Medical history (history of illness) represents an important component in the diagnosis of galactorrhea (abnormal breast milk discharge).
Family history
Social history
- Is there any evidence of psychosocial stress or based on your family situation?
Current medical history/systemic history (somatic and psychological complaints).
- How long has the discharge been present?
- What does the discharge look like? Clear, purulent, bloody, multicolored?
- Is the breast increased tenderness?
- Does the discharge occur on both sides?
- When was your last menstrual period? At what intervals does your period occur?
- Is your libido affected?
- Do you experience headaches or visual disturbances* ? If so, do these occur regularly?
- Do you suffer from nausea and vomiting?
- Do you suffer from fatigue, adynamia?
- Have you noticed any other symptoms such as pain, fever or changes in the chest?
Vegetative history including nutritional history.
- Have you gained body weight unintentionally?
Self history including medication history.
- Pre-existing conditions (diseases of the breast, hormonal disorders, chronic renal insufficiency (kidney weakness)).
- Operations
- Radiotherapy
- Vaccination status
- Allergies
- Pregnancies
- Medication history
Medications that may lead to hyperprolactinemia (There is no claim to completeness!):
- Antiarrhythmics (verapamil).
- Antidepressants
- MAO inhibitors (moclobemide, rasagiline, selegiline, tranylcypromine).
- Selective serotonin reuptake inhibitors (SSRIs) – citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline.
- Tricyclic antidepressants (amitryptiline, amitriptyline oxide, clomipramine, desipramine, dopexin, imipramine, maprotiline, nortriptyline, opipramol, tranylcypromine, trimipramine).
- Antiemetics (domperidone, metoclopramide).
- Antihistamines (synonyms: histamine receptor blockers or histamine receptor antagonists).
- Antihypertensives (clonidine, methyldopa).
- Calcium channel blockers (amlodipine, dilitiazem, nifedipine).
- Antipsychotics (neuroleptics).
- Conventional (Classical) antipsychotics (neuroleptics).
- Butyrophenones – benperidone, fluspirilene, haloperidol, melperone, pipamperone.
- Tricyclic neuroleptics
- Phenothiazines (chlorpromazine, fluphenazine, levomepromazine, perazine, perphenazine, promethazine, thioridazine).
- Thioxanthenes (chlorprothixene, flupentixol, zuclopenthixol).
- Atypical antipsychotics (neuroleptics).
- Benzamides – sulpiride
- Benzisoxazolepiperidine – risperidone
- Dibenzodiazepines – olanzapine, quetiapine
- Conventional (Classical) antipsychotics (neuroleptics).
- Antisympathotonics (reserpine).
- Endogenous opiates (endorphins)
- Endorphin
- Hormones
- Adrenaline (epinephrine)
- Angiotensin II
- Antiandrogens (cyproterone acetate)
- GnRH
- Melatonin
- Oxytocin
- Estrogens
- TRH
- TSH-releasing hormone (synonyms: thyroid-stimulating hormone, thyrotropin).
- Vasopressin
- H2 receptor blockers (cimetidine, ranitidine).
- Indirect dopamine antagonists
- Naltrexone
- Tetrabenzene
- MAO inhibitors (monoamine oxidase inhibitors).
- Moclobemide
- Rasagiline
- Selegiline
- Tranylcypromine
- Opioids (hydromorphone, morphine)
- Prokinetics
- Domperidone
- Metoclopramide
- Alizapride
- Psychotropic drugs (phenothiazines, thioxanthenes).
- Serotonin