Galactorrhea


Galactorrhea

Overview

Galactorrhea  is a milky nipple discharge unrelated to the normal milk production of breast-feeding. Galactorrhea itself isn't a disease, but it could be a sign of an underlying problem. It usually occurs in women, even those who have never had children or after menopause. But galactorrhea can happen in men and even in infants.


Excessive breast stimulation, medication side effects or disorders of the pituitary gland all may contribute to galactorrhea. Often, galactorrhea results from increased levels of prolactin, the hormone that stimulates milk production.


Sometimes, the cause of galactorrhea can't be determined. The condition may resolve on its own.


Symptoms


Signs and symptoms associated with galactorrhea include:


  • Persistent or intermittent milky nipple discharge
  • Nipple discharge involving multiple milk ducts
  • Spontaneously leaked or manually expressed nipple discharge
  • One or both breasts affected
  • Absent or irregular menstrual periods
  • Headaches or vision problems

When to see a clinician


If you have a persistent, spontaneous milky nipple discharge from one or both of your breasts and you're not pregnant or breast-feeding, make an appointment to see your doctor.

If breast stimulation — such as excessive nipple manipulation during sexual activity — triggers nipple discharge from multiple ducts, you have little cause for worry. The discharge probably doesn't signal anything abnormal, and this discharge often resolves on its own. If you have persistent discharge that doesn't go away, make an appointment with your doctor to get it checked out.


Nonmilky nipple discharge — particularly bloody, yellow or clear spontaneous discharge that comes from one duct or is associated with a lump you can feel — requires prompt medical attention, as it may be a sign of an underlying breast cancer.


Causes



Pituitary gland and hypothalamus

Galactorrhea often results from having too much prolactin — the hormone responsible for milk production when you have a baby. Prolactin is produced by your pituitary gland, a small bean-shaped gland at the base of your brain that secretes and regulates several hormones.


Possible causes of galactorrhea include:



  • Medications, such as certain sedatives, antidepressants, antipsychotics and high blood pressure drugs
  • Opioid use
  • Herbal supplements, such as fennel, anise or fenugreek seed
  • Birth control pills
  • A noncancerous pituitary tumor (prolactinoma) or other disorder of the pituitary gland
  • Underactive thyroid (hypothyroidism)
  • Chronic kidney disease
  • Excessive breast stimulation, which may be associated with sexual activity, frequent breast self-exams with nipple manipulation or prolonged clothing friction
  • Nerve damage to the chest wall from chest surgery, burns or other chest injuries
  • Spinal cord surgery, injury or tumors
  • Stress


Idiopathic galactorrhea

Sometimes doctors can't find a cause for galactorrhea. This is called idiopathic galactorrhea, and it may just mean that your breast tissue is particularly sensitive to the milk-producing hormone prolactin in your blood. If you have increased sensitivity to prolactin, even normal prolactin levels can lead to galactorrhea.


Galactorrhea in men


In males, galactorrhea may be associated with testosterone deficiency (male hypogonadism) and usually occurs with breast enlargement or tenderness (gynecomastia). Erectile dysfunction and a lack of sexual desire also are associated with testosterone deficiency.


Galactorrhea in newborns


Galactorrhea sometimes occurs in newborns. High maternal estrogen levels cross the placenta into the baby's blood. This can cause enlargement of the baby's breast tissue, which may be associated with a milky nipple discharge. This milky discharge is temporary and resolves on its own. If the discharge is persistent, the newborn should be evaluated by a doctor.


Diagnosis


Finding the underlying cause of galactorrhea can be a complex task because there are so many possibilities.

Testing may involve:



  • A physical exam, during which your doctor may try to express some of the fluid from your nipple by gently examining the area around your nipple. Your doctor may also check for breast lumps or other suspicious areas of thickened breast tissue.
  • Analysis of fluid discharged from the nipple, to see if fat droplets are present in the fluid, which can help confirm the diagnosis of galactorrhea.
  • A blood test, to check the level of prolactin in your system. If your prolactin level is elevated, your doctor will most likely check your thyroid-stimulating hormone (TSH) level, too.
  • A pregnancy test, to exclude pregnancy as a possible cause of nipple discharge.
  • Mammography, ultrasound or both, to obtain images of your breast tissue if your doctor finds a breast lump or observes other suspicious breast or nipple changes during your physical exam.
  • Magnetic resonance imaging (MRI) of the brain, to check for a tumor or other abnormality of your pituitary gland if your blood test reveals an elevated prolactin level.




If your doctor suspects that a medicine you're taking might be the cause of galactorrhea, he or she might instruct you to stop taking the medicine for a short time to assess this possible cause.


Treatment


When needed, galactorrhea treatment focuses on resolving the underlying cause.


Sometimes doctors can't determine an exact cause of galactorrhea. Your doctor might recommend treatment anyway if you have bothersome or persistent nipple discharge. A medication that blocks the effects of prolactin or lowers your body's prolactin level could help eliminate galactorrhea.

Underlying cause Possible treatment


Medication use : Stop taking medication, change dose or switch to another medication. Make medication changes only if your doctor says it's OK to do so.

Underactive thyroid gland (hypothyroidism) : Take a medication, such as levothyroxine (Levothroid, Synthroid, others), to counter insufficient hormone production by your thyroid gland (thyroid replacement therapy).

Pituitary tumor (prolactinoma): Use a medication to shrink the tumor or have surgery to remove it.

Unknown cause : Try a medication, such as bromocriptine (Cycloset) or cabergoline, to lower your prolactin level and minimize or stop milky nipple discharge. Side effects of these medications commonly include nausea, dizziness and headaches.Request an Appointment at Mayo Clinic

Lifestyle and home remedies



Often, milky discharge associated with idiopathic galactorrhea goes away on its own, particularly if you can avoid breast stimulation or medications that are known to cause nipple discharge.


To lessen breast stimulation:


  • Try not to overdo it when touching your nipples during sexual activity

  • Avoid squeezing, pinching or otherwise manipulating your nipples
  • Wear clothing that minimizes friction between the fabric and your nipple




For galactorrhea, possible questions to ask your doctor include:

  • What's likely causing my symptoms?
  • Are there any other possible causes?
  • What kind of tests might I need?
  • What treatment approach do you recommend for me?
  • Is there a generic equivalent for the medicine you're prescribing me?
  • Are there any at-home remedies I might try?



What to expect from your clinician

Your doctor may ask you questions, such as:


  • What color is your nipple discharge?
  • Does nipple discharge occur in one or both breasts?
  • Do you have other breast signs or symptoms, such as a lump or area of thickening?
  • Do you have breast pain?
  • How often do you perform breast self-exams?
  • Have you noticed any breast changes?
  • Are you pregnant or breast-feeding?
  • Do you still have regular menstrual periods?
  • Are you having trouble getting pregnant?
  • What medications do you take?
  • Do you have headaches or vision problems?


What you can do in the meantime


Until your appointment, follow these tips to deal with unwanted nipple discharge:

  • Avoid breast stimulation to reduce or stop nipple discharge. For instance, avoid stimulating the nipples during sexual activity. Don't wear clothing that causes a lot of friction on your nipples.

  • Use breast pads to absorb nipple discharge and prevent it from seeping through your clothing.

What is ketoconazole shampoo? Treatment of fungal infection in the head.

ketoconazole shampoo usage and side-effects

Ketoconazole shampoos treat fungal infections that occur on or around the scalp. In some cases, a healthcare professional may recommend using ketoconazole for other off-label purposes. Treatment of dandruff in most cases.

In this article, we discuss what ketoconazole shampoo is, who can use it, and its potential side effects including ketoconazole shampoo hair loss

What Is ketoconazole shampoo?


Ketoconazole shampoo is a red-orange liquid that a person can use to treat fungal infections on the scalp. It contains ketoconazole, which is a synthetic antifungal agent.


The Food and Drug Administration (FDA) approved ketoconazole in the form of a 2% solution to treat certain conditions, such as dandruff, seborrheic dermatitis, and tinea versicolor, which is a noncontagious fungal infection of the skin.


It is available in both over-the-counter (OTC) and prescription strengths.


A person should talk to their doctor if they suspect that they have a fungal infection. A doctor can provide more advice on effective treatments for their condition. ketoconazole shampoo side effects

How to use it


A person should follow all the instructions on the label or those that the doctor gives them.


In most cases, the person will need to work up a lather with the shampoo and apply it directly to the hair, ensuring that it reaches the scalp. They should leave the shampoo on their scalp for about 5 minutes before rinsing it off thoroughly.


People aged 12 years old and over should apply the shampoo to the scalp every 3–4 days for up to 8 weeks. After that, the product is only necessary if the person needs to control dandruff.



Who can use it?



Anyone who is allergic to the active ingredient, ketoconazole, should not use the shampoo.


According to 2019 research, ketoconazole is safe to use topically, and people should be able to use ketoconazole shampoo for its intended purpose safely. However, the researchers note that in some cases, contact dermatitis may occur.


People who experience an allergic reaction when they use ketoconazole should discontinue its use. how to use ketoconazole shampoo,ketoconazole shampoo dosage

If the reaction is severe, they should seek immediate medical attention.

Pregnancy or breastfeeding



It is safe to use ketoconazole shampoo when breastfeeding. According to a 2018 article, the use of ketoconazole shampoo does not pose a risk to the infant. However, breastfeeding women should avoid applying it to the breasts or the nipples due to the chance of the infant ingesting it.


There does not appear to be much research on the use of ketoconazole shampoo during pregnancy. According to the FDA, a person should not use ketoconazole during pregnancy unless the benefit outweighs any potential risks to the fetus.


However, more recent 2017 research suggests that ketoconazole is likely safe but that if a pregnant woman uses it, she should only do so on limited areas for short periods.


There are not enough studies to indicate whether the ingredients could be harmful to the developing baby.


Children under the age of 2 years should also avoid using the shampoo unless a doctor recommends it. The safety of ketoconazole shampoo on children remains unclear. ketoconazole shampoo on face,ketoconazole shampoo reviews

Side effects


Ketoconazole shampoo generally has limited side effects.

According to the FDA, some reported side effects include:

  • odd color and feel of the hair
  • itching
  • burning sensation
  • hives
  • hypersensitivity
  • dry skin
  • alopecia
  • swelling
  • rash
  • irritated skin



If a person experiences a severe allergic reaction, which is called anaphylaxis, they should seek emergency medical help.


The symptoms of anaphylaxis include:

  • wheezing
  • passing out
  • tight chest
  • hoarse voice
  • hives
  • diarrhea
  • difficulty swallowing
  • a feeling of impending doom


Interaction with other medications



A person should talk to their doctor about any medications that they are taking. A doctor can advise whether certain medications will interfere with, or react to, ketoconazole.


If a reaction does occur, a person should talk to their doctor as soon as possible. It is possible that an alternative shampoo or medication may work without interactions.


Ingestion



If a person swallows ketoconazole shampoo, they should seek emergency medical treatment as soon as possible at any nearest health facility.


When to see a Clinician



A person should talk to their doctor if they have tried using an OTC ketoconazole shampoo and still have symptoms of the condition that they are trying to treat.


A person should also see a doctor if they experience any of the following symptoms on using the shampoo:

  • rash
  • shortness of breath
  • angioedema, which is a swelling that occurs under the skin
  • skin reactions


Summary

Ketoconazole shampoo comes in both prescription and OTC strengths.


A person may be able to use ketoconazole shampoo to help with seborrheic dermatitis and dandruff, as well as fungal infections, including tinea versicolor.


A person should discontinue the use of ketoconazole shampoo if they have an allergic reaction to it. Women who are pregnant or breastfeeding should talk to their doctor before using the shampoo.

What are the different types of abortion?

abortion types,safe abortion




An abortion is a medical means of ending a pregnancy.
There are a number of types of abortion, and options depend on the duration of the pregnancy.
Worldwide, around half of all reported unintended pregnancies end in abortion. Abortion is legal throughout the majority of the United States and in many other countries.
In this article, we describe the different types of abortion, when and where they are available, and what they involve. We also look into advantages and disadvantages, recovery, and potential risks.

When can a woman have an abortion?


Where abortion is legal in the U.S., doctors usually perform them in the first trimester or the early part of the second trimester.


The first trimester lasts from conception to week 12 of pregnancy. The second trimester is from week 13 to week 28. Some states allow abortion in the latter part of the second trimester.


In 2015, two-thirds (65.4%) of reported abortions in the country took place when the pregnancy had lasted fewer than 8 weeks, according to the Centers for Disease Control and Prevention (CDC).


In the same year, almost all of the reported abortions (91.1%) took place when the pregnancy had lasted fewer than 13 weeks.


In the first trimester, options for abortion commonly include:

  • medical abortion
  • vacuum aspiration



A woman can usually access medical abortion until about 10 weeks after her last period. It involves taking two types of medication.


Surgical options, such as vacuum aspiration and dilation and evacuation, are more common after 10 weeks.


In the second trimester, a woman may undergo:

  • dilation and evacuation
  • labor induction abortion



Abortion is rare during the third trimester, but a doctor may perform it after 29 weeks of pregnancy if a woman’s life is in danger. They may use the same methods that are used during the second trimester.

Medical abortion



A medical abortion requires a woman to take pills at separate times.
How it works

This type of abortion involves taking two medications, mifepristone and misoprostol.


A doctor or nurse will advise about the timing, but a woman should take the second medication, misoprostol, no more than 48 hours after taking the first, mifepristone.


Mifepristone stops the pregnancy from developing. Misoprostol triggers the uterus to empty, which will begin 1–4 hours after taking the pill.


A woman will experience cramping and bleeding as the uterus empties, which may feel like having an unusually heavy period. Some women feel more severe cramping than others.


Within around 4–5 hours, the pregnancy tissue will likely have passed from the body, but it can take longer.

Advantages



Some advantages of a medical abortion are:

  • It does not involve surgery.
  • It is available in the first trimester.
  • It does not require an anesthetic.

Disadvantages


Some disadvantages of a medical abortion are:

  • It is not available in the second trimester.
  • Only part of the treatment takes place in a clinic.
  • It may cause painful cramping.
  • Rarely, it is not effective.



It may be a good idea to have a partner or friend close by for support while the tissue is passing.

Recovery



Recovery from a medical abortion involves:
some bleeding and spotting that may last for several weeks
a check-up with the doctor to monitor recovery

Risks



Some women experience side effects of the medications. These can include:

  • nausea
  • heavy vaginal bleeding
  • dizziness
  • fatigue
  • diarrhea
  • mild fever


Vacuum aspiration



Vacuum aspiration is a type of surgical abortion that involves using gentle suction to end a pregnancy. Doctors typically recommend this during the first trimester.

How it works



A doctor begins the vacuum aspiration procedure by inserting a speculum into the woman’s vagina. They then apply medication or use an injection to numb the area.


Next, they use thin rods called dilators to open the cervix, then insert a tube into the uterus. Then, they use either a manual or mechanic suction device to empty the uterus.

Advantages



The advantages of vacuum aspiration are:

  • It is available in the first 12 weeks of pregnancy.
  • It is quick, with the procedure only taking 5–10 minutes.
  • It is relatively pain-free, though some women experience cramping, sweating, nausea, or a combination.
  • It does not require a general anesthetic.

Disadvantages



The main disadvantage of vacuum aspiration is that it is not available in the second trimester.

Recovery



Recovery from vacuum aspiration involves:

  • resting for up to 1 hour after treatment
  • taking antibiotics to prevent infection
  • avoiding sex for 1 week after treatment



Also, some women experience cramping for a few days following the procedure, and irregular bleeding or spotting can occur for several weeks.

Risks



The potential complications of vacuum aspiration include bleeding and infection. However, the risk of these complications is low.


Speak to the doctor right away if signs of bleeding or new symptoms occur.


Dilation and evacuation



Dilation and evacuation is a type of surgical abortion that doctors commonly use during the second trimester.

How it works


A doctor may give a general anesthetic before performing a dilation and evacuation. This type of anesthetic ensures that a person does not feel anything during the procedure.


The doctor begins by inserting a speculum into the woman’s vagina. Then, they use dilators to open the cervix.


Next, they remove the pregnancy tissue with small forceps. Finally, they use suction to remove any remaining tissue.

Advantages



The advantages of dilation and evacuation are:

  • It is available in the second trimester.
  • It is a safe and effective way to end a pregnancy.

Disadvantages

The disadvantage of dilation and evacuation is that it can require a general anesthetic.

Recovery



Recovery from dilation and evacuation involves resting.


Mild pain and cramping can occur for a few days after the procedure, and there may be some bleeding for up to 2 weeks.

Risks



Potential complications of dilation and evacuation include:

  • infection
  • heavy bleeding
  • injury to the uterus



The risk of injury to the uterus or other organs during a second-trimester abortion is less than 1 in 1,000, according to The American College of Obstetricians and Gynecologists.


Labor induction abortion



Labor induction abortion is a late-term method of ending a pregnancy in the second or third trimester.


This type of abortion is rare, and a doctor may recommend it if a woman’s life is in danger.

How it works



Labor induction involves using medications to start labor, which causes the uterus to empty over a period of around 12–24 hours. A woman can take these medications by mouth or the doctor may place them into the vagina or inject them into the uterus.


Doctors usually also administer pain relief medication or a local anesthetic, as intense cramping occurs during this type of abortion.

Recovery


After the abortion is complete, a woman tends to remain in the clinic or hospital for anywhere from a few hours to 1–2 days, depending on health and other factors.


The doctor can help determine the length of the stay, and they may be able to estimate it before the abortion.

Risks

The medications that induce labor can cause side effects, such as:

  • nausea and vomiting
  • fever
  • diarrhea

Complications are rare but can include:


  • hemorrhage
  • cervical injury
  • infection
  • rupture of the uterus
  • incomplete release of the pregnancy tissue

When do periods start after abortion?

Period After Abortion

Abortion is a low risk medical procedure that end pregnancies. It is normal to experience bleeding right after having an abortion, but a woman’s first period will usually occur several weeks later.when do periods start after abortion? What causes blood clots after abortion? Still bleeding 3 weeks after abortion,How to stop bleeding after abortion naturally?first period after abortion how long does it last? prolonged bleeding after abortion what does it signifies?


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This article discusses what women can expect to happen to their periods after an abortion. Read on to learn how medical and surgical abortions affect the menstrual cycle.


What is postabortion bleeding?

Many people experience some bleeding after having an abortion. Doctors call this postabortion bleeding. It is a good idea to use pads after an abortion to track how much blood is resulting. this bleeding needs to be assessed for some dangers because it can be caused by incomplete abortion that can complicate to infection of the uterus.

Types of abortion

The two main types of abortion are medical and surgical. Here, we discuss these types of abortion and bleeding that women may experience afterward.
Bleeding after a medical abortion


A woman may experience bleeding right after an abortion, but it will take several weeks for periods to return.


A medical abortion is when the doctor gives a woman abortion pills to end her pregnancy. This type of abortion is available in the first 10 weeks of pregnancy.


During a medical abortion, the doctor gives a woman two pills:

  • mifepristone to stop the pregnancy developing
  • misoprostol to trigger the uterus to expel the pregnancy tissue



Misoprostol causes the uterus to contract, which forces the pregnancy tissue to pass out through the vagina. This treatment results in bleeding, which can be similar to having a heavy period. Some people experience heavier bleeding than others, and it may contain large blood clots.


A woman may then experience spotting or light bleeding for up to 2 weeks after the pregnancy tissue passes out. how to stop bleeding after abortion
Bleeding after a surgical abortion


Surgical abortions typically take place after week 10 of pregnancy. There are two types of surgical abortion:
vacuum aspiration, which involves removing the pregnancy by the use of suction
dilation and evacuation, which involves dilating the cervix with forceps and removing the pregnancy with suction


Doctors usually use vacuum aspiration up to around 14–16 weeks after a woman’s last period. After a longer time, they will generally recommend dilation and evacuation.


Surgical abortions can also cause postabortion bleeding, which may be similar to a normal period. Bleeding after a surgical abortion usually lasts around 1–2 weeks. Some women may experience spotting up until their next period.

Prolonged bleeding after abortion

Prolonged bleeding after abortion is due to certain reasons and the major common cause is what we call incomplete abortion. when abortion is done either medical or surgical there are possibilities that some products of conception maybe left in the uterus and that is called incomplete abortion. The bleeding may not stop until the remaining part is removed it can be a placenta, hand leg or any part.


How does abortion affect the menstrual cycle?

A woman will usually have her next period 4–8 weeks after having an abortion. The abortion empties the uterus, so restarts the menstrual cycle.


The start date of a woman’s next period will depend on whether she is using birth control and, if so, which type.


If a woman’s periods do not start within 8 weeks of having an abortion, she should speak to her doctor.


Does it cause irregular periods?



Some birth control methods may affect the regularity of periods after an abortion. If a person typically has irregular periods, they may continue to experience these after an abortion.


Having an abortion can lead to emotional stress, which may also affect someone’s menstrual cycle. Experiencing stress can change the regularity of periods.


If a woman has irregular periods after an abortion and did not previously, she should speak to her doctor.


What to expect for the first period



After a surgical abortion, a woman’s first period may be shorter than usual. The abortion procedure fully empties the uterus, so there is less tissue to expel, which can result in a lighter period.


A women’s first period may be longer than usual, following a medical abortion, because the treatment uses hormones that may impact her cycle length. This period can also be heavier as the body may have additional tissue to expel after the procedure.


Using pads during the first period after an abortion allows a woman to monitor the amount of blood she is losing.

What to expect for the second period



The second period after an abortion is likely to return to how an individual’s periods were before.


That said, some women may find that it takes two or three cycles for their periods to return to normal. If this does not happen, they should speak to their doctor.


When can you start birth control?


Women can start using birth control straight after an abortion. If they want to use an intrauterine device (IUD), they can ask a healthcare professional to fit one during the same appointment as the abortion.


IUDs are an effective form of birth control. Both hormone-free copper IUDs and hormonal-plastic IUDs are available.


The advantage of copper IUDs is that they do not affect mood, but they may cause heavier periods.


Hormonal IUDs may lighten periods but, as with all hormonal contraception, they may affect mood.


Condoms offer a reliable hormone-free contraception method that does not require surgery.


Which contraception method to use is a personal choice, and different options work for different people.


When to see a doctor


Anyone who feels faint or has a high temperature after an abortion should consider speaking to a doctor.


If a woman experiences very heavy bleeding after an abortion or pain that is not manageable with over-the-counter pain medication, she should speak to her doctor.


Blood clots up to the size of a lemon are normal during postabortion bleeding. Blood clots that are larger than this are something to discuss with a doctor.


Symptoms that may include dizziness, sweating, and nausea during or after an abortion are typical. However, women who feel very faint or have a high temperature should talk to their doctor.


If a woman experiences any symptoms that worry or alarm her, speaking to a doctor for reassurance is a good idea.

When do periods start after abortion?

for now you have clear and complete answers. if there is any question you can simply visit our contact us page and talk to a Doctor

Summary


Abortions lead to the menstrual cycle restarting. Most women get their period 4–8 weeks after an abortion.


The first periods after a medical abortion may be heavier and longer than before. The first period after a surgical abortion may be shorter and lighter.


If a woman’s periods do not start 8 weeks after an abortion or return to normal after 3 months, she should see her doctor.


Postabortion bleeding is normal. If this is very heavy, continues for more than 2 weeks (prolonge period,) or contains blood clots larger than a lemon, a woman should speak to her doctor

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