Menopause and galactorrhea
Introduction
Introduction Amenorrhea refers to menstruation stopped for at least 6 months. Amenorrhea can be divided into two categories: one is physiological amenorrhea. That is, women have a period of menstrual cramps due to certain physiological reasons, such as pregnancy, lactation, postmenopausal, etc.; the other type is pathological amenorrhea, which means that menstrual cramps may be caused by certain pathological reasons. Caused by systemic or localized lesions. The galactorrhea is an abnormal phenomenon in which the emulsion is secreted during non-breastfeeding. It may be caused by some physiological diseases, or it may be caused by drugs or bad stimuli. Therefore, when this condition occurs, in addition to paying attention to breast health, it should also identify the cause and target treatment. She continued lactation during her non-partum lactation or after she stopped breastfeeding for one year, indicating that she developed galactorrhea. If lactation is accompanied by amenorrhea, it is called galactorrhea. In most patients, serum prolactin exceeds the normal high limit (1-25 mg/L) and is hyperprolactinemia. Lactation-emphasis syndrome, also known as galactorrhea-menopausal syndrome, refers to the pathological state characterized by lactation and amenorrhea. Strictly speaking, it is not a disease, but can be caused by different diseases, but Syndrome with common clinical features.
Cause
Cause
1. A disease of the hypothalamic tumor or dysfunction, the hypothalamus, and adjacent parts.
2. Such as encephalitis, craniopharynx, pineal tumor and so on.
3. Pituitary diseases, such as pituitary tumors, pituitary hyperfunction, partial vacuolar sella syndrome.
4. Primary hypothyroidism.
5. Improper medication, such as excessive use of sedatives.
6. nerve stimulation, such as chest surgery, burns, chest and back banded cancer rash.
Examine
an examination
Related inspection
Gynecological ultrasound examination of nipple discharge examination
Lactation-menopausal syndrome is generally divided into three types, the diagnosis points are as follows:
1, Chiari-Frommel syndrome
Occurred after the birth, the nipple is stimulated by unreasonable breastfeeding or long-term sucking, resulting in hypofunction of the hypothalamic-pituitary-ovarian system. No pituitary tumors. Prolactin levels in the blood are elevated, while follicle stimulating hormone (FSH) and luteinizing hormone (LH) are reduced. It is mostly transient and can last for several years. It can often be re-sent after the next pregnancy.
2, Argonz-delCastillo syndrome (idiopathic galactorrhea syndrome)
Occurred in non-pregnancy lactation, mostly due to hypothalamic-pituitary dysfunction, surgery, trauma, anesthesia, mental stimulation and other factors can be caused. No pituitary tumors. The excitation or inhibition test of hypothalamic-pituitary function was positive. Some of the patients can recover spontaneously after the pathogenic factors are relieved; however, many patients can continue for a long time and cannot be cured without medical treatment.
3, Forbes-Albright syndrome
Occurs in non-pregnancy lactation, mostly due to pituitary tumors. Fundus changes or narrow vision can occur due to tumor compression. A pituitary canine examination can detect a tumor. Symptoms will not be relieved until the pituitary tumor is removed.
Diagnosis
Differential diagnosis
What are the symptoms of menopause and galactorrhea?
Pituitary tumors: Pituitary tumors or pituitary microadenomas (tumor diameter <5mm) can cause galactorrhea due to the secretion of large amounts of prolactin.
Hypothalamic lesions: Under normal conditions, the secretion of prolactin is restricted by the hypothalamus. The hypothalamus produces dopamine and another prolactin-releasing factor, the former inhibiting prolactin secretion and the latter stimulating prolactin secretion. Any abnormal cause of a decrease in dopamine or an increase in prolactin releasing factor may cause galactorrhea.
Abnormal ovarian function: Estrogen and progesterone can feedback inhibition of prolactin secretion. When the bilateral ovaries are removed for any reason, or because the bilateral ovarian function is low, it is not enough to cause feedback, and the secretion of prolactin is increased. This situation is like lactation after childbirth.
Effects of certain drugs: Rauvolfia drugs, such as reserpine; sedatives, such as chlorpromazine; oral contraceptives and levodopa, can be inhibited by prolactin inhibitors, resulting in an abnormal increase in prolactin secretion .
Thyroid dysfunction: If the thyroid function is low, the secretion of thyrotropin is increased in the pituitary gland, and prolactin secretion can be increased at the same time, and amenorrhea occurs.
Other reasons: such as long-term sucking nipples, stimulate the sensory nerves in the nipple, reflexive stimulation of hypothalamic prolactin-producing cells, induce pituitary secretion of prolactin. A rare form of bronchial lung cancer that produces an active substance similar in structure to prolactin, induces abnormal galactorrhea, and can also cause galactorrhea-menopausal syndrome.
Under normal circumstances, adolescent women with the growing maturity of the breast, the nipple can intermittently flow a small amount of liquid, which is the body to ensure the smoothness of the breast. Normal liquids should be white or colorless, and sometimes yellowish or pale green. However, if there is a large amount of liquid that is dark brown or has pus, it is likely that the breast is infected with bacteria.
