Editing Galactorrhea (section)

==Causes==
Galactorrhea can take place as a result of dysregulation of certain [[hormone]]s. Hormonal causes most frequently associated with galactorrhea are [[hyperprolactinemia]] and [[thyroid]] conditions with elevated levels{{efn|which may also suggest [[Pituitary disease]]}} of [[thyroid-stimulating hormone]] (TSH) or [[thyrotropin-releasing hormone]] (TRH). No obvious cause is found in about 50% of cases.<ref name=Sakiyama_1983/>

[[Lactation]] requires the presence of [[prolactin]], and the evaluation of galactorrhea includes eliciting a history for various medications or foods ([[methyldopa]], [[opioid]]s,  [[antipsychotic]]s, [[serotonin reuptake inhibitor]]s<ref>{{Cite journal | pmid = 23456048| pmc = 3683415| year = 2013| last1 = Karimi| first1 = H| title = Burns, hypertrophic scar and galactorrhea| journal = Journal of Injury and Violence Research| volume = 5| issue = 2| pages = 117–9| last2 = Nourizad| first2 = S| last3 = Momeni| first3 = M| last4 = Rahbar| first4 = H| last5 = Momeni| first5 = M| last6 = Farhadi| first6 = K| doi = 10.5249/jivr.v5i2.314}}</ref>) and for behavioral causes (stress, breast, and chest wall stimulation), as well as evaluation for gestation, [[pituitary adenoma]]s (with overproduction of [[prolactin]] or compression of the [[pituitary]] stalk), and [[hypothyroidism]]. Adenomas of the anterior pituitary are most often prolactinomas. Overproduction of prolactin leads to cessation of menstrual periods and [[infertility]], which may be a diagnostic clue. Galactorrhea may also be caused by hormonal imbalances owing to birth control pills.

Galactorrhea is also a side effect associated with the use of the second-generation [[H2 receptor antagonist|H<sub>2</sub> receptor antagonist]] [[cimetidine]] (Tagamet). Galactorrhea can also be caused by antipsychotics that cause hyperprolactinemia by blocking dopamine receptors responsible for control of prolactin release. Of these, [[risperidone]] is the most notorious for causing this complication.<ref>{{cite journal |last1=Popli |first1=A |title=Risperidone-induced galactorrhea associated with a prolactin elevation. |journal=Ann Clin Psychiatry |volume=10 |issue=1 |date=March 1998 |pages=31–3 |pmid=9622047 |doi=10.3109/10401239809148815 }}</ref> Case reports suggest [[proton-pump inhibitor]]s have been shown to cause galactorrhea.