gives birth. However, some unmarried girls or women who are married but not

pregnant or give birth often find a moist stain on their bras. If they are squeezed occasionally

< p> Lower breasts, some milky white liquid will also flow out from the nipples. It is different from the bloody liquid secreted by patients with breast ductal cancer and is real milk. Girls who experience this situation are often reluctant to seek medical attention due to shyness

Prompt diagnosis and treatment, or are worried about having "strange diseases", which aggravates the symptoms, so it is necessary to treat them

A brief introduction to this phenomenon. To clarify the reason, we must first talk about how normal women's milk is produced after childbirth.

An important substance in milk secretion - prolactin

People have long known that the development of women's breasts is mainly affected by the effects of estrogen and progesterone secreted by the ovaries. Estrogen can promote the development of breast lobules, while progesterone can cause the growth of breast ducts. Under the synergistic effect of estrogen and progesterone

the breasts gradually develop into a pair of hemispherical protrusions, which not only shows the unique bodybuilding of women, but also provides a healthy body after childbirth. Breastfeeding ready. However, with the gradual deepening of research, people have discovered that estrogen

and progesterone alone cannot cause the mammary glands to produce milk. So where does milk come from and what is it controlled by?

p>

What about adjustment?

With the advancement of radioimmunoassay technology, medical staff have been able to detect prolactin, a hormone directly related to milk secretion, from women's blood. It turns out that milk secretion is under the control of the nervous system. The reproductive endocrine axis composed of the three main links of

hypothalamus-pituitary-ovary, secretes prolactin

< p> to adjust the control.

The hypothalamus is located in the lower part of the third ventricle. It is the "regulatory center" for the secretion of countless hormones in the body and the "command" for milk secretion

regulation. There are many microvilli at the upper end of the hypothalamus extending into the third ventricular cavity. Like a "scout" sent out, it can obtain information on systemic hormone levels through the various hormone contents in the ventricular fluid. "Retribution". When hormones in the body increase or decrease, the microvilli will "report" to the hypothalamus in time, and the hypothalamus will produce two major types of substances in a timely manner based on this "intelligence", one is called " "Releasing factors" are signals that direct hormone production; the other type, called "inhibitory factors," are signals that direct hormones to decrease. These two types of substances reach the pituitary gland through the pituitary portal system at the lower end of the hypothalamus.

The pituitary gland is located in the sella cavity at the lower end of the hypothalamus. Its role is like a "combat troop" that acts under the command of the headquarters.

The pituitary gland immediately responds to increase or decrease production according to signals from the hypothalamus, producing various types of "stimulating hormones". These "stimulating hormones" are like "commands", "conveyed" to their respective "targets" - the corresponding organs and tissues throughout the body.

When these "targets" receive "commands" from the pituitary gland, they will produce an appropriate amount of hormones according to the amount of pituitary hormones to maintain the body's needs.

For example, the ovaries are located on both sides of the uterus in a woman's pelvic cavity, and they change according to gonadotropins, a type of stimulating hormone. Different amounts of estrogen or progesterone can be secreted periodically to maintain female sexual function and female sexual

characteristics.

Breast development is mainly affected by estrogen and progesterone secreted by the ovaries, and prolactin secreted by the pituitary gland

to determine the degree of development.

How is normal milk secretion regulated?

The content of prolactin in normal women is very small, only 0 to 20 nanograms per milliliter of blood. It only

Can maintain normal mammary gland development without causing milk secretion.

After a woman is pregnant, in addition to the fetus and placenta secreting a certain amount of prolactin, the more important reason is that the level of sex hormones in the pregnant woman's body increases. These hormones enter the third body through body fluids. In the third ventricle, after receiving this information, the hypothalamus begins to "prepare" for the future delivery of the baby. In order to prepare the baby's "food" - milk, the hypothalamus produces "prolactin-secreting cells" to synthesize prolactin. This prolactin begins to increase rapidly after one and a half months of pregnancy. It can reach 3-4 times that before pregnancy, and can reach more than 200 nanograms per milliliter before delivery. Such a large amount of lactation hormone directly acts on the lactation of the mammary gland. On the cell membrane, certain enzymes on the cell membrane can be activated, and under the combined stimulation of estrogen

and progesterone, milk is formed in the lactating cells. However, why do pregnant women not secrete milk?

Does lactation have to occur after delivery? The current explanation is that after delivery, the estrogen and progesterone in the mother's body drop sharply, and this information is initiated after it is transmitted to the hypothalamus. To achieve lactation, and then maintain normal milk secretion with the participation of other factors (such as growth hormone, thyroxine, insulin, aldosterone, calcium ions, etc.). p>. After milk secretion starts, a large amount of prolactin is no longer needed, so after 3-4 months of breastfeeding, the prolactin in the mother's blood gradually returns to normal levels. When the baby sucks the mother's nipple, this stimulation can cause a short-term increase in prolactin through the hypothalamus-pituitary axis. In this way, milk secretion continues.

It doesn’t stop completely until half a month after the lactation period.

So why don’t normal unmarried girls or postpartum mothers produce milk when they are not pregnant?

When the woman's hypothalamus produces "prolactin inhibitory factor", this factor acts on the pituitary lactation cells to inhibit the secretion of prolactin by the pituitary gland and maintain prolactin in the blood at 20 milliliters per milliliter. Less than micrograms, so the breasts do not secrete milk.

Now we can turn to the topic and talk about why unmarried girls also secrete milk.

Is the "protagonist"

From a medical point of view, anyone who is not pregnant or giving birth but has lactation, or who has stopped breastfeeding for more than half a year

but still continues to lactate, Regardless of whether the person has other obvious discomforts, it belongs to the scope of pathology. This kind of milk secreted during non-lactation is called galactorrhea. How can this phenomenon occur regardless of the reason? /p>

Reducing the production of prolactin inhibitory factor in the hypothalamus, or causing the pituitary gland to secrete excess prolactin, can

increase prolactin in the blood, leading to abnormal galactorrhea. , this symptom is called "hyperprolactinemia"

In addition to galactorrhea, patients with hyperprolactinemia are often accompanied by varying degrees of menstrual disorders, and in severe cases

< p> to amenorrhea; during physical examination, symptoms such as hair loss, weight gain, headache, visual impairment, and external genital atrophy can be found, forming a group of patients with galactorrhea, amenorrhea, and infertility as the main manifestations. The disease is called "galactorrhea-amenorrhea syndrome". However, regardless of the severity of the symptoms, the main reason is the production of excessive prolactin.

There are many causes of hyperprolactinemia, which can be roughly divided into the following categories:

1. Hypothalamic disorders

Hypothalamus and adjacent parts Diseases, such as encephalitis, craniopharynoma, pineal tumor, partial hypothalamic infarction, pseudotumor, pituitary stalk amputation, etc., can all cause the production of prolactin inhibitory factor by the hypothalamus. Decreased, or increased prolactin-releasing factor and thyroid-stimulating hormone-releasing factor. The former can cause prolactin to be produced blindly due to loss of inhibition, while the latter two directly promote the increase of prolactin production.

One of the more common hypothalamic disorders is "postpartum galactorrhea-amenorrhea syndrome", which is characterized by persistent galactorrhea after stopping breastfeeding for more than half a year

and is often accompanied by There is amenorrhea and uterine and ovarian atrophy. People suffering from this disease often experience delayed development of secondary sexual characteristics and irregular menstruation during adolescence.

2. Pituitary disorders

Mainly are various tumors in the pituitary gland. In addition, some vacuolar sella syndrome and hyperpituitarism can also cause galactorrhea and amenorrhea.

3. Primary hypothyroidism

The thyroid gland and the mammary gland, one in the neck and the other in the chest, seem to be two unrelated organs, but In fact, the endocrine relationship between the two is very close. When hypothyroidism occurs, information about insufficient thyroid secretion is fed back to the hypothalamus, causing the hypothalamus to produce a large amount of thyroid-stimulating hormone-releasing factor, which stimulates pituitary secretion. Thyroid-stimulating hormone can also stimulate the excessive secretion of prolactin from the pituitary gland, causing galactorrhea.

4. Drug factors

Sedatives that act on the central nervous system, such as chlorpromazine, morphine, etc., can reduce the content of catecholamines in the hypothalamus

Thereby reducing the activity of prolactin-releasing factors produced by the hypothalamus; antihypertensive drugs methyldopa and reserpine

can inhibit the release of prolactin-inhibiting factors; metoclopramide can stimulate excess prolactin in the pituitary gland secretion.

5. Nerve stimulation

Irritation of the skin in certain parts, especially the chest, including severe pain caused by peripheral nerve damage, can all occur through the nerves

Passed to the hypothalamus causing an increase in prolactin. Such as chest surgery, burns, herpes zoster on the chest and back, etc. In addition, frequent irritation of the breasts, such as chronic breast abscesses; cystic breast tumors, especially those who allow children to frequently suck nipples, may also be caused by long-term nerve irritation. It can lead to endocrine control disorders and even galactorrhea. This symptom can also occur in patients with spinal cord disease and hysterectomy.

There are many other factors, such as those suffering from adrenaloid tumors, adrenal adenomas, and bronchial lung cancer, which can produce non-pituitary prolactin in the lesion

; severe mental trauma And obvious changes in living habits can also cause temporary galactorrhea. However, about 30-40% of patients with galactorrhea cannot find any cause, and can only be collectively referred to as "unexplained galactorrhea".

What to do after galactorrhea

Since there are many factors that cause galactorrhea, it is recommended that women with menstrual disorders or amenorrhea should have regular menstrual bleeding themselves

Press both breasts. Once nipple discharge is found, you should go to the hospital for detailed examination in time, including measurement of prolactin and other endocrine hormones in the blood, to clarify the location and cause of the disease.

/p>

Supplement thyroxine; if it is caused by drugs, it is mostly temporary galactorrhea, which usually disappears after stopping the drug for a period of time.

2. There is no ideal drug for inhibiting hyperprolactin. L-dopa 0.5 g, 4 times a day, can only inhibit galactorrhea in a small number of patients.

Recently, a semi-synthetic ergot alkaloid derivative, bromocriptine, has been produced abroad to treat hyperprolactinemia. The dose is 2.5 mg per day at the beginning. After one week, if there are no adverse reactions, it will be gradually Increase the dose to 5

-7.5 mg per day, orally divided into 2 times, and the effect will usually be achieved after one month. However, the disadvantages of this drug are that firstly, it is expensive, with each tablet costing several RMB; secondly, blood prolactin may still rise after stopping the drug. Therefore, more ideal drugs for the treatment of this disease are a subject actively explored by the medical community.

During non-pregnancy and non-lactation periods, fluid flowing out when squeezing the nipple is called nipple discharge. Nipple discharge is one of the common symptoms of breast disease. According to statistics, patients with nipple discharge as the first symptom account for 3% to 14% of breast diseases, and the incidence is second only to breast lumps and breast pain. If the nipple discharge is single nipple discharge, it is mostly related to breast diseases such as breast duct ectasia, intraductal papilloma, and cystic breast hyperplasia. In addition to bloody nipple discharge, there are two types of breast cystic hyperplasia. Characteristics: First, it manifests as cyclic breast swelling and pain, which often occurs or worsens in the early period of menstruation. In mild cases, patients are not bothered by it, but in severe cases, it can affect work and life. Second, breast lumps are often multiple and can be found on one or both sides. They can also be limited to a part of the breast or dispersed throughout the breast.

The mass is nodular and varies in size. It is tough but not hard, has no adhesion to the skin, and has unclear boundaries with surrounding tissues. The mass may shrink after menstruation. In your case, if you are of childbearing age, it is very likely to be cystic breast hyperplasia, but the possibility of cancer cannot be ruled out.