Why do my breasts produce milk yet I’ve never been pregnant?


DR FLO: Why do my breasts produce milk yet I’ve never been pregnant?

Galactorrhea usually results from a rise in the hormone prolactin, which stimulates milk production

Why do my breasts produce milk yet I’ve never been pregnant?

Dr Flo, I have this burning sensation on the right side of my pelvis. It extends to the right leg in form of tingling or numbness. I also have chronic waist and back pain. Recently my breasts started producing milk. I am 24 and I’ve never been pregnant. Please help me, I’m worried! Nelly

?

Dear Nelly,

The back pain, waist pain and burning and tingling sensation in the right pelvis and leg are most likely related. The most likely cause is a problem in the lower back that is affecting the sciatic nerve. The sciatic nerve is a big nerve that starts at the lower spine, and passes through the buttocks/pelvic area and down the leg, with branches all the way to the toes. When the sciatic nerve is compressed, you feel pain, starting either in the lower back, or at the hip or buttocks, sometimes spreading down the leg up to the toes.

The nerve can be compressed because of problems in the lower back, e.g. protrusion of the cushioning disc that is usually between the bones of the spine (disc herniation), or due to arthritis in the bones of the spine.

The nerve can also be compressed by contractions of muscles as it passes through the pelvic area.

You need to see an orthopaedic specialist so that physical examination and some tests like x-rays and MRI scan can be done to find out the exact problem.

Treatment includes medications for pain, both oral, and injections; stretching exercises, physiotherapy, massage, and even surgery, if required. You also need to get a comfortable chair and to stand and stretch, or do some exercises after sitting for some time.

Milk production from the breasts other than during normal breastfeeding, is called galactorrhea. It usually happens in women, but it can also happen in men and even in infants.

Galactorrhea usually results from a rise in the hormone prolactin, which stimulates milk production.

It can happen due to increased breast stimulation, use of some medications (for mental illness, depression, anxiety, vomiting, high blood pressure), or disorders of the pituitary gland (which produces prolactin), chronic kidney disease, thyroid problems, hormonal medications or nerve damage. Sometimes the cause is not found.

The underlying cause of the milk production may be cause for concern. You need to see a doctor so that you can be examined and the exact cause identified and treated.

In the meantime, do not stimulate or examine your nipples frequently, and avoid wearing clothing that creates friction with the nipples.

?

Dr Flo, I am a 30-year-old mother of a five-year-old. I realised I was pregnant in May this year, then in mid-June, I started feeling pain in my lower abdomen and three days later, I had a miscarriage. I did not go for cleaning; I opted to let it bleed out, then three days later, I went for a scan that showed everything had come out.

A gynaecologist assured me that I could get pregnant again at any time, but since then I have not conceived.

Someone also advised me to start taking folic acid tablets to help me conceive, but it still hasn’t happened. I get my periods regularly and at times they have clots.

Do I need to have my uterus cleaned so as to conceive again or should I just wait for it to happen when it happens?

Or is it advisable to go back to using the contraceptive implant until next year, then I start trying to get pregnant again next year? Alice

?

Dear Alice,

You do not need to get “cleaned” because as per the ultrasound done after your miscarriage, everything had come out, so there is nothing to clean. Getting pregnant again is usually possible from six weeks after the pregnancy loss. Just like anyone else, conceiving is not automatic, and may happen when you want it or it may take some time.

Medical professionals only get concerned when you have been unable to conceive for a year.

If you are ready for another pregnancy, then it is okay to keep trying. If you would rather wait till next year then you can use the implant. In the meantime, you need to be aware of any psychological issues that you may have like fear, guilt or trying to replace the baby you lost.

You may need to talk to a psychologist/counsellor to help you deal with these issues even as you look forward to another pregnancy. Severe emotional stress may actually contribute to a delay in getting pregnant.

The folic acid does not help you conceive. It is a supplement that is necessary for the development of the brain and nerves of the baby and it is beneficial when you have adequate levels in your body before and during pregnancy.

?

Dr Flo, thank you for your informative articles. Which medicine can I take to shrink fibroids? Everlyn

?

Dear Everlyn,

Fibroids are non-cancerous growths in the uterus that are made up of fibrous and muscle tissue.

They are not cancerous. In most cases, there are no symptoms or the symptoms are mild. Some women may experience heavy bleeding, painful periods, low abdominal pain or back pain, constipation, passing urine frequently or discomfort during sexual intercourse. Rarely, fibroids can lead to infertility or complications during pregnancy. There is no known cause of fibroids, but their development is associated with the hormone oestrogen, which is produced by the ovaries. They are common in women aged between 30 and 50 years and tend to shrink at menopause.

You can take medication to target the symptoms, for example, painkillers to manage pain; tranexamic acid, hormonal contraceptives or progestin-releasing intra-uterine device to reduce bleeding.

Medications called gonadotropin releasing hormone (GnRH) agonists can shrink fibroids by blocking the production of oestrogen and progesterone.

These medications create a menopausal state in the body, and it causes periods to stop and you can develop hot flashes.

The medication should not be used without a gynaecologist’s supervision neither should it be used for longer than six months because it can lead to osteoporosis (weak bones).

The other ways of managing fibroids are surgical which range from minimally invasive to open surgery, and are done by the gynaecologist if there’s a need for it.

?

Send your medical questions to [email protected]