Women who are pregnant and give birth often find wet stains on their bras. If they pinch one once in a while,
Under the breast, there will be some milky white liquid flowing out of the nipple, which is different from those patients with ductal carcinoma of the breast.
The secreted liquid with blood is different, it is real milk. Girls in this situation are often too shy to see a doctor.
Timely diagnosis and treatment, or worry about "strange diseases", aggravated the symptoms, this still needs attention.
Briefly introduce this phenomenon. To make it clear, the first thing to say is how normal women's postpartum milk is.
Produced.
Prolactin, an important substance of milk secretion
It has long been known that the development of female breasts is mainly influenced by estrogen and progesterone secreted by ovaries. female
Hormone can promote the development of mammary lobules, and progesterone can make mammary ducts grow. Estrogen and progesterone
Under the synergistic effect, the breast gradually develops into a pair of hemispherical protrusions, which not only shows the unique bodybuilding of women,
Be prepared to breastfeed after delivery. However, with the deepening of research, people found that estrogen alone.
And progesterone can't make breast produce milk, so where does milk come from and what is it controlled by?
What about adjustment?
With the development of radioimmunoassay technology, medical staff have been able to detect a kind of milk from female blood.
Fruit juice secretes a hormone directly related to prolactin. It turns out that milk secretion is controlled by the nervous system.
The reproductive endocrine shafting composed of hypothalamus-pituitary-ovary, through the secretion of prolactin
To adjust the control.
Hypothalamus is located in the lower part of the third ventricle, which is the "regulation center" of countless hormones secretion in the body and is also a component of milk.
Secretion regulates the "headquarters". There are many microvilli at the upper end of hypothalamus extending into the cavity of the third ventricle, like a hair.
Like scouts, we can get the "mood" of the whole body hormone level through the contents of various hormones in the ventricular fluid.
Report. "When hormones rise or fall in the body, microvilli will report to the hypothalamus in time, so the hypothalamus
According to this "intelligence", two substances are produced in time, one is called "release factor", which is to command hormone increase.
Signal of production; The other is called "inhibitory factor", which is a signal to guide hormone reduction. These two substances pass through the hypothalamus.
The portal vein system of pituitary gland reaches the pituitary gland.
The pituitary gland is located in the sellar cavity at the lower end of the hypothalamus, and its function is like a "combat soldier", taking orders from the headquarters and taking action.
Group ". The pituitary gland immediately responds to the signal from the hypothalamus, increasing or decreasing the output, thus producing various types.
Hormones. These gonadotropins, like "commands", "convey" to their respective "goals"—
Corresponding organs and tissues of the whole body. When these "targets" receive the "command" of pituitary stimulating hormone, they will be based on
The amount of hormones can produce the right amount of hormones to maintain human needs.
For example, the ovary is located on both sides of the female pelvic uterus, which is based on a gonadotropin-gonadotropin.
Change. Different amounts of estrogen or progesterone can be secreted periodically to maintain female sexual function and sexual desire.
Features.
Breast development is mainly influenced by estrogen and progesterone secreted by ovary and prolactin secreted by pituitary gland.
To determine its development degree.
How is normal milk secretion regulated?
The content of prolactin in normal women is very small, only 0 ~ 20 nanograms per milliliter of blood, which is only
Can maintain normal breast development, but can not cause milk secretion. After pregnancy, women can be divided into fetus and placenta.
In addition to secreting a certain amount of prolactin, the main reason is that the level of sex hormones in pregnant women increases, and these hormones pass through
Body fluids enter the third ventricle, and when the hypothalamus receives this information, it begins to prepare for the future delivery of babies.
Work. In order to prepare the baby's "food"-milk, the hypothalamus produces "synthetic prolactin secreting cells".
Prolactin, a prolactin, begins to increase rapidly after one and a half months of pregnancy and can reach it in the third month of pregnancy.
It is 3-4 times before pregnancy, and it can reach more than 200 ng/ml before delivery. Such a large amount of lactation
Hormones directly act on the lactating cell membrane of mammary gland, which can activate some enzymes on the cell membrane and play an important role in estrogen.
Under the common stimulation of progesterone and progesterone, milk is formed in lactating cells. But why don't pregnant women secrete milk?
Does lactation have to wait until postpartum? At present, the explanation is that after delivery, estrogen in the mother and pregnancy shock.
Hormone drops sharply, and this information reaches the hypothalamus, and lactation begins, followed by other factors (such as growth stimulation).
Hormone, thyroxine, insulin, aldosterone, calcium ion, etc. ) to maintain normal milk secretion.
. After the start of milk secretion, you don't need a lot of prolactin, so after breastfeeding for 3-4 months, the blood
Prolactin in the liquid gradually returned to normal level. However, this kind of stimulation is common when a baby sucks its mother's nipple.
Prolactin can be increased in a short time through the hypothalamus-pituitary axis. In this way, milk secretion continues until
It will not stop completely until half a month to one month after the end of lactation.
So why don't normal unmarried girls or weaned women secrete milk? It turns out that when I was not pregnant,
Hou introduced that women's hypothalamus will produce "prolactin inhibitory factor", which can act on milk-secreting cells in the pituitary gland.
Inhibition of pituitary prolactin secretion, so that the blood prolactin is maintained below 20 nanograms per milliliter, so there is no breast.
Milk secretion.
Now we can get down to business and talk about why unmarried girls also have milk secretion.
The prolactin is the "protagonist"
From a medical point of view, anyone who is not pregnant or has not given birth, but has breast milk secretion, stops breastfeeding for half a year.
Those who continue breastfeeding above, regardless of other obvious discomfort, belong to the pathological scope, not
The milk secreted during lactation is called galactorrhea. How did this happen? For whatever reason, as long as you can
Reduce the production of prolactin inhibitory factor in hypothalamus, or promote the secretion of excessive prolactin in pituitary gland, then you can.
In order to increase prolactin in the blood, abnormal galactorrhea occurs, which is called "hyperprolactinemia"
. In addition to galactorrhea, patients with hyperprolactinemia are often accompanied by different degrees of menstrual disorder, which is more serious.
Amenorrhea; Hair loss, weight gain, headache, visual impairment and impotence of external genitalia can be found during physical examination.
Atrophy and other symptoms, forming a group of diseases with galactorrhea, amenorrhea and infertility as the main manifestations, called "galactorrhea-amenorrhea syndrome"
Combination symbol. "However, regardless of the severity of the symptoms, the main reason is excessive prolactin secretion.
Reason.
There are many reasons for hyperprolactinemia, which can be roughly divided into the following categories:
I. Hypothalamic diseases
Diseases of hypothalamus and its adjacent parts, such as encephalitis, craniopharyngioma, pineal tumor, partial infarction of hypothalamus and pseudotumor.
Brain tumor, pituitary stalk amputation, etc. Both can cause the reduction of prolactin inhibitory factor produced by hypothalamus or the release of prolactin.
Release factor and thyrotropin-releasing factor increased. The former can lead to the blind production of prolactin due to the loss of inhibition,
The latter two directly promote the increase of prolactin production.
There is a common "postpartum galactorrhea-amenorrhea syndrome" in hypothalamic diseases, which is characterized by stopping breastfeeding for half a day.
There is still persistent galactorrhea over the age of 18, often accompanied by amenorrhea and uterine and ovarian atrophy. Suffering from this disease, its adolescence
Secondary developmental delay and irregular menstruation often occur.
Second, pituitary diseases.
Mainly various tumors of the pituitary gland. In addition, some empty sella syndrome and pituitary hyperfunction can be cited.
Galactorrhea and amenorrhea.
Third, primary hypothyroidism.
Thyroid gland and mammary gland, one in the neck and the other in the chest, seem to be two unrelated organs, but they are real.
The endocrine relationship between them is very close. Information about hypothyroidism.
Feedback to the hypothalamus, so that the hypothalamus produces a large number of thyrotropin-releasing factors, stimulating
At the same time, the pituitary gland secretes thyrotropin, which can also stimulate pituitary prolactin to secrete too much, causing galactorrhea.
Fourth, the drug factor.
Sedatives acting on the central nervous system, such as chlorpromazine and morphine, can increase the content of catecholamine in hypothalamus.
Decrease, thereby reducing the activity of prolactin releasing factor produced by hypothalamus; Antihypertensive drugs such as methyldopa and reserpine.
Can inhibit the release of prolactin inhibitory factor; Mettriline can stimulate pituitary prolactin's excessive secretion.
Verb (abbreviation for verb) nerve stimulation
Some parts of the skin, especially the chest, are stimulated, including the severe pain caused by peripheral nerve injury, which can be passed through God.
It is transmitted to the hypothalamus and causes an increase in prolactin. Such as chest surgery, burns, herpes zoster in the chest and back. this
External and regular stimulation of the breast, such as chronic breast abscess; Cystic breast adenomas, especially those that make children frequent.
People who suck nipples will also cause endocrine control disorder due to long-term nerve stimulation, and even lead to galactorrhea and spine.
This sign may also appear in patients with myelopathy and hysterectomy.
There are many other factors, such as adrenal adenoma, adrenal adenoma, bronchogenic carcinoma, etc., which can be located in the lesion.
Produce non-pituitary prolactin; Severe mental trauma and obvious changes in living habits can also cause temporary problems.
Sexual galactorrhea. However, about 30-40% of patients with galactorrhea can't find any reason and can only be collectively referred to as "
Unexplained galactorrhea. "
What should I do after galactorrhea?
Because there are many factors that cause galactorrhea, it is recommended that women with menstrual disorders or amenorrhea should be regular.
Gently press both breasts. Once nipple discharge is found, you should go to the hospital for detailed examination, including blood test.
Determination of prolactin and other endocrine hormones to determine the location and cause of the lesion.
At present, the treatment of galactorrhea mainly includes:
First, pituitary adenoma can be treated with bone destructor, which can be surgically removed; Hypothyroidism can give
Supplementation of thyroxine; Most of the cases caused by drugs are transient galactorrhea, which usually disappears after stopping taking drugs for a period of time.
Second, there is no ideal drug, levodopa 0.5g, four times a day, to inhibit hyperprolactinemia, which is only effective for a few patients.
Suppress galactorrhea. Recently, a semi-synthetic ergotamine derivative, bromocriptine, was produced abroad to treat hyperprolactinemia.
The dose of anemia is 2.5 mg per day at the beginning, and gradually increases to 5 mg per day after one week if there is no adverse reaction.
-7.5 mg, taken orally twice, usually takes effect after one month. But the disadvantage of this medicine is that it is expensive.
Expensive, each tablet costs several dollars; Second, prolactin can still increase after drug withdrawal. Therefore, the treatment of this disease.
The medical community is actively exploring more ideal drugs.
Non-pregnancy and non-lactation, nipple discharge when pinching nipple is called nipple discharge. Nipple discharge is one of the common symptoms of breast diseases. According to statistics, nipple discharge is the main symptom, accounting for 3% ~ 14% of breast diseases, and the incidence rate is second only to breast lump and breast pain. If nipple discharge is a single nipple discharge, it is mostly related to breast diseases, such as mammary duct ectasia, intraductal papilloma and cystic hyperplasia of breast. Among them, besides bloody nipple discharge, cystic hyperplasia of breast has two characteristics: first, it is characterized by periodic breast pain, which is easy to occur or worsen in the premenstrual period, and patients do not care, and serious cases can affect work and life. Second, breast lumps are often multiple, which can be seen on one side or both sides, or can be confined to a part of the breast or scattered throughout the breast. The mass is nodular in different sizes, tough and not hard, does not adhere to the skin, and has unclear boundaries with surrounding tissues. The mass can shrink after menstruation. Your condition, at the reproductive age, is likely to be cystic hyperplasia of the breast, but it does not rule out the possibility of cancer.